Podcasts about conard

Here's my new idea for an episode. Welcome to it. I want to talk about a major theme running through the last few episodes of Relentless Health Value. And this theme is, heads up, going to continue through a few upcoming shows as well. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. We have Matt McQuide coming up, talking about patient engagement, and Christine Hale, MD, MBA, talking about high-cost claimants. And we also have an encore coming up with Kenny Cole, MD, talking about a lot of things; but patient trust is one of them. But before I get to the main theme to ponder here, let me talk about what gets selected to talk about on Relentless Health Value. I will freely admit, how topics for shows get picked, it's not exactly a linear sort of affair. And furthermore, even if it were, I can't always get the stars to align to get a specific cluster of guests to all come on like one after the other. So, for sure, it might be less than obvious at times where my head is at—and sometimes, admittedly, I don't even know. This may sound incredibly scattershot (and it probably is), but in my defense, this whole healthcare thing, in case you didn't know, it's really complicated. Every time I get a chance to chat with an expert, I learn something new. I feel like it's almost impossible to sit in a vacuum and mastermind some kind of grand insight. Very, very fortunately, I don't need to sit in a cave and do all this heavy thinking all by myself. We got ourselves a tribe here of like-minded, really smart folks between the guests and you lot, all of you in the tribe of listeners who are here every week. Yeah, you rock! And I can always count on you to start teasing out the themes and the through lines and the really key actionable points. You email me. You write great posts and comments on LinkedIn and elsewhere. Even if I am a little bit behind the eight ball translating my instinct into an actual trend line, it doesn't slow this bus down. It's you who keeps it moving, which is why I can confidently say it's you all who are to blame for this new idea I came up with the other day after the podcast with Al Lewis (EP464) triggered so much amazing and really deep insight and dot connecting back and forth that hooked together the past six, I'm gonna say, or so shows. Let's just start at the beginning. Let's start with the topics that have been discussed in the past several episodes of the pod. Here I go. Emergency room visits are now costing about 6% of total plan sponsor spend on average. That was the holy crap moment from the episode with Al Lewis (EP464). Emergency room volume is up, and also prices are up. In that show with Al Lewis, I did quote John Lee, MD, who is an emergency room doctor, by the way. I quoted him because he told a story about a patient who came into the ER, winds up getting a big workup in his ER. Dr. Lee says he sees this situation a lot where the patient comes in, they've had something going on for a while, they've tried to make an appointment with their PCP or even urgent care, they could not get in. It's also really hard to coordinate and get all the blood work or the scans and have that all looked at that's needed for the workup to even happen. I've spoken with multiple ER doctors at this point, and they all say pretty much the same thing. They see the same scenario happen often enough, maybe even multiple times a day. Patient comes in with something that may or may not be emergent, and they are now in the ER because they've been worried about it for weeks or months. And the ER is like the only place where they can get to the bottom of what is going on with their body. And then the patient, you know, they spend the whole day in the ER getting what amounts to weeks' worth of outpatient workup accomplished and scans and imaging and labs. And there's no prior authing anything down. It's also incredibly expensive. Moving on from the Al Lewis show, earlier than that I had had on Rushika Fernandopulle, MD (EP460) and then also Scott Conard, MD (EP462). Both are PCPs, both talking about primary care and what makes good primary care and what makes bad primary care and how our current “healthcare marketplace,” as Dr. Conard puts it, incentivizes either no primary care and/or primary care where volume driven throughput is the name of the game—you know, like seeing 25 patients a day. These visits or episodes of care are often pretty transactional. If relationships are formed, it's because the doctor and/or the patient are rising above the system, not the other way around. And none of that is good for primary care doctors, nurses, or other clinicians. It's also not good for patients, and it's not good for plan sponsors or any of the ultimate purchasers here (taxpayers, patients themselves) because while all of this is going on, those patients getting no or not good primary care are somebody's next high-cost claimant. Okay, so those were the shows with Rushika Fernandopulle and Scott Conard. Then this past week was the show with Vivian Ho, PhD (EP466), who discusses the incentives that hospital leadership often has. And these incentives may actually sound great on paper, but IRL, they wind up actually jacking up prices and set up some weird incentives to increase the number of beds and the heads in them. There was also two shows, one of them with Betsy Seals (EP463) and then another one with Wendell Potter (EP384), about Medicare Advantage and what payers are up to. Alright, so let's dig in. What's the big theme? What's the big through line here? Let's take it from the top. Theme 1 is largely this (and Scott Conard actually said this flat out in his show): Primary care—good primary care, I mean—is an investment. Everything else is a cost. And those skyrocketing ER costs are pure evidence of this. Again, listen to that show with Al Lewis earlier (EP464) for a lot of details about this. But total plan costs … 6% are ER visits. Tim Denman from Premise Health wrote, “That is an insane number! Anything over 2% warrants concern.” But yeah, these days we have, on average across the country, 200 plan members out of 1000 every single year dipping into their local ER. That number, by the way, will rise and fall depending on the access and availability of primary care and/or good urgent cares. Here's from a Web site entitled ER Visit Statistics, Facts & Trends: “In the United States, emergency room visits often highlight gaps in healthcare accessibility. Many individuals turn to ERs for conditions that could have been managed through preventative or primary care. … This indicates that inadequate access to healthcare often leads to increased reliance on emergency departments. … “ED visits can entail significant costs, particularly when a considerable portion of these visits is classified as non-urgent. … [Non-urgent] visits—not requiring immediate medical intervention—often lead to unnecessary expenditures that could be better allocated in primary care settings.” And by the way, if you look at the total cost across the country of ER visits, it's billions and billions and billions of dollars. In 2017, ED visits (I don't have a stat right in front of me), but in 2017, ED visits were $76.3 billion in the United States. Alright, so, the Al Lewis show comes out, I see that, and then, like a bolt of lightning, François de Brantes, MBA, enters the chat. François de Brantes was on Relentless Health Value several years ago (EP220). I should have him come back on. But François de Brantes cemented with mortar the connectivity between runaway ER costs and the lack of primary care. He started out talking actually about a new study from the Milbank Memorial Fund. Only like 5% of our spend going to primary care is way lower than any other developed country in the world—all of whom, of course, have far higher life expectancies than us. So, yeah … they might be onto something. François de Brantes wrote (with some light editing), “Setting aside the impotence of policies, the real question we should ask ourselves is whether we're looking at the right numbers. The short answer is no, with all due respect to the researchers that crunched the numbers. That's probably because the lens they're using is incredibly narrow and misses everything else.” And he's talking now about, is that 5% primary care number actually accurate? François de Brantes continues, “Consider, for example, that in commercially insured plans, the total spend on … EDs is 6% or more.” And then he says, “Check out Stacey Richter's podcast on the subject, but 6% is essentially what researchers say is spent on, you know, ‘primary care.' Except … they don't count those costs, the ER costs. They don't count many other costs that are for primary care, meaning for the treatment of routine preventative and sick care, all the things that family practices used to manage but don't anymore. They don't count them because those services are rendered by clinicians other than those in primary care practice.” François concludes (and he wrote a great article) that if you add up all the dollars that are spent on things that amount to primary care but just didn't happen in a primary care office, it's conservatively around 17% of total dollars. So, yeah … it's not like anyone is saving money by not making sure that every plan member or patient across the country has a relationship with an actual primary care team—you know, a doctor or a nurse who they can get on the phone with who knows them. Listen to the show coming up with Matt McQuide. This theme will continue. But any plan not making sure that primary care happens in primary care offices is shelling out for the most expensive primary care money can buy, you know, because it's gonna happen either in the ER or elsewhere. Jeff Charles Goldsmith, PhD, put this really well. He wrote, “As others have said, [this surge in ER dollars is a] direct consequence of [a] worsening primary care shortage.” Then Dr. John Lee turned up. He, I had quoted on the Al Lewis show, but he wrote a great post on LinkedIn; and part of it was this: “Toward a systemic solution, [we gotta do some unsqueezing of the balloon]. Stacey and Al likened our system to a squeezed balloon, with pressure forcing patients into the [emergency room]. The true solution is to ‘unsqueeze' the system by improving access to care outside the [emergency room]. Addressing these upstream issues could prevent patients from ending up in the [emergency room]. … While the necessary changes are staring us in the face, unsqueezing the balloon is far more challenging than it sounds.” And speaking of ER docs weighing in, then we had Mick Connors, MD, who left a banger of a comment with a bunch of suggestions to untangle some of these challenges that are more challenging than they may sound at first glance that Dr. Lee mentions. And as I said, he's a 30-year pediatric emergency physician, so I'm inclined to take his suggestions seriously. You can find them on LinkedIn. But yeah, I can see why some communities are paying 40 bucks a month or something for patients without access to primary care to get it just like they pay fire departments or police departments. Here's a link to Primary Care for All Americans, who are trying to help local communities get their citizens primary care. And Dr. Conard talked about this a little bit in that episode (EP462). I can also see why plan sponsors have every incentive to change the incentives such that primary care teams can be all in on doing what they do. Dr. Fernandopulle (EP460) hits on this. This is truly vital, making sure that the incentives are right, because we can't forget, as Rob Andrews has said repeatedly, organizations do what you pay them to do. And unless a plan sponsor gets into the mix, it is super rare to encounter anybody paying anybody for amazing primary care in an actual primary care setting. At that point, Alex Sommers, MD, ABEM, DipABLM, arrived on the scene; and he wrote (again with light editing—sorry, I can't read), “This one is in my wheelhouse. There is a ton that could be done here. There just has to be strategy in any given market. It's a function of access, resources, and like-minded employers willing to invest in a direct relationship with providers. But not just any providers. Providers who are willing to solve a big X in this case. You certainly don't need a trauma team on standby to remove a splinter or take off a wart. A great advanced primary care relationship is one way, but another thing is just access to care off-hours with the resources to make a difference in a cost-plus model. You can't help everybody at once. But you can help a lot of people if there is a collaborative opportunity.” And then Dr. Alex Sommers continues. He says, “We already have EKG, most procedures and supplies, X-ray, ultrasounds, and MRI in our clinics. All that's missing is a CT scanner. It just takes a feasible critical mass to invest in a given geography for that type of alternative care model to alter the course here. Six percent of plan spend going to the ER. My goodness.” So, then we have Ann Lewandowski, who just gets to the heart of the matter and the rate critical for primary care to become the investment that it could be: trust. Ann Lewandowski says, “I 100% agree with all of this, basically. I think strong primary care that promotes trust before things get so bad people think they need to go to the emergency room is the way to go.” This whole human concept of trust is a gigantic requirement for clinical and probably financial success. We need primary care to be an investment, but for it to be an investment, there's got to be relationships and there has to be trust between patients and their care teams. Now, neither relationships nor trust are super measurable constructs, so it's really easy for some finance pro to do things in the name of efficiency or optimization that undermine the entire spirit of the endeavor without even realizing it. Then we have a lot of primary care that doesn't happen in primary care offices. It happens in care settings like the ER. So, let's tug this theme along to the shows that concern carriers, meaning the shows with Wendell Potter (EP384) on how shareholders influence carrier behavior and with Betsy Seals (EP463) on Medicare Advantage plans and what they're up to. Here's where the primary care/ER through line starts to connect to carriers. Here's a LinkedIn post by the indomitable Steve Schutzer, MD. Dr. Schutzer wrote about the Betsy Seals conversation, and he said, “Stacey, you made a comment during this fabulous episode with Betsy that I really believe should be amplified from North to South, coast to coast—something that unfortunately is not top of mind for many in this industry. And that was ‘focus on the value that accrues to the patient'—period, end of story. That is the north star of the [value-based care] movement, lest we forget. Financial outcome measures are important in the value equation, but the numerator must be about the patient. As always, grateful for your insights and ongoing leadership.” Oh, thank you so much. And same to you. Grateful for yours. Betsy Seals in that podcast, though, she reminded carrier listeners about this “think about the value accruing to the patient” in that episode. And in the Wendell Potter encore that came out right before the show with Betsy, yeah, what Wendell said kind of made me realize why Betsy felt it important to remind carriers to think about the value accruing to patients. Wall Street rewards profit maximization in the short term. It does not reward value accruing to the patient. However—and here's me agreeing with Dr. Steve Schutzer, because I think this is what underlies his comment—if what we're doing gets so far removed from what is of value to the patient, then yeah, we're getting so removed from the human beings we're allegedly serving, that smart people can make smart decisions in theoretical model world. But what's being done lacks a fundamental grounding in actual reality. And that's dangerous for plan members, but it's also pretty treacherous from a business and legal perspective, as I think we're seeing here. Okay, so back to our theme of broken primary care and accelerating ER costs. Are carriers getting in there and putting a stop to it? I mean, as aforementioned about 8 to 10 times, if you have a broken primary care system, you're gonna pay for primary care, alright. It's just gonna be in really expensive care settings. You gotta figure carriers are wise to this and they're the ones that are supposed to be keeping healthcare costs under control for all America. Well, relative to keeping ER costs under control, here's a link to a study Vivian Ho, PhD, sent from Health Affairs showing how much ER prices have gone up. ER prices are way higher than they used to be. So, you'd think that carriers would have a huge incentive to get members primary care and do lots and lots of things to ensure that not only would members have access to primary care, but it'd be amazing primary care with doctors and nurses that were trusted and relationships that would be built. It'd be salad days for value. Except … they're not doing a whole lot at any scale that I could find. We have Iora and ChenMed and a few others aside. These are advanced primary care groups that are deployed by carriers, and these organizations can do great things. But I also think they serve—and this came up in the Dr. Fernandopulle show (EP460)—they serve like 1% of overall patient populations. Dr. Fernandopulle talked about this in the context of why these advanced primary care disruptors may have great impact on individual patients but they have very little overall impact at a national scale. They're just not scaled, and they're not nationwide. But why not? I mean, why aren't carriers all over this stuff? Well, first of all—and again, kind of like back to the Wendell show (EP384) now—if we're thinking short term, as a carrier, like Wall Street encourages, you know, quarter by quarter, and if only the outlier, mission-driven folks (the knights) in any given carrier organization are checking what's going on actually with plans, members, and patients like Betsy advised, keep in mind it's a whole lot cheaper and it's easier to just deny care. And you can do that at scale if you get yourself an AI engine and press Go. Or you can come up with, I don't know, exciting new ways to maximize your risk adjustment and upcoding. There's an article that was written by Sergei Polevikov, ABD, MBA, MS, MA

Life often nudges us toward moments of profound transformation and spiritual awakening, and today's episode is one such occasion. We welcome Prageet Harris and Julieanne Conard, remarkable channelers whose journeys into the spiritual realms and work with the Stargate offer deep insights into the nature of consciousness and interdimensional connections. Their experiences reveal the power of opening oneself to higher dimensions and the extraordinary potentials that lie within.Prageet Harris's journey into channeling began unexpectedly in 1988. Living on Maui, he was part of a group planning to turn a hotel into a healing center. During a deeply relaxing massage session, Prageet found himself speaking unknowingly, delivering messages from a being named Alcazar. "I heard loud and clear, Alcazar, and I thought, well, that's such a weird name, it's not the kind of name that I would make up," he recalls. Despite his initial skepticism, the accuracy and profound nature of the messages gradually convinced him of their authenticity. Alcazar, a high-dimensional guide, began instructing Prageet to build a structure called a Stargate, an interdimensional doorway that facilitates powerful meditative experiences and connections with higher realms.Julieanne Conard's path intersected with Prageet's in 2012. With a background in molecular biology, Julieanne was initially skeptical of metaphysical phenomena. However, after attending a Reconnective Healing seminar, her curiosity about channeling was piqued. She discovered the Stargate through a meetup group and experienced a profound sense of déjà vu and anticipation upon meeting Prageet. "When I saw his face for the first time, it felt like déjà vu, but like I was remembering the future," she explains. Julieanne's connection with Alcazar and the Stargate deepened, leading her to work closely with Prageet in bringing these transformative experiences to people worldwide.The Stargate, as described by Prageet and Julieanne, is more than a physical structure. It acts as an anchor for higher dimensional consciousness, facilitating connections with the angelic realms, Ascended Masters, and other interdimensional beings. "When we do groups with it, it responds to each person in the group in a very unique way," Prageet explains. This interactive energy enables participants to have profound personal experiences, accessing states of consciousness that transcend ordinary reality.SPIRITUAL TAKEAWAYSInterdimensional Connectivity: The Stargate provides a means to connect with higher dimensions, allowing individuals to access profound states of consciousness and spiritual insight. This connection emphasizes the importance of recognizing and embracing our multi-dimensional nature.Transformational Energy: The experiences facilitated by the Stargate demonstrate the power of focused intention and energy in creating transformative spiritual experiences. By engaging with these energies, individuals can unlock deeper levels of healing and self-awareness.Trust and Surrender: Both Prageet and Julieanne's journeys highlight the importance of trusting and surrendering to the process of spiritual awakening. By letting go of skepticism and embracing the guidance from higher realms, they have been able to facilitate profound transformations for themselves and others.During our conversation, Prageet and Julieanne also emphasized the significance of living in the moment and being conscious of our thoughts and actions. "Our subconscious works about 100 times faster than our conscious mind," Prageet notes, underscoring the importance of becoming aware of and transforming subconscious patterns. By doing so, we can become more conscious creators of our reality, aligning our lives with higher vibrational states.Prageet and Julieanne's work with the Stargate and their channeling of Alcazar offer a powerful reminder of the potential within each of us to connect with higher dimensions and transform our reality. Their insights encourage us to embrace our true nature, recognize our interconnectedness, and live with greater compassion and kindness. By doing so, we can contribute to the ongoing shift in human consciousness and help create a more enlightened and harmonious world.Please enjoy my conversation with Prageet Harris and Julieanne Conard.Become a supporter of this podcast: https://www.spreaker.com/podcast/next-level-soul-podcast-with-alex-ferrari--4858435/support.

#BeAGoodFriend and check out episode #128 of #FeeneyTalksWithFriends featuring Patrice Taffe, Victor Gonzalez and Kyle Egress! It was great to talk with my #friends, Patrice, Victor and Kyle! The trio are Rotarians for The Rotary Club of West Hartford. Their 13th Annual Vines of March event is on Saturday, March 1, 2025. We talked about:The Vines of March event (minute 1)The Rotary Club Dictionary Program (minute 2.30)What makes Diane Barber a good #friend? (minute 3.30)Local vendors attending the event (minute 4.30)Celebrate West Hartford in June (minute 7)Dr. Rick Liftig (minute 9.30)Bowling for Books fundraiser hosted by Bennett (minute 10.30)West Hartford is a great community! (minute 12.30)THE HAPPY FINE! (minute 13.30)How to join The Rotary Club (minute 15)Adam from Harvey's Wine & Liquors (minute 17.30)Food from West Hartford at the event (minute 18.40)Podcast sponsors (minute 20)9 Keys (sponsored by West Hartford Lock) to being a good Rotarian (minute 22)#BeAGoodTeacher / #FriendsOfHudson tee shirt! (minute 28)Cricket Press (minute 30)Favorite movies (minute 32)Rotary Club Events: First, Last, Best, Worst (minute 34)Super Bowl and Saquon Barkley (minute 36)Feeney's drive to Conard (minute 38)Favorite teachers (minute 41)Favorite Superheroes (minute 45)Nate Bondini (minute 48)Wine Tasting (minute 50)Friends of Fox  (minute 52)Victor's twin brother (minute 54)Patrice's closing remarks (minute 55)Thank you to Westfield Bank (minute 56)Does John Decker pass the basketball? (minute 57)Victor's closing remarks (minute 59)Podcast Sponsors: The Fix IV - www.thefixivtherapy.comWest Hartford Lock - www.westhartfordlock.comKeating Agency Insurance - www.keatingagency.comGoff Law Group - www.gofflawgroup.netParkville Management - www.parkvillemanagement.comLuna Pizza - www.lunapizzawh.com/lunas-menuPeoplesBank - www.bankatpeoples.comFloat 41 - www.float41.comMaximum Beverage - www.maximumbev.com

This podcast today is with Dr. Scott Conard, founder of Converging Health. You might remember him from the earlier episode (EP391). First of all, I enjoyed how it came to be. Brian Uhlig, an employee benefit consultant of some acclaim, came to me and offered to sponsor a show for someone else. Not himself. I gotta say, it's stuff like this that warms my heart. It's this village that we have here, this tribe of Relentless folks trying so hard to stand up for and help patients. So, thanks again to Brian Uhlig. Right now, Dr. Conard is doing a bunch of work with Mike Adams from 7-Eleven, helping their plan members. A lot of this work is centered on and about a few pretty striking but very common insights that many plan sponsors will find in their own data. It turns out about 70%, give or take, of people who wind up costing the plan whatever the high-cost threshold is in any given plan year. These higher-cost claimants didn't fall out of the sky unexpectedly, 70% of them. They were actually high risk but low cost in prior years. So, the trick is to find these individuals and help them not fall into the high-risk and high-cost part of the graph. If the goal is how to best manage a population of members, a lot of that is, again, identifying high-risk patients who are currently in the low-cost zone, who, any given plan year, are gonna go out of that zone and get into the high-cost area. So, if we're thinking about best practices to avoid this, I'm gonna run through Dr. Conard's list that we mostly run through in the show that follows. Lastly, we touch a little bit in the show today on community-run primary care. This is a community paying for primary care for community members, just like they pay the fire department and the police department. There's a town in Rhode Island doing this that Dr. Conard talks about today. In fact, Michael Fine, MD, is part of this effort in Rhode Island.  === LINKS ===

There have been two episodes lately that have sent me down a rabbit hole that I wanted to bring to your attention. Now, disclaimer: I know you people; you're busy. You listen on average to, like, 26 minutes of any given episode. So, yeah … look at me being self-aware. I say all this to say welcome to this inbetweenisode, otherwise known as The Rabbit Hole. But it's like a 20-something-minute rabbit hole, not a day-and-a-half retreat; so just be kind if you email me and tell me I forgot something or failed to dredge into a nuance or a background point. It might be that I just could not manage to pack it in. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. This rabbit hole really, really matters for anybody creating benefit design. It really matters for anybody trying to optimize the health that can be derived from said benefit design. It also probably matters for a whole lot of operational decisions involving patients or members, nothing for nothing. But it really matters for anybody trying not to, by accident, as an unintended consequence, hammer plan members or patients with some really blunt-force cost containment measures that do a lot of harm in the process of containing costs or, flip side, accidentally cost a whole lot but don't actually improve member health. Nina Lathia, RPh, MSc, PhD, kind of summed up this whole point or gave an adjacent thought really eloquently in episode 426. She said there's better or worse ways to do things and doing the worst kinds of cost containment may not actually contain costs. You squeeze a balloon, and that works great for some, like pharmacy vendors who don't really have any skin in the game. (See me using the “skin in the game” term for other people besides plan members? That's some really good foreshadowing right there, by the way.) So, squeezing the balloon works for some when they don't have skin in the game, in the place where the air goes when you squeeze the balloon—like a pharmacy vendor who makes it super unaffordable for patients to get meds so the patient doesn't take their meds and winds up in the ICU, or the patient's formerly controlled with meds condition that is now newly uncontrolled and requires all kinds of medical interventions to get said condition back under control. Like, these are the reasons and the why behind why some cost containment efforts don't actually contain costs at the plan level. But not at the vendor level. You see what I mean? Most pharmacy vendors don't get penalized if medical costs wind up going up. And I'm picking on pharmacy vendors a little bit here, but it's true for a lot of siloed entities. But, you know, balloon squeezing can also work, actually, at the plan level if where the air goes, it's to a place where the member or the patient has to pay themselves. Like, if there's a huge, I don't know, max out of pocket or deductible, does it really matter to a very mercenary plan that's running on a very short time horizon? Do they really care, that plan, if the patient's formerly controlled condition gets uncontrolled? Maybe not, I guess, as long as it doesn't cost more than the max out of pocket that the patient is on the hook for, for any given plan year. So, yeah … again, there are better or worse ways to do things; and a lot of questions kind of add up to, What kind of plan do we want to be? What are our values, and does the plan align with them? But that's not the rabbit hole I wanted to go down today—the aligning with our values rabbit hole—so let us move on. The Relentless Health Value episode that kicked off the rabbit hole for me on multiple levels was the show with Bill Sarraille (EP459) about co-pay maximizers and accumulators. And don't get me wrong, that is a complicated topic with lots of pros, lots of cons; and I am not weighing in on the inherent lawfulness or value of any of this. I am also not weighing in on the fact that there are forthright and well-run maximizers and really not good ones, which cause patients financial, for sure, and possibly clinical harm. But not talking about that right now at all. Go back and listen to the show with Bill Sarraille if you are interested. Where my “down the rabbit hole” spiral started was when I started noticing the very, very common main plan pushback that was given right out of the gate so often when talking about the problems that any given plan sponsor has with these pharma co-pay programs—that if these pharmacopeia card dollars count toward the plan deductibles, then the patient's deductible gets met and the plan member will then often overuse healthcare and cost the plan excessive dollars from that point forward. So again, if you ask any given plan sponsor what I was gonna say their main issue but a main issue that they have with these pharma co-pay programs, that's gonna be it—that if these pharma dollars count toward the plan deductible, then the patient's deductible is met and from that point henceforth, the patient goes nuts and overuses healthcare services and it costs the plan a lot of money. The second episode causing this rabbit hole to open up is the one coming up actually with Scott Conard, MD. So, check back in a couple of weeks for that one. But in the show with Dr. Conard, we get into the impact of high-deductible health plans or just big out of pockets, however they transpire in the benefit design. Both of these scenarios, by the way, the maximizer meets the deductible scenario and the very, very high-deductible plan scenario are to blame, in other words, for this rabbit hole of an inbetweenisode. So, let's do this thing. Let's talk about the moral hazard of insurance to start us off. In the context of health insurance, if you haven't heard that term moral hazard before, it's an economics term; and it is used to capture the idea that insurance coverage, by lowering the cost of care to the individual, because their plan is paying for part of said care, by lowering the cost of care to the individual, it increases healthcare use. So, you could see why this may be related to having a deductible fully paid or not. Pre-deductible, the plan is not paying for a part of said care or paying a much smaller part. And after the deductible is paid for, then the plan is paying for a much larger percentage of care. So, moral hazard kicks in bigger after the deductible is fully paid, when the plan is paying for a bigger percentage or a bigger part of the care. So, before I proceed, let me just offer again a disclaimer to the many economists who listen to this show that this is a short inbetweenisode; so I am 100% glossing over some of the points that, for sure, have a lot of nuance. For anyone who wants a thick pack of pages for background reading, I have included some links below. Because you see, a few weeks ago, my Sunday did not go as planned. And instead of running errands, I wound up reading eight papers on moral hazard. So, my lack of groceries is your gain. You're welcome. I am happy to send you these links if you really want to dig in hard on this. Okay … so, moral hazard is the concept that individuals have incentives to offer their behavior when their risk or cost is borne by others. That's the why with deductibles, actually. We gotta give patients skin in the game because once a member has their deductible paid, it's like member gone wild and they will get all manner of excessive care. Again, I hear that a lot from plan sponsors—a lot, in all kinds of contexts but almost always, again, whenever the conversation has anything to do with manufacturer co-pay card programs and a lot when it has to do with just, you know, high-deductible plans and what happens when the patient meets their deductible. Once a patient or family has a fully paid deductible, their medical trend is like a spike, I hear over and over again. And again, this is the reason why many insist—and again, no judgment here, maybe they're right, I'm just rehashing the conversation—but this is why many insist the moral hazard of letting people have their deductible paid for them by Pharma or whatever is the reason why some believe it is imperative to have maximizers or accumulators where pharma dollars can absolutely not apply to patient deductibles. Because then we have sick patients who now have their deductibles reached, who have very few financial disincentives to go seek whatever care they want. Right. Moral hazard has entered the building. I've beaten this point to death, so let's move on. One time, I asked a plan sponsor, What exactly is it that these plan members are going wild spending plan money on once their deductible gets paid off? And he said, well, you know, they go get their suspicious-looking moles checked. Did you hear that silence just now? Yeah, that was my reaction. I don't know. I would consider getting suspicious moles checked kind of high-value care. There are posters all over the place saying if you have a suspicious-looking mole, it might be melanoma. Cancer. So, you should get ahead of that before you have a metastasized cancer. I'm no doctor, but yeah, this feels like high-value care. So, let's just, in arguendo, say it is high-value care and follow this thread for a sec. Once members reach their deductible, let's say they run around and get high-value care, care they actually need but haven't gotten before because they couldn't afford it earlier or were putting it off until they saved up enough, right? Like, this is the other side of the moral hazard coin. If patients delay or abandon care—and, by the way, there was a survey (it's in the Wayne Jenkins, MD, show from a while ago [EP358])—but 46% of patients with commercial insurance these days have delayed or abandoned care due to cost. But if they delay or abandon care that is high value and medically actually necessary and they put it off or abandon that high-value care because they cannot afford said care, then yeah, we have, again, the opposite of the moral hazard problem. We have members paying a whole lot for insurance that they cannot afford to use, they're functionally uninsured, and it's not gonna end healthfully if they need high-value care and they're not getting it. It's not. Functionally uninsured patients who have chronic conditions that really should be managed will, as per evidence, wind up with health problems if those chronic conditions are not managed. I read another study about this just recently. This is why members with chronic diseases on high-deductible health plans tend to have worse health, by the way. Now, I need to say, same rules do not always apply for healthy patients who, at least at this point, don't need regular healthcare. But do keep in mind, as it comes up in the Dr. Scott Conard show, 30% of patients who think they're healthy, they feel fine—actually they are not fine and will become sick and costly in the coming years. So, yeah … tune back in for that discussion if you are interested, but you get the gist of this whole thing, right? So, that's scenario 1 as to what patients may choose to buy once they're in the moral hazard zone and have met their deductible. They go get high-value care. So, let's move on from the high-value care case study where patients reach their deductible and get high-value care or they haven't met their deductible and fail to get care they actually need. I want to circle over to the other moral hazard potential situation: patients who meet their deductible. And in this scenario, they again embark on a health system jamboree; but they don't get a whole lot of high-value care in this scenario. They run around getting all manner of all kinds of stuff that is well outside of any evidence-based pathway. Like, weird example, I went to a doctor recently asking a question about something that everyone ultimately agreed was nothing. At which point, the doctor asked if I wanted an MRI. I was like, “What?” We and everyone else just agreed this was a big nothing burger. Why would I want an MRI? Is there something else that we didn't discuss to indicate that I need imaging? Like, why are we going there? And the doc said, “Oh, well, everyone in New York City has an anxiety problem. So, I thought you might just want to get an MRI.” Yeah, low-value stuff like that is now not financially prohibitive. So, someone who had met their deductible, in a similar situation to my example, might have shrugged and said, “Sure, I do have some anxiety. Let's go get that MRI.” Or if they hadn't met their deductible, then the whole skin-in-the-game, market-driven approach may work, I guess, to prevent them from getting low-value care that was clearly excessive and pretty wasteful. So, summing up these two scenarios, the implications of the moral hazard issue are, if it's expensive, people don't do it. If it's free or cheap, they will overutilize. And the issue with both of these patient choices is, patients are not good at discerning low-value care from high-value care. And because patients are not good at discerning high-value from low-value care, moral hazard is not mitigated with any sort of binary kind of vote for moral hazard or against moral hazard types of brute-force, broad-stroke tactics. Like, say I'm a moral hazard full-on believer. I assume all or most of the care a patient will go for is low value, right? Because if I try to prevent moral hazard from happening, then by default, what I'm effectively saying is, whatever they choose to buy on the basis of moral hazard is low value. So, I make basically everything I can pretty unaffordable so as not to invoke any moral hazard. But right, the problem with that is that some of the care is actually high value. And it's also expensive for the patient, so they don't get it. And patients are harmed, and balloons might get squeezed. Or the opposite, against moral hazard, right? Like, I'm against the concept of moral hazard. I don't believe in it, so I don't set up absolutely anything to combat it. Maybe because I assume all care that a patient might want to get is actually high value and totally worth it. That's gonna be a problem for the opposite reason. Plans can waste a lot of money this way. Random example, in 2014, the Commonwealth of Virginia reported spending $586 million on unnecessary costs from low-value care. I mean, they say something like a third of all care is waste and unnecessary, so … yeah. Plan sponsors can waste a lot of money on low-value care, and a bunch of that may happen when patients have less skin in the game because they reach their deductible, as one example, and the care is not financially prohibitive and moral hazard is realized. So, yeah … as I said, a couple of weeks ago, I did not spend my Sunday as planned. I spent my Sunday reading papers about moral hazard in insurance and how financial incentives impact patient decision making. And I'm gonna repeat the grand takeaway because this is a podcast and you might be multitasking. So, once again, here's the sum of it all: If it's expensive, people tend not to do it. If it's free or cheap, they will overutilize. And the issue with both of these patient choices is, patients are simply quite bad at distinguishing high-value care from low-value care. Once their deductibles are met, most patients will—due to moral hazard—they will, in fact, go on a spending spree; and part of what they will get done will be really, really important and necessary stuff, like getting their unusual moles looked at or their heart pain checked out or going for that follow-up visit or lab work that their doctor told them they need to come in for. And the other part of what they will do will be things that are outside the best-practice, evidence-based pathway guidelines by the length of the Appalachian Trail—you know, doing what appears to be a tour of specialty medicine physicians for unclear reasons but which lead to a cascade of testing and who knows what else. Why do they do this, these members? Do they do this on purpose? No. There is study after study that shows, again, members/patients do not, most of the time, have the chops to figure out if some medical service is high-value or low-value care. And no kidding. Most members and patients have no clinical training. They're not doctors. They're not nurses. They're not physician assistants. They're humans whose uncle died of cancer, and now they have a pain in their foot and they're convinced it's a tumor. Right? Like, do we blame them when they finally go see a doctor because they crushed their budget that particular year paying thousands and thousands of dollars out of pocket for whatever earlier in the year, and now they've made it to their deductible—do we blame them for taking the very rational step of getting the most out of those thousands of dollars of sunk costs? At that point, it's a “let me get my money's worth” situation because they can't afford to do this again next year. I mean, we hire employees because they're smart and rational, and this is really actually a pretty smart and rational thing to do. It's not somebody trying to commit fraud. Okay, sure … some people are. There's always bad apples. But the vast majority are just trying to live their life and not spend all of their vacation money next year on medical services like they did this year. I'm saying all this because it's actionable, by the way. And I'm getting to that, but indulge me for like 60 more seconds because I want to acknowledge you, listeners of this show, are probably nodding along to this whole thing this whole time and thinking all of this is pretty obvious. Well, yeah … maybe. Except here's the reason I decided to do an inbetweenisode about this rabbit hole instead of doing my normal thing, which is just ranting about it over dinner for three days straight—and God bless my husband for sitting through it—is the bottom line. But the reason we are here together today is the number of emails and posts and et cetera that cross my desk where it doesn't seem like these dots have been connected on all of this or at least connected in magic marker. Like fat, indelible magic marker, which is what I think is necessary for these dots to be connected with the ones between moral hazard and patients not being able to discern high- and low-value care. There are so many ways and places these dots will show up. Like, here's another moral hazard issue with those maximizers or accumulators, which apparently are on my mind right now—the not good ones I'm talking about now, where patients find themselves on the hook for hundreds or thousands of dollars midyear if they want to pick up the meds that they've been prescribed. If you need more details on how that might happen to understand what I'm saying fully, listen to the show again a couple of weeks ago with Bill Sarraille (EP459). But even if you're a little confused, it doesn't matter because the question is this: Do we justify having programs that make drugs really expensive for patients? Do we put in place one of these pretty darn punitive types of accumulators or maximizers, right? Like, there's different kinds, and I'm talking about the punitive ones of accumulators or maximizers. Do we justify putting one of those into place and figure that if a patient really wants the med, they'll pay a whole lot of money for it? Because if they're willing to pay a whole lot of money for it, then, right? It must be high-value care, so they'll figure out how to pay for it. Keep in mind, as I said earlier, if it's expensive, people don't do it. If it's free or cheap, they will overutilize. And the issue with both of these patient choices is, patients are not good at discerning low-value care or meds from high-value care or meds. So, look, Pharma can be up to all kinds of crap, and list prices are really expensive. No arguments here. That isn't the point. The point is, What is the actual problem that we're trying to solve for, for our plan and our patients and our members? And if that problem is making sure that the right patients get the right high-value meds or care, then not letting members get co-pay assistance such that all drugs—the good ones and the too-expensive ones and the ones that we don't really want our members to take for whatever reason—if we make all of them way too expensive with a maximizer or accumulator designed to make all the drugs really expensive … dots connected. We wind up with the all-in to prevent moral hazard issue we just talked about, where patients could easily be harmed and the plan can easily get into a balloon squeezing situation. All I'm saying is that there's a big-picture view of moral hazard here that we need to be looking at and over-indexing into binary, moral hazard black and white, where we attribute malice to members, some of whom, some of the time, may actually be trying to get high-value care, or the flip side, the plan's paying too much for low-value care and causing financial difficulties and not understanding the root cause. Going black and white or over-indexing to prevent outlier kind of stuff is probably not gonna end well. Not seeking a middle way can easily result in a solution that is possibly worse than the problem. So, look, moral hazard is actually a thing. There are lots of implications to patients not being able to distinguish high-value and low-value care. But if we know this, then, philosophically at least, how do we conceptualize a solve? What should we be doing? If we're not doing black and white, what does the gray in the middle look like? Alright, we don't want to be a solution looking around for a problem. So, let's think about the problems that we want to solve for. I would start with, What's the goal? The goal of plan sponsors providing insurance most of the time is attract and retain talent. Also, I was at the HBCH (Houston Business Coalition on Health) Conference at the beginning of December 2024. And there was a poll question. There was a bunch of employers in the audience, and the poll question asked the audience, “What's your biggest plan goal this year?” Main answer by a mile: Cut costs. Okay … so, we want to attract and retain, and we want to control costs. Obviously, you can go about achieving these three things a bunch of different ways, and they will all be tradeoffs. As Luke Prettol reminded me of the other day, there are no solutions, only tradeoffs. And so, with that, right now, I want to introduce the second concept that I have been ruminating over in my rabbit hole lately, that I've kind of been hinting at for this whole time. But here's a word we've been waiting for to solve all of our problems in a good kind of way, not the bad black-and-white ways that are so often either financially a problem or deploying brute force and harming patients in the name of solving something else: Pareto optimality. Pareto optimality is the state where resources are allocated as efficiently as possible so that improving one criterion will not worsen other criteria. It's essential to consider this, that Pareto optimality is the ideal we should at least be striving for when attempting to overcome any challenge but, in particular, the moral hazard issue, when we know that patients do not know what care is high value and what care is low value. Because if we don't try to at least Pareto optimize (if that's a word), if we try to fix the moral hazard problem and wind up with a new problem or new problems that might be worse than the old problem, that's not optimal. We have improved one criterion and worsened another. So, fixing the members going wild after they meet their deductible by slamming the lid on the fingers of members trying to get high-value care as well as low-value care, well … not sure about this, but I'd assume if not the attract but at least the retain criterion might be compromised by member dissatisfaction. But also, as I've said nine times, we might not actually cut costs. We might be doing a squeeze of the balloon. Especially that could be true when, as we all probably know or suspect, what's driving costs at the plan level is rising hospital prices. There's a show coming up on rising hospital prices as a primary driver of rising plan costs, and it's pretty hard to argue with. So, it's financially pretty advantageous to keep patients from needing to go to the hospital. So, yeah … I'd strongly suggest not squeezing balloons when hospitalizations are where the air goes. I'm not gonna belabor this. My only suggestion is, do the Pareto optimality math. A lot of you already are, I'm sure, and do a great job. But just for any given policy plan change, or decision, keep in mind moral hazard and then really go through the whole cascade of likely impact on other factors based on likely member/patient behavior. It's so easy to get sucked into kind of these philosophical, “those are my enemies” kinds of conversations that are actually philosophically sort of interesting, but they aren't the goal. I mean, there's always unintended consequences; but not all unintended consequences should come as some kind of, like, wild-ass surprise. They were pretty predictable, actually. Let me also mention that when considering Pareto optimal solutions, advanced primary care starts to get really compelling. It's because having a PCP team with data and a relationship to the patient helps patients stay on the high-value care bus. And that can minimize the bad that comes from lowering the barrier to care and inviting in a little bit of moral hazard. Just saying. Okay, so this has been going on a little bit longer than I had originally intended, but I do want to remind you of the so-called theory of second best. It's probably really appropriate here, and one of the reasons why I'm mentioning this and not finishing the show right now is that, in a very synchronistic moment, I was writing up my outline for this inbetweenisode and—how random is this?—Steve Schutzer, MD, wrote an email that included something about the theory of second best. Great minds and all of that. Anyway, the theory of second best is really aligned with Pareto optimality. It's just that sometimes you gotta be really practical. You gotta be a little scrappy. If you cannot achieve the best option, either because you just can't or because the best option for one thing results in too many negative consequences elsewhere, then don't do the best option. Forget it. Do the second best (ie, the theory of second best). There is nothing wrong with that. Don't be a hero. Okay, so in summary, moral hazard is actually a thing and so is the opposite; and it's even more of an impactful thing because most people cannot distinguish high-value from low-value care. And if they meet their deductible that they have paid a lot of money to reach, of course, they are going to want to try to get through their checklist of medical appointments that they have been putting off. This is not a surprise. And it's not all bad, as long as the care that they are trying to go get is high value; and that matters if we're trying to cut costs. Because to cut costs for real and not in a squeezing of the balloon way, we need to direct or limit somehow what gets done to high-value care. And we got to do that without accidentally causing other problems, meaning think through Pareto optimality and possibly consider the theory of second best. I hope this has been helpful at some level. It's helped me. I feel better having vented. Also mentioned in this episode are Nina Lathia, RPh, MSc, PhD; Bill Sarraille; Scott Conard, MD; Wayne Jenkins, MD; Houston Business Coalition on Health (HBCH); Luke Prettol; and Steve Schutzer, MD. Additional studies mentioned: Moral Hazard in Health Insurance: What We Know and How We Know It Do People Choose Wisely After Satisfying Health Plan Deductibles? Evidence From the Use of Low-Value Health Care Services Healthcare and the Moral Hazard Problem Distinguishing Moral Hazard From Access for High-Cost Healthcare Under Insurance   For more information, go to aventriahealth.com.   Each week on Relentless Health Value, Stacey uses her voice and thought leadership to provide insights for healthcare industry decision makers trying to do the right thing. Each show features expert guests who break down the twists and tricks in the medical field to help improve outcomes and lower costs across the care continuum. Relentless Health Value is a top 100 podcast on iTunes in the medicine category and reaches tens of thousands of engaged listeners across the healthcare industry. In addition to hosting Relentless Health Value, Stacey is co-president of QC-Health, a benefit corporation finding cost-effective ways to improve the health of Americans. She is also co-president of Aventria Health Group, a consultancy working with clients who endeavor to form collaborations with payers, providers, Pharma, employer organizations, or patient advocacy groups.   04:05 Where did Stacey's rabbit hole spiral start? 05:40 What is the moral hazard of insurance? 09:31 EP358 with Wayne Jenkins, MD. 12:49 Why isn't moral hazard mitigated in insurance? 18:16 EP459 with Bill Sarraille. 20:51 “How do we conceptualize a solve?” 22:24 Why should we be striving for Pareto optimality? 25:20 What is the theory of second best?   For more information, go to aventriahealth.com.   Our host, Stacey Richter, discusses considerations for #plansponsors and others. #healthcare #podcast #changemanagement #healthcareleadership #healthcaretransformation #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Chris Crawford, Dr Rushika Fernandopulle, Bill Sarraille, Stacey Richter (INBW41), Andreas Mang (Encore! EP419), Dr Komal Bajaj, Cynthia Fisher, Stacey Richter (INBW40), Mark Cuban and Ferrin Williams (Encore! EP418), Rob Andrews (Encore! EP415)  

Bill Conard shares his story with us. For more resources, visit emetministry.org Follow us: on Instagram https://www.instagram.com/emetministries/profilecard/?igsh=Z2c5NnA1dTJhN20y on Spotify:⁠https://open.spotify.com/show/3xqsSY1... on Apple Podcast:⁠https://podcasts.apple.com/us/podcast... my reading list:⁠ https://www.goodreads.com/user/show/74696644-christian-barrett

#BeAGoodFriend and check out episode #122 of #FeeneyTalksWithFriends featuring Stephen Espinal. It was great to talk with my #friend and neighbor, Stephen! Stephen is an Account Executive for Telecommunications at Universal Connectivity. We talked about: Telecommunications (minute 1) Past episodes and podcast sponsors (minute 3) 4 Keys (sponsored by West Hartford Lock) to being an Account Executive (minute 4) The West Hartford Chamber of Commerce (minute 5) Mechanical Engineer degree from CCSU (minute 7.30) Work days: First, Last, Best, Worst (minute 9) Podcast guest #98, Tom Pincince (minute 11) Stephen's favorite teachers (minute 14) Conard's Mock Trial Team (minute 19) Coaching Travel Soccer (minute 24) West Hartford Girls Softball Team sponsored by Friends of Feeney (minute 25) Feeney's daughters love to read! (minute 28) Recommendations (minute 31) Feeney playing Madden vs his nephew, Nick (minute 35) European Soccer (minute 38) Pick up soccer and basketball at Wolcott Park (minute 43) Rinku from South Main Wine and Spirits (minute 45) What's next for Friends of Feeney? (minute 48) Join us at The Hartford Wolf Pack game on February 28th (minute 50) WeHa Whiskey Fest (minute 53) Stephen won the “Podcast Guest Appearance” in a raffle (minute 54) What makes @JumpsByChi a good #friend? (minute 55) Closing remarks (minute 56) Podcast Sponsors: Donut Crazy - www.donutcrazy.com The Fix IV - www.thefixivtherapy.com West Hartford Lock - www.westhartfordlock.com Keating Agency Insurance - www.keatingagency.com Goff Law Group - www.gofflawgroup.net Parkville Management - www.parkvillemanagement.com Luna Pizza - www.lunapizzawh.com/lunas-menu PeoplesBank - www.bankatpeoples.com

Ruth Conard joins us to tell her story. More from Ruth: https://designedtobepillars.wordpress.comhttps://www.amazon.com/stores/Ruth-Tuttle-Conard/author/B001KIRXXS?ref=dbs_a_mng_rwt_scns_share&isDramIntegrated=true&shoppingPortalEnabled=true For more resources, visit emetministry.org Follow us: on Instagram https://www.instagram.com/emetministries/profilecard/?igsh=Z2c5NnA1dTJhN20y on Spotify:⁠https://open.spotify.com/show/3xqsSY1... on Apple Podcast:⁠https://podcasts.apple.com/us/podcast... my reading list:⁠ https://www.goodreads.com/user/show/74696644-christian-barrett

"Quit tolerating mediocrity. Go get in action. Find the right broker consultant that will take you to a new place. Don't give up hope." - Scott Conard Dr. Scott Conard tragically lost 3 patients one summer to unexpected heart problems, and immediately changed how he thought of healthcare. This week on Self-Funded, we talk about “conscious capitalism”, and by extension “conscious healthcare”, what the 7 numbers that everybody needs to know are, and how we need to change the way we approach health risk. Chapters: 00:00:00 Meet Scott Conard 00:02:08 Crony Capitalism In Healthcare 00:06:34 Focus On Aligning Incentives 00:15:38 Holistic Well-being Approach To Healthcare 00:27:12 Revolutionizing Self-Insurance 00:37:54 Healthcare Advocacy And Engagement 00:42:22 How Do We Get People To Care About Their Health? 00:49:08 Primary Care's Role in Healthcare Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  Conscious Capitalism, Employer Driven Healthcare, insurance, healthcare, health insurance, Empowering Employers, Incentive Programs, Risk Management, Alternative Risk, health risk, fixing healthcare, selffunded, podcast #ConsciousCapitalism #EmployerDrivenHealthcare #insurance #healthcare #healthinsurance #EmpoweringEmployers #IncentivePrograms  #RiskManagement #AlternativeRisk #healthrisk #fixinghealthcare #selffunded #podcast --- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support

"Quit tolerating mediocrity. Go get in action. Find the right broker consultant that will take you to a new place. Don't give up hope." - Scott Conard Dr. Scott Conard tragically lost 3 patients one summer to unexpected heart problems, and immediately changed how he thought of healthcare. This week on Self-Funded, we talk about “conscious capitalism”, and by extension “conscious healthcare”, what the 7 numbers that everybody needs to know are, and how we need to change the way we approach health risk. Chapters: 00:00:00 Meet Scott Conard 00:02:08 Crony Capitalism In Healthcare 00:06:34 Focus On Aligning Incentives 00:15:38 Holistic Well-being Approach To Healthcare 00:27:12 Revolutionizing Self-Insurance 00:37:54 Healthcare Advocacy And Engagement 00:42:22 How Do We Get People To Care About Their Health? 00:49:08 Primary Care's Role in Healthcare Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/ Key Words:  Conscious Capitalism, Employer Driven Healthcare, insurance, healthcare, health insurance, Empowering Employers, Incentive Programs, Risk Management, Alternative Risk, health risk, fixing healthcare, selffunded, podcast #ConsciousCapitalism #EmployerDrivenHealthcare #insurance #healthcare #healthinsurance #EmpoweringEmployers #IncentivePrograms  #RiskManagement #AlternativeRisk #healthrisk #fixinghealthcare #selffunded #podcast --- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support

Jacob has been on the podcast several times in the last few years.  A fabricator and motorcycle builder whom I admire heavily!  Peoples champ winner Born free invited builder who currently builds motorcycles at the famous West Coast choppers in Austin, Texas! Give Jacob a Follow on Instagram at https://www.instagram.com/jacob_conard/   Don't miss out on our exclusive weekly podcast "Garage Talk" available only on our Patreon community. Join the Fast Life Crew today to get access to ad-free audio podcasts. Click the link download the app and connect with other members on our community chat. Stay ahead of the game with exclusive updates and behind-the-scenes insights of the Fast Life Garage. Sign up now! https://Www.patreon.com/fastlifegarage @simpson_motorcycle_helmets  I swear by Simpson's helmets! After riding thousands of miles in them, I can confidently say that they fit me like a glove and enhance my riding experience. Not to mention, I always look like a badass while cruising down the highway! https://www.simpsonmotorcyclehelmets.com  @Thundermaxefi For years, I have relied on the TMax modules to power my fuel-injected Harleys, and I must say, their auto-tune technology has made these computers worth their weight in gold!  https://www.thunder-max.com Use Offer code “fastlife” for 10% off  @arlennessmotorcycles From complete design collections that can take your bike from stock to custom. Or their parts can be the finishing touches to your custom build.  Their performance line of parts gives you the custom look we all want while maintaining functionality. Head on over to https://www.arlenness.com to check out all the amazing products for your build. Drop the FASTLIFE10 offer code to save yourself 10% on your purchases  @lexinmoto I listen to everything from music and podcasts to even audiobooks as I smash miles across the country with Lexin! Also, don't sleep on their Gen 2 air pumps, a must-have for motorcycle travel in case of a tire issue https://www.lexin-moto.com Offer code “fastlife” for 15% off Cowboy Harley has your HD needs covered with the performance upgrades we all want, including service, sales, a stacked parts department, and the best gear and clothing. Check out   https://www.cowboyharleyAustin.com and on Instagram @cowboyhdaustin Make sure to tell them The Fastlife sent you! Custom Dynamics, with over 20 years in business, is here to serve the motorcycle community with High-quality lighting options for your Harley Davidson!  With a lifetime warranty and the largest selection of lighting, they have something for your bike!   Https://www.customdynamics.com 

For a full transcript of this episode, click here. Here's a great musing that I read on LinkedIn: How will alternative primary care models fare when growth mode gets balanced with profitability and VC-supported burn rate is transformed to Big Retail bottom-line expectations? Mission v. margin. I'm gonna add to this: How will alternative primary care models, or even just doing good primary care, fare when it encounters the current system rife with perverse incentives of all kinds, including, yeah, for sure, Big Retail bottom-line expectations but also Big Health System and Big Payer bottom-line expectations and current business models? This show from last year was wildly popular—maybe one of our most popular shows—and relisten to it in the current context of what's going on right now in the primary care and MSO (Managed Services Only) space. Coming up, I'm gonna probably do a whole show on this if I can get my act together; but this encore is really relevant right now. One piece of podcast business before we get into the episode: Please sign up for our weekly email if you haven't already, especially if you consider yourself part of the Relentless Health Tribe. I am mentioning this not only because it's a great way to keep track of our shows because you can do an email search to remember where you heard something, since a good deal of the show intros are in the emails, but also, there's a plan afoot to hold some Zoom meetings to talk about different topics etc—and you won't be notified of such goings-on unless you're subscribed. You can unsubscribe whenever you want, by the way; and I am way too busy to send more than one email a week or spam if that was a concern. On Relentless Health Value, I don't often get into our guests' personal histories. There are a bunch of reasons for this, which, if you buy me beer, we can talk podcast philosophy and I will tell you all about my personal, very arguable opinion here. Nevertheless, in this healthcare podcast, we are going rogue; and I am talking with Scott Conard, MD, who shares his personal story. You may ask why I decided to go this route for this particular episode, and I will tell you point-blank that Dr. Conard's experience, his narrative, is like the perfect analogue (Is analogue the right word [allegory, composite example]?). His story just sums up in a nutshell what happens when a PCP (primary care provider) does the right thing, manages to improve patient care for real, and then at some point gets sucked into the intrigue and gambits and maneuvering that is, sadly, the business of healthcare in the United States today. Before we kick in, I just want to highlight a statement that Scott Conard makes toward the end of the show. He says: So, this isn't about punishing or blaming aspects of care that are being overrewarded today. It's really about what's the path forward for corporations, for middle-class Americans, and for primary care doctors who don't choose to be part of a big system. We have to figure out how to solve this problem. I hope people don't hear this and think that there are horrible people at some not-for-profit hospital systems, for example. There are some great people at not-for-profit health systems, but they have some really screwed-up incentives. A few notable notes from Dr. Scott Conard's journey and words of wisdom that I will just highlight up front here: He says that as a PCP, you actually can produce high-value care in a fee-for-service model … if you think differently and you change practice patterns. I have heard this from others as well, including most recently David Muhlestein, PhD, JD, who says this in an episode (EP393). As Dr. Scott Conard says later in this episode, healthcare organizations must embrace the art of medical leadership. So, I guess that's a spoiler alert there. Another point that Dr. Conard makes very crisply toward the end of the show is that doctors can kinda get pushed and pulled around in this mix. You have docs just trying to provide good care, and they work for one entity that gets bought and now it's some other entity … and what's happening upstairs and the prices being charged or somebody somewhere deciding not to make prices transparent, or deciding to sue low-income patients for unpaid medical bills or what charity care to offer or not to offer. These are not doctors in clinics making these calls, and we need to be careful here not to homogenize what some of these health systems are choosing to do like some kind of democratic vote was taken by everybody who works there. Health systems, hospitals, are many-celled complex entities. And a third takeaway—there are a bunch of takeaways in this show, but a third one I'll highlight here from Dr. Conard's story—is the old fiduciary responsibility code word being used by health system administrators as a euphemism for strategies that might need a euphemistic code word because the strategy has questionable community benefit. In the case study that we talk about today, the local health system managed to raise healthcare spend in North Texas by $100 million year over year. Employers and employees in North Texas communities wound up paying $100 million more year over year in healthcare one particular year. This was prices going up. It also was removing a big systemic initiative to keep heads out of hospital beds. Reiterating here, we are not talking about doctors here particularly because, of course, the vast majority of doctors are trying to prevent avoidable hospitalizations. But suddenly in North Texas, physicians did not have the population health efforts and the team really standing behind them helping to prevent avoidable hospitalizations. That sucks for everybody trying to do the right thing, and, as has been said, burnout is moral injury in a cheap Halloween costume. Moral injury happens when you have good people, clinicians, doctors, and others who realize that what is going on, at best, is not helping the patient. Also mentioned in this episode are Benjamin Schwartz, MD, MBA; David Muhlestein, PhD, JD; Brian Klepper, PhD; Al Lewis; Robert Pearl, MD; Karen Root, MBA, CCXP; and Wendell Potter.   You can learn more by emailing Dr. Conard at scott.conard@converginghealth.com.   Scott Conard, MD, DABFP, FAAFM, is board certified in family and integrative medicine and has been seeing patients for more than 35 years. He was an associate clinical professor at the University of Texas Health Science Center at Dallas for 21 years. He has been the principal investigator in more than 60 clinical trials, written many articles, and published five books on health, well-being, leadership, and empowerment. Starting as a solo practitioner, he grew his medical practice to more than 510 clinicians over the next 20 years. In its final form, the practice was a value-based integrated delivery network that reduced the cost of care dramatically through prevention and proactive engagement. When this was acquired by a hospital system, he became the chief medical officer for a brokerage/consulting firm and an innovation lab for effective health risk–reducing interventions. Today, he is co-founder of Converging Health, LLC, a technology-empowered consulting and services company working with at-risk entities like self-insured corporations, medical groups and accountable care organizations taking financial risk, and insurance captives to improve well-being, reduce costs, and improve the members' experience. Through Dr. Conard's work with a variety of organizations and companies, he understands that every organization has a unique culture and needs. It is his ability to find opportunities and customize solutions that delivers success through improved health and lower costs for his clients.   06:54 What triggered Scott's career journey? 07:31 What caused Scott to rethink what is good primary care? 08:11 Why did Scott realize that he is actually a risk-management expert as a primary care doctor rather than someone who treats symptoms? 09:25 EP335 with Brian Klepper, PhD. 09:53 How did Scott's practice change after this realization? 10:04 What is a “Whole-Person Risk Score”? 11:08 Scott's book, The Seven Numbers (That Will Save Your Life). 13:05 “You start to move from a transactional model to a relationship model.” 15:31 Did Scott have any risk-based contracts? 16:08 Why is it so important to look at total cost of care and not just primary care cost? 21:08 Scott's book, The Art of Medical Leadership. 22:13 EP381 with Karen Root. 30:43 Why did Scott move over to help corporations? 33:10 EP364 with David Muhlestein, PhD, JD. 33:51 “Everybody thought they were honoring their fiduciary responsibility, and the incentives are completely misaligned.” 34:31 EP384 with Wendell Potter. 34:43 “It's the system that's broken; it's not bad people.”   You can learn more by emailing Dr. Conard at scott.conard@converginghealth.com.   @ScottConardMD discusses #primarycare #marginvsmission on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Jerry Durham, Kate Wolin, Dr Kenny Cole, Barbara Wachsman, Luke Slindee, Julie Selesnick, Rik Renard, AJ Loiacono (Encore! EP379), Nina Lathia, Marshall Allen

Tuscola High School - Casey Conard (24:12)

We hear this year after year, presidential candidates campaigning to lower health care costs and the cost of pharmaceuticals. Yet, the prices keep going up and up and up. What is going on? To sort fact from fiction is Dr. Scott Conard, an international healthcare thought leader.

Conard's Corner co-curator Link Schreiber shares an update about the program.

On today's episode, without any shame, we're again talking about birds. I got to sit down with Chris Conard and continue this conversation around wildlife success stories in unlikely places, as well as concerning trends. Chris is uniquely qualified to talk about this as he's spent the last 30 years working in a very unlikely wildlife refuge, aptly named the Bufferlands, which surrounds a sewage treatment plant in south Sacramento County. In fact, he kind of embodies the All land is Beautiful ethos. He was also involved in the most recent Sacramento County Breeding Bird Atlas effort, which found that there are actually more bird species breeding in the county than there were 30 years ago, and is the best individual I personally know at auditory identification of birds, though he's certainly not one to brag and would be quick to point out others who are better. More information and events at the Bufferlands Preserve can be found on the Buff Blog. To go on a field trip with Sacramento Audubon click here.

Did you know that one year ago the community of East Palestine Ohio was poisoned by a Norfolk Southern train derailment and the resulting purposeful burning of vinyl chloride? Join Food Sleuth Radio host and Registered Dietitian, Melinda Hemmelgarn, for her interview with Jess Conard, Appalachia Director at Beyond Plastics who discusses the ongoing public health consequences facing her community. Conard explains that any community in close proximity to rail lines is at risk for a similar fate, and encourages citizen action to encourage the EPA to ban vinyl chloride.https://www.beyondplastics.org/actions/ban-vinyl-chloride Related website:  https://www.beyondplastics.org/actions/ban-vinyl-chlorideGrist: One Year After the Toxic Train Derailment…https://grist.org/accountability/is-east-palestine-safe-depends-who-you-ask/ 

Alison Conard has been working hard to level up her game. Leaning into agility work and athlete mindset has helped her earn an MVJ plus she has gone from a Solid C team skater to chasing that B team roster spot. We are so excited to share her inspirational story with you!If you want to level up your game click here https://join.krissykrash.com/kcit-m-app  to apply for Krash Course in Transformation If you want to start down the path of being a powerful athlete on the track and in life click here to apply for Krash Course. We breed athletes, MVP's, and badasses in our proven system that has helped over 500 people level up their game. Follow me on Instagram for daily derby tips, tricks, and motivation @krissykrash

#BeAGoodFriend and check out episode #93 of #FeeneyTalksWithFriends featuring Riley Fox. It was great to talk with my #friend, Riley Fox. Riley is a scholar-athlete and good friend. He is the all-time leading scorer in basketball at Conard High School. We talked about: Going for 2000 points! (minute 1) Keys to being a good teammate (minute 3) Going to Yale (minute 5.30) The Cathedral of Sweat (minute 7.20) New Haven pizza (minute 12) Riley vs Thai shooting contest (minute 15) 100th Podcast Celebration on February 12th (minute 17.30) Prep School or Conard? (minute 21) Carrot Sticks (minute 25) 3 Keys (sponsored by West Hartford Lock) to being a good basketball player (minute 27) Hots Ones gift for Tevin (minute 29) Baked Potato Pizza from Luna (minute 31) Coach Leghorn (minute 33) Coach David Horowitz (minute 35) Kenny Mayne (minute 37) Commitment Edits (minute 39) Keep the Vision (minute 41) Riley's girlfriend, Sarah (minute 43) Fritz Photos (minute 45) Basketball Games: First, Last, Best, Worst (minute 49) Breaking the all-time scoring record at Conard (minute 56) Coach John Decker (minute 1.02) Autographed Photos (minute 1.07) Hot One - Last dab with Da Bomb (minute 1.09) Crazy Questions (sponsored by Donut Crazy) (minute 1.11) Riley‘s mom cuts his hair (minute 1.16) Closing Remarks (minute 1.18) Podcast links: Episode #22: Feeney Talks with Thai, Scott and Andy https://www.youtube.com/watch?v=UtKx-_Ajt5c Episode #38: Feeney Talks with Kenny Mayne https://www.youtube.com/watch?v=10NP2a6jS2M Episode #65: Feeney Talks with John Decker https://www.youtube.com/watch?v=VwN2EhQbf5g Podcast Sponsors: Donut Crazy - www.donutcrazy.com The Fix IV - www.thefixivtherapy.com West Hartford Lock - www.westhartfordlock.com Keating Agency Insurance - www.keatingagency.com Goff Law Group - www.gofflawgroup.net Parkville Management - www.parkvillemanagement.com Luna Pizza - www.lunapizzawh.com/lunas-menu PeoplesBank - www.bankatpeoples.com --- Support this podcast: https://podcasters.spotify.com/pod/show/friendsoffeeney/support

Prageet Harris, who began his journey as a teacher in London, encountered Osho, spending 5 years with him in India and 3 in Oregon; meanwhile, Julieanne Conard, after studying molecular biology at UCSC, stumbled upon the Stargate in 2012 during a move, leading her to channel Alcazar within 3 months. The Stargate, a channeled sacred geometrical structure crafted by Prageet in 1989, empowers ordinary individuals to undergo profound spiritual experiences through guided meditations in high vibrational energy fields. It was during a massage in 1988 on Maui that Prageet unexpectedly channeled for the first time. Since 2013, Prageet and Jules have been globe-trotting together, sharing the transformative Stargate experience worldwide.Please enjoy my conversation with Prageet Harris and Julieanne Conard.This show is part of the Spreaker Prime Network, if you are interested in advertising on this podcast, contact us at https://www.spreaker.com/show/4858435/advertisement

Join us for a DNA myster. Our guest Alexis Bagale from Michigan  has been navigating DNA testing results to uncover the parents of her 2nd great-grandmother, Ellen Conard. Does her answer lie within the X chromosome? Let's review inheritance of the X-chromosome.Don't forget to share your thoughts on our Facebook page!Be sure to bookmark linktr.ee/a3genealogy for your one stop access to Kathleen Brandt, the host of Hittin' the Bricks with Kathleen. And, visit us on YouTube: Off the Wall with Kathleen John and Chewey video recorded specials.Hittin' the Bricks is produced through the not-for-profit, 501c3 TracingAncestors.org.

The GameTimeCT Pick'Em podcast and board has returned for Week 11 of the 2023 football season. THE RUNDOWN 0:00 - 2:34 — Opener 2:35 - 4:15 — Conard (1-8) at Hall (6-3) 4:16 - 5:20 — ATI (7-1) at Bullard Havens (7-2) 5:20 - 6:07 — Waterford (2-6) at Weaver (1-7) 6:08 - 7:19 — Granby/Canton (8-1) at SMSA co-op (8-1) 7:20 - 8:47 — Fairfield Prep (2-6) at Notre Dame-West Haven (2-6) 8:48 - 10:08 — Manchester (6-2) at East Hartford (4-5) 10:09 - 11:47 — New Fairfield (3-5) at Windham (6-2) 11:48 - 14:04 — Daniel Hand (7-1) at Sheehan (5-3) 14:05 - 15:29 — Bloomfield (8-0) at Windsor (8-1) 15:30 - 17:34 — Shelton (7-2) at Wilton (7-2) 17:35 - 19:06 — Wrap Learn more about your ad choices. Visit megaphone.fm/adchoices

I cut this clip out of episode 407 with Vivek Garg, MD, MBA, from Humana; and it's actually a really nice follow-on from the show last week with Scott Conard, MD, where we talked about the blowback that happened with clinicians at a clinic. This clinic had put into effect a bunch of the comprehensive primary care kinds of things that Dr. Garg talks about in this summer short. But what happened in Dr. Conard's case is a new practice manager tried to go back to the olden days, and, spoiler alert, it was a kerfuffle. All the docs and the rest of the clinicians staged what sounded like a “mutiny on the bounty” moment from the way Dr. Conard described it. So, this summer short you're about to hear and the one from last week again share one key point: Doctors, advanced practice clinicians, medical assistants, pretty much everybody on the team really likes a well-executed, operationally excellent transformed primary care model. And it produces better patient care. I was reading Dr. Robert Pearl's book Uncaring the other day, and he summed up the reason why, I think, these transformed primary care practices do better. He was quoting Atul Gawande, and here's the quoted quote: “The public's experience is that we have amazing clinicians and technologies but little consistent sense that they come together to provide an actual system of care, from start to finish, for people. We train, hire, and pay doctors to be cowboys. But it's pit crews people need.” I interviewed Dr. Pearl, by the way, so stay tuned for that show coming up. In this summer short, Dr. Garg digs into one common objection to more comprehensively comprehensive primary care, and that is that by improving care, we decrease throughput and, therefore, access to primary care, especially in areas where there are not enough primary care doctors.   You can learn more at humana.com, centerwellprimarycare.com, and the Humana report.     Vivek Garg, MD, MBA, is a physician and executive dedicated to building the models and cultures of care we need for loved ones and healthcare professionals to thrive. He leads national clinical strategy and excellence, care model development and innovation, and the clinical teams for Humana's Primary Care Organization, CenterWell and Conviva, as chief medical officer (CMO), where they serve approximately 250,000 seniors across the country as their community-based primary care home, with a physician-led team of practitioners, including advanced practice clinicians, nurses, social workers, pharmacists, and therapists. Dr. Garg is the former chief medical officer of CareMore and Aspire Health, innovative integrated healthcare delivery organizations with over 180,000 patients in over 30 states. He also previously led CareMore's growth and product functions as chief product officer, including expansion into Medicaid primary care and home-based complex care. Earlier in his career, Dr. Garg joined Oscar Health during its first year of operations as medical director and led care management, utilization management, pharmacy, and quality, leading to Oscar's initial NCQA accreditation. He was medical director at One Medical Group, focusing on primary care quality and virtual care, and worked at the Medicare Payment Advisory Commission, a Congressional advisory body on payment innovation in Medicare. Dr. Garg graduated summa cum laude from Yale University with a bachelor's degree in biology and earned his MD from Harvard Medical School and MBA from Harvard Business School. He trained in internal medicine at Brigham and Women's Hospital, received board certification, and resides in New Jersey.   02:31 Does advanced primary care reduce access to patients? 03:01 Are five-minute visits with patients really access? 04:17 Will advanced primary care provide outcomes that make certain PCP responsibilities unnecessary?   You can learn more at humana.com, centerwellprimarycare.com, and the Humana report.   @vgargMD discusses #advancedprimarycare on our #healthcarepodcast. #healthcare #podcast   Recent past interviews: Click a guest's name for their latest RHV episode! Dr Scott Conard, Brennan Bilberry, Stacey Richter (INBW38), Scott Haas, Chris Deacon, Dr Vivek Garg, Lauren Vela, Dale Folwell (Encore! EP249), Eric Gallagher, Dr Suhas Gondi

Back at the beginning of this year, I was so sad when I had to edit out the clip that follows from the original and extremely popular episode 391 with Scott Conard, MD. In the literally probably three minutes that follows in this clip with Dr. Conard after I finish my ramblings here, Dr. Conard introduces the impact that changing the practice model in a PCP practice in Queens, New York, had on the staff and patients alike. Spoiler alert: No way no how were they going back to the old way of doing things. The “Before” here was a clinic where the waiting room was filled to overflowing out into the hall with patients waiting to be seen, and this included a mix of really sick people who really needed to be seen and also … others. And thus they had, among a whole host of other bad things going on, the whole issue of suboptimal ER (emergency room) visits and urgent care usage. Anyone who couldn't wait just headed elsewhere. Also, as it is so many places, care was pretty transactional. A patient who wasn't in clinic had an “out of sight, out of mind” relationship with their PCPs. There was no systemic way for the clinical teams to really think about the “in between spaces,” as Amy Scanlan, MD, put it (EP402)—the spaces in between office visits. But then as a result, of course, we wind up dealing with uncontrolled chronic conditions and the failure to prevent preventable disease. We wind up with urgent needs for care and acute situations that had, frankly, no business getting to that stage in the first place. So, Dr. Scott Conard and his team worked on practice transformation, including focusing on operational excellence. I say all that to say, here's Dr. Scott Conard: DR. CONARD: We went and did one pilot clinic, which is, I think, the right way to do it. And then the practice manager was recruited by a competing group. They put another person in the clinic, another practice manager. And she immediately came in and thought that her job was to go back and put the old way of doing things in place, and within literally four or five days, they got together and sat down and said, “Look, we understand where you're coming from, but we will never go back. We are not going back to that old system. We are going to do things in this new way because it makes our lives—and we work together—so much better. And we enjoy being together, and we're seeing … we like not having 30 people waiting to get here at work. We like people getting … having a waiting room be close to empty as we just have one or two of the next people coming in. And we will never go back to that old system.” And, to her credit, she's like, “Okay … cool. Let me understand this.” And she's now one of the strongest leaders in that organization for this transformation. STACEY: So, the PCPs … it was like mutiny on the bounty. They were like, “No way no how are we going back.” DR. CONARD: Oh, it was the entire team: their receptionist, the telephone operator, the MAs. They have a patient navigator, which is another part of the equation we haven't talked about that's really important. And so, the whole team said no. Listen to the full episode 391 to learn more about Dr. Scott Conard and his team's approach to practice transformation. But in the meantime, Peter Watson, MD, captured a few learnings from the original episode really nicely on LinkedIn; so let me quote him here: Dr. Watson has some other really great posts on the topics of value-based care and primary care. I would highly recommend following him on LinkedIn. Should you continue to be interested in this topic of transformational primary care, additional shows on transforming primary care—including bright spots and challenges—are the shows with Eric Gallagher (EP405) and, as aforementioned, the show with Dr. Amy Scanlan (EP402). Also check out the upcoming show with Larry Bauer, which will be approximately episode 409, should I get my act together. And Vivek Garg, MD, MBA (EP407), who, by the way, is coming up in next week's summer short talking about the common rebuke of comprehensive primary care, which is that it diminishes patient access because PCP patient panel sizes tend to be smaller in comprehensive primary care models. Since the original show with Dr. Scott Conard aired, his new book Which Door? came out. I'm gonna say that this book is relevant. It's written for employers but still relevant here because employers have a terrible track record for helping (ie, paying for healthcare) in a way that enables PCPs who want to do comprehensive primary care to actually do comprehensive primary care. When an employer lets the status quo prevail, employees get fragmented care provided by PCPs struggling under the weight of brutal administrative burden and often nasty and counterproductive incentives.   You can learn more by emailing Dr. Conard at scott@scottconard.com.     Scott Conard, MD, DABFP, FAAFM, is board certified in family and integrative medicine and has been seeing patients for more than 35 years. He was an associate clinical professor at the University of Texas Health Science Center at Dallas for 21 years. He has been the principal investigator in more than 60 clinical trials, written many articles, and published five books on health, well-being, leadership, and empowerment. Starting as a solo practitioner, he grew his medical practice to more than 510 clinicians over the next 20 years. In its final form, the practice was a value-based integrated delivery network that reduced the cost of care dramatically through prevention and proactive engagement. When this was acquired by a hospital system, he became the chief medical officer for a brokerage/consulting firm and an innovation lab for effective health risk–reducing interventions. Today, he is co-founder of Converging Health, LLC, a technology-empowered consulting and services company working with at-risk entities like self-insured corporations, medical groups and accountable care organizations taking financial risk, and insurance captives to improve well-being, reduce costs, and improve the members' experience. Through Dr. Conard's work with a variety of organizations and companies, he understands that every organization has a unique culture and needs. It is his ability to find opportunities and customize solutions that delivers success through improved health and lower costs for his clients.   02:15 Why a transformed PCP practice didn't want to go back to the old way of doing things. 03:39 Dr. Peter Watson's takeaways from Dr. Conrad's EP391. 04:02 Can fee for service in the short term still benefit primary practice? 04:43 EP405 with Eric Gallagher; EP402 with Amy Scanlan, MD; upcoming episode with Larry Bauer; and EP407 with Vivek Garg, MD, MBA. 05:24 Scott Conard's new book, Which Door?   You can learn more by emailing Dr. Conard at scott@scottconard.com.   @ScottConardMD discusses #PCP transformation on our #healthcarepodcast. #healthcare #podcast   Recent past interviews: Click a guest's name for their latest RHV episode! Brennan Bilberry, Stacey Richter (INBW38), Scott Haas, Chris Deacon, Dr Vivek Garg, Lauren Vela, Dale Folwell (Encore! EP249), Eric Gallagher, Dr Suhas Gondi, Dr Rachel Reid

Ellie introduces Eliza Roberts, a special guest on the show who is helping to run a company called Town at Town, which started as an educational platform for actors, models, and people in the industry. They are now working on developing a new casting app and offering classes. Eliza invites Ellie to attend one of her workshops as she is now one of the instructors. They discuss the challenges and changes in the entertainment industry, with Eliza describing it as a "wild ride like a wooden roller coaster". Johnny acknowledges that passion for acting is a factor in the change. The panel also discuss an upcoming project titled "WE 5" starring Eric Roberts, Ellie Conard, Chad Dudley, Brandon Rainwater, Keaton Simons, Eliza Roberts and John Signorella. --- Support this podcast: https://podcasters.spotify.com/pod/show/thelifenetwork/support

On this month's episode of the NWYM Podcast, Jacob (Meridian Friends) was solo this week as Austin was welcoming a new baby. Jacob had two shorter conversations about Friends Summit 2023. Friends Summit is a national gathering of Evangelical Friends Churches that happens every four years. The first conversation was with Jesse Penna. Jesse teaches at Barclay College (https://www.barclaycollege.edu) and is the Youth Superintendent of Mid America Yearly Meeting. Jesse has been involved with Friends Summit since the beginning in 2010 so he offers a little history on the event and what it's goal is. The second conversation is with Conard Harrison. Conard is a student at George Fox University and is from Entiat Friends. Conard attended Friends Summit in 2018 and he also recently attended a planning trip to help plan Friends Summit 2023. Conard offers perspective on what it is like attending the conference as a young adult and why it is important that our churches send students and young adults to attend. We hope you enjoy this month's episode. You can find out more info about Friends Summit here: http://friendssummit.com

Over the past month, YouTube came out with its big push for bringing more podcasts to the platform with YouTube podcasts. While this doesn't mean anyone and everyone should slap their podcast onto YouTube, there are some things that you can do to utilize this update and reach new audiences. This week, episode 95 of Listeners to Leads is about updates on YouTube and podcasting! Sarah J. Conard is a YouTube strategist, video editor, and all-around online content enthusiast. With a background in both marketing and theatre, she strives to provide women with the tools and tips they need to look great, sound great, and create content to their fullest potential. Sarah also has the distinct privilege of being part of Alesia's team! In this episode of Listeners to Leads, my guest Sarah Conrad shares the importance of tailoring your conversations to where your audience is consuming your content and what you need to know to have a good-quality video podcast. Sarah and I also chat about the following: The overall do's and don'ts of putting your podcast on YouTube. The 3 tiers of video podcasting. Everything you should consider as it applies to having a high-quality video podcast. At the end of the day, it comes down to the intentionality of your podcast as a hobby podcast vs. a podcast that acts as a lead-generating tool is going to have completely different things to think about. Be sure to tune in to all the episodes to receive tons of practical tips on turning your podcast listeners into leads and to hear even more about the points outlined above. Thank you for listening! If you enjoyed this episode, take a screenshot of the episode to post in your stories and tag me! And don't forget to follow, rate, and review the podcast and tell me your key takeaways!Learn more about Listeners to Leads at www.listenerstoleads.comCONNECT WITH SARAH CONARD:Instagram CONNECT WITH ALESIA GALATI:InstagramLinkedInWork with Galati Media! LINKS MENTIONED:Riverside.fmDescriptThe Goulet Pen Company YouTube

Two Charlotte-Mecklenburg police officers who fired shots during the deadly shooting of an armed robbery suspect last June were justified in their use of force, the district attorney announced Tuesday.  CMPD responded to a reported armed robbery at a Food Lion on Tuckaseegee Road around 1 p.m. on June 26. Officers spotted a person matching Kevin Boston's description while en route to the store and attempted to contact him. When officers approached Boston, he allegedly put both bags on the ground and reached toward his pants and pulled out a gun, according to District Attorney Spencer Merriweather. READ MORE: https://www.wcnc.com/article/news/crime/deadly-police-shooting-officers-justified-district-attorney-says/275-1a4b32be-5037-4cac-bbec-e12d5fef6254 With less than a month on the job, new Gastonia Police Chief Trent Conard has his hands full as he tries to recruit more officers to the force. This is something he acknowledged Tuesday night as he presented some incentives to Gastonia city leaders that he says will help retain and recruit officers. “Law enforcement is faced with a difficult time in history,” Conard said. “Having adequate staffing has become an issue.” Gastonia's police department faces the same challenges that other law enforcement departments do – trying to get officers when it's even harder to recruit. READ MORE: https://www.wcnc.com/article/money/gastonia-police-department-recruitment-employeers-officers/275-6e610499-7fb0-4f11-b446-11e7ade47776 Watch Wake Up Charlotte each weekday morning from 4:30 to 7 a.m. on WCNC Charlotte, and as always, join the conversation on social media using #WakeUpCLT! 

Two Charlotte-Mecklenburg police officers who fired shots during the deadly shooting of an armed robbery suspect last June were justified in their use of force, the district attorney announced Tuesday. CMPD responded to a reported armed robbery at a Food Lion on Tuckaseegee Road around 1 p.m. on June 26. Officers spotted a person matching Kevin Boston's description while en route to the store and attempted to contact him. When officers approached Boston, he allegedly put both bags on the ground and reached toward his pants and pulled out a gun, according to District Attorney Spencer Merriweather.READ MORE: https://www.wcnc.com/article/news/crime/deadly-police-shooting-officers-justified-district-attorney-says/275-1a4b32be-5037-4cac-bbec-e12d5fef6254With less than a month on the job, new Gastonia Police Chief Trent Conard has his hands full as he tries to recruit more officers to the force.This is something he acknowledged Tuesday night as he presented some incentives to Gastonia city leaders that he says will help retain and recruit officers.“Law enforcement is faced with a difficult time in history,” Conard said. “Having adequate staffing has become an issue.”Gastonia's police department faces the same challenges that other law enforcement departments do – trying to get officers when it's even harder to recruit.READ MORE: https://www.wcnc.com/article/money/gastonia-police-department-recruitment-employeers-officers/275-6e610499-7fb0-4f11-b446-11e7ade47776Watch Wake Up Charlotte each weekday morning from 4:30 to 7 a.m. on WCNC Charlotte, and as always, join the conversation on social media using #WakeUpCLT! 

Whitney is a relatively new vintage seller who opened an Instagram shop in April 2021, after being furloughed then quitting her job as a nurse. She opened her Etsy shop - ThriftyWhitneyShop - in December 2021, and then launched her own website at thriftywhitney.com where she focuses on selling vintage home decor and textiles sourced from the Midwest. Buy Me A Coffee - https://www.buymeacoffee.com/etsyconvo Connect with me on Instagram -  https://www.instagram.com/etsyconversations/ Be My Podcast Guest - https://convome.com/be-my-etsy-conversations-podcast-guest/

In recent decades there has been a major restructuring of the economy from capital-intensive manufacturing to knowledge-intensive, innovation-driven fields which increases the demand for high skilled workers. But why is it, that the US is producing a lot more innovation than other parts of the world?Edward W. Conard is an American businessman, author, and scholar. He is a New York Times-bestselling author of The Upside of Inequality: How Good Intentions Undermine the Middle Class and Unintended Consequences: Why Everything You've Been Told About the Economy Is Wrong; and a contributor to the book Income, Wealth, Consumption, and Inequality. Conard is an adjunct fellow at the American Enterprise Institute for Public Policy Research. Previously, he was a managing director at Bain Capital, where he worked closely with former presidential candidate Mitt Romney.Edward and Greg talk about how information technology led to increased productivity and how the vast majority of the benefits generated by these technological advances go to the consumers and only a tiny fraction is captured by the people that are in the business of producing it. They also discuss why the argument that the middle class is being hollowed out is wrong, and Edward's strategy for increasing wages for the middle and working classes.Episode Quotes:The constraint to growth in the world04:52: We can't afford to waste our talent because we have a lot less of it. And we have a lot more need from our population in terms of the economic help they need in order to live a happy life and in our economy. Because we have a lot of talent, a lot of it is not properly trained, and ultimately, we have to get the properly trained talent to take risks. (05:20) Because if all we do is our doctor or lawyer, they're not going to increase productivity. They're not going to produce innovation. And so that is the constraint to growth in our economy, it's probably the constraint to growth in the world.41:41: The lack of talent is a real constraint in trying to get things done. Not only find the ideas but reduce the risk. And so that's a very important piece of it. This whole risk with our savings gives the impression that capital's really cheap.How ideas affect taxes07:22: If you have great ideas, the tax rate is going to matter a lot because you're multiplying by the tax rate. If you don't have good ideas, it doesn't matter if you have zero times in a high or a low tax; then we're still going to be zero.Two effects of properly trained talent 39:41: Properly trained talent has two effects. One is that it goes out and finds the ideas because, without talent, you don't find the ideas. But the second thing it does is reduce the risk of implementing those ideas. So it has this risk-reducing function.Show Links:Recommended Resources:Thomas PikettyEquality and Efficiency: The Big Tradeoff by Arthur Okun Guest Profile:Professional at American Enterprise InstituteEdward Conard's WebsiteEdward Conard on LinkedInEdward Conard on TwitterEdward Conard on YoutubeEdward Conard on FacebookHis Work:Articles in National ReviewThe Upside of Inequality: How Good Intentions Undermine the Middle Class Unintended Consequences: Why Everything You've Been Told About the Economy Is Wrong The Economics of Inequality in High-wage Economies By Edward Conard

On Relentless Health Value, I don't often get into our guests' personal histories. There are a bunch of reasons for this, which, if you buy me beer, we can talk podcast philosophy and I will tell you all about my personal, very arguable opinion here. Nevertheless, in this healthcare podcast, we are going rogue; and I am talking with Scott Conard, MD, who shares his personal story. You may ask why I decided to go this route for this particular episode, and I will tell you point blank that Dr. Conard's experience, his narrative, is like the perfect analogue (Is analogue the right word [allegory, composite example]?). His story just sums up in a nutshell what happens when a PCP (primary care provider) does the right thing, manages to improve patient care for real, and then at some point gets sucked into the intrigue and gambits and maneuvering that is, sadly, the business of healthcare in the United States today. Before we kick in, I just want to highlight a statement that Scott Conard makes toward the end of the show. He says: So, this isn't about punishing or blaming aspects of care that are being overrewarded today. It's really about what's the path forward for corporations, for middle-class Americans, and for primary care doctors who don't choose to be part of a big system. We have to figure out how to solve this problem. I hope people don't hear this and think that there are horrible people at some not-for-profit hospital systems, for example. There are some great people at not-for-profit health systems, but they have some really screwed-up incentives. A few notable notes from Dr. Scott Conard's journey and words of wisdom that I will just highlight up front here: He says that as a PCP, you actually can produce high-value care in a fee-for-service model … if you think differently and you change practice patterns. I have heard this from others as well, including most recently David Muhlestein, PhD, JD, who says this in an upcoming episode. Now here's a surefire way to fail at that, though: Be a physician who is getting asked to basically do everything a patient needs done alone and by themselves with little or no help and being told to do all of this within a seven-minute visit. This surefire way to not do well also could mean working on a team that's a team in name only because it's more of a marketing thing than an actual thing. As Dr. Scott Conard says later in this episode, healthcare organizations must embrace the art of medical leadership. So, I guess that's a spoiler alert there. Another point that Dr. Conard makes very crisply toward the end of the show is that doctors can kinda get pushed and pulled around in this mix. You have docs just trying to provide good care, and they work for one entity that gets bought and now it's some other entity … and what's happening upstairs and the prices being charged or somebody somewhere deciding not to make prices transparent, or deciding to sue low-income patients for unpaid medical bills or what charity care to offer or not to offer. These are not doctors in clinics making these calls, and we need to be careful here not to homogenize what some of these health systems are choosing to do like some kind of democratic vote was taken by everybody who works there. Health systems, hospitals, are many-celled complex entities. And a third takeaway—there are a bunch of takeaways in this show, but a third one I'll highlight here from Dr. Conard's story—is the old fiduciary responsibility code word being used by health system administrators as a euphemism for strategies that might need a euphemistic code word because the strategy has questionable community benefit. In the case study that we talk about today, the local health system managed to raise healthcare spend in North Texas by $100 million year over year. Employers and employees in North Texas, communities, wound up paying $100 million more year over year in healthcare one particular year. This was prices going up. It also was removing a big systemic initiative to keep heads out of hospital beds. Reiterating here, we are not talking about doctors here particularly because, of course, the vast majority of doctors are trying to prevent avoidable hospitalizations. But suddenly in North Texas, physicians did not have the population health efforts and the team really standing behind them helping to prevent avoidable hospitalizations. That sucks for everybody trying to do the right thing, and, as has been said, burnout is moral injury in a cheap Halloween costume. Moral injury happens when you have good people, clinicians, doctors, and others who realize that what is going on, at best, is not helping the patient. You can learn more by emailing Dr. Conard at scott@scottconard.com. Scott Conard, MD, DABFP, FAAFM, is board certified in family and integrative medicine and has been seeing patients for more than 35 years. He was an associate clinical professor at the University of Texas Health Science Center at Dallas for 21 years. He has been the principal investigator in more than 60 clinical trials, written many articles, and published five books on health, well-being, leadership, and empowerment. Starting as a solo practitioner, he grew his medical practice to more than 510 clinicians over the next 20 years. In its final form, the practice was a value-based integrated delivery network that reduced the cost of care dramatically through prevention and proactive engagement. When this was acquired by a hospital system, he became the chief medical officer for a brokerage/consulting firm and an innovation lab for effective health risk–reducing interventions. Today, he is co-founder of Converging Health, LLC, a technology-empowered consulting and services company working with at-risk entities like self-insured corporations, medical groups and accountable care organizations taking financial risk, and insurance captives to improve well-being, reduce costs, and improve the members' experience. Through Dr. Conard's work with a variety of organizations and companies, he understands that every organization has a unique culture and needs. It is his ability to find opportunities and customize solutions that delivers success through improved health and lower costs for his clients. 05:26 What triggered Scott's career journey? 06:02 What caused Scott to rethink what is good primary care? 06:42 Why did Scott realize that he is actually a risk-management expert as a primary care doctor rather than someone who treats symptoms? 07:56 Encore! EP335 with Brian Klepper, PhD. 08:24 How did Scott's practice change after this realization? 08:35 What is a “Whole-Person Risk Score”? 09:39 Scott's book, The Seven Numbers (That Will Save Your Life). 11:37 “You start to move from a transactional model to a relationship model.” 14:02 Did Scott have any risk-based contracts? 14:39 Why is it so important to look at total cost of care and not just primary care cost? 19:39 Scott's book, The Art of Medical Leadership. 20:44 EP381 with Karen Root. 29:14 Why did Scott move over to help corporations? 31:42 EP364 with David Muhlestein, PhD, JD. 32:22 “Everybody thought they were honoring their fiduciary responsibility, and the incentives are completely misaligned.” 33:02 EP384 with Wendell Potter. 33:15 “It's the system that's broken; it's not bad people.” You can learn more by emailing Dr. Conard at scott@scottconard.com. @ScottConardMD discusses #privateequity on our #healthcarepodcast. #healthcare #podcast #PCP #patients Recent past interviews: Click a guest's name for their latest RHV episode! Gloria Sachdev and Chris Skisak, Mike Thompson, Dr Rishi Wadhera (Encore! EP326), Ge Bai (Encore! EP356), Dave Dierk and Stacey Richter (INBW37), Merrill Goozner, Betsy Seals (EP387), Stacey Richter (INBW36), Dr Eric Bricker (Encore! EP351), Al Lewis, Dan Mendelson, Wendell Potter, Nick Stefanizzi, Brian Klepper (Encore! EP335), Dr Aaron Mitchell (EP382), Karen Root, Mark Miller, AJ Loiacono, Josh LaRosa, Stacey Richter (INBW35), Rebecca Etz (Encore! EP295), Olivia Webb (Encore! EP337), Mike Baldzicki, Lisa Bari, Betsy Seals (EP375), Dave Chase, Cora Opsahl (EP373), Cora Opsahl (EP372)    

After finding lingerie and odd texts, Mark suspects why Lindsay is now dragging her feet with their wedding. Lindsay denies cheating and says she just doesn't want a big wedding. 

Camden joins Drs. Andrew Klumpp, Pamela-Riney Kehrberg, and Rebecca Conard for a wide-ranging conversation about regionalism, state and local history, and a recent issue of The Annals of Iowa. If you are interested in learning more about The Annals of Iowa, previous issues are available here: https://pubs.lib.uiowa.edu/annals-of-iowa/issues/

The Burros of Berea sit down in Giraffe Studio with Zac Conard to hear his personal testimony. Being raised in church and receiving the call to preach at the age of 10 years old, Zac tells of the difficulty of growing up in front of the church, being set apart with higher expectations. We hope you'll listen in to hear this fascinating story of trials, tribulations, mountaintops and valleys and the struggle to make sense of it all. Its a story of Sinners, Saints, the effect of Gossip and ultimately the necessity of the Grace of God. Thanks for listening and supporting our podcast! Please visit our website at www.burrosofberea.com and our Patreon page!

Jen Sherman and Randi Leopald serve on the West Hartford Special Education Parent Teacher Organization. (West Hartford SEPTO). Jen is the President and Randi is the Fundraiser. In addition to that, Jen and Randi are both educators. Jen teaches Business and Hospitality for the Hartford Public Schools. Randi teaches Pre-K for the West Hartford Public Schools. www.facebook.com/whsepto www.whps.org/pupil-services/septo-special-education-pto info@whsepto.org It was great to sit down and talk with Jen and Randi. We talked about: What is SEPTO (minute 2) "How to Stop Losing Your Sh*t With Your Kids" Comedy and Book Event (minute 5) 3 Keys (sponsored by West Hartford Lock) to run SEPTO (minute 8) Events: First, Last, Best, Worst (minute 10) Rita's Celebrity Server Event (minute 14) Miracle League Field (minute 16) Jen and Randi's Favorite Teacher (minute 20) Special Education in West Hartford Public Schools (minute 27) Extra-curricular school activities (minute 30) How they got involved with SEPTO (minute 37) Safe Grad (minute 45) Speak Up about Stubbs (minute 48) Crazy Questions sponsored by Donut Crazy (minute 53) The Bird Call Game (minute 1.03) "Community Voices Toward Equity West Hartford Listens" book (minute 1.10) Shout outs: Directline Media - www.directlinemediaproductions.com WeHa Brewing and Roasting - www.wehabrewing.com Speak Up about Stubbs - www.youtube.com/watch?v=f0fm-Gcbz6g Safe Grad for Conard - https://conard.whps.org/parent-portal/pto/safe-grad-information Safe Grad for Hall - https://hall.whps.org/pto-and-safe-grad/hall-safegrad Podcast Sponsors: Donut Crazy - www.donutcrazy.com The Fix IV - www.thefixivtherapy.com West Hartford Lock - www.westhartfordlock.com Keating Agency Insurance - www.keatingagency.com GastoPark - www.thegastropark.com --- Support this podcast: https://anchor.fm/friendsoffeeney/support

Dr. Chad Hackel and his athletic patient share his story of pain and recovery. Dr. Chad Hackel I have enjoyed providing chiropractic, acupuncture and nutritional care to Custer County, for the last 18 years at Backbone of Healthcare. I grew up on a farm near Ord Nebraska and then attended NE Community College and NE Christian College where I met my wonderful wife, Marci. Together we have four terrific children. In college I had an interest in natural healing and a desire to help others achieve good health. After much research it seemed like chiropractic would be a great fit. I graduated from Cleveland Chiropractic College in Kansas City Missouri in 2001. From there I moved to Lincoln to work at Conard-Love Chiropractic for about a year. Dr Conard specialized in alternative treatments such as nutrition, acupuncture and chiropractic. He taught me a lot about running a business and the treatment of hard cases. In January 2003, we opened Backbone of Healthcare in Broken Bow. Since moving here I have received post doctorate certificates in Acupuncture, Cox Technique (specialized treatment for herniated discs and arthritis) and most recently Sports Certification. I really enjoy helping people suffering from herniated discs and sports injuries and many other health conditions. Continuing my education in the latest chiropractic approaches to natural health and treatment is a priority. Also, this last year our office participated in a nationwide clinical study of failed back surgeries. Any spare time is filled with watching my kids participate in music, 4-H and sporting events. I also enjoy volunteering my time at church and church camp. If I can squeeze in a good football game or help my parents on the farm, my weekend feels complete. Resources: backboneofhealthcare.com Find a Back Doctor The Cox 8 Table by Haven Medical  

Jacob is back in the studio to talk about his Born Free Build as well as his last almost year working at West Coast Choppers!   Support the podcast by joining our Patreon community where you can gain access to unreleased content and support the podcast!  Www.patreon.com/fastlifegarage   @simpson_motorcycle_helmets For me personally I have logged thousands of miles in Simpson's and the fit and quality is perfect for me from how I ride and how I wanna look rolling down the highway!   ⚡️www.simpsonmotorcyclehelmets.com   @houseofharley  House of Harley Davidson located in Milwaukee Wisconsin, has been my go to for Harley Davidson parts, its where I buy my bikes and get high end work done!  Head over to  www.houseofharley.com  Offer code FASTLIFE at check out saves you 13%   @Thundermaxefi I have ran these computers for years on my bikes, thundermax is the shit at keeping my bike running it's best and keeping my M8 cool with their electric fan!  ⚡️www.shoptmax.com Offer code “fastlife” for 10% off   @lexinmoto I listen to everything from music and podcasts to even audio books as I smash miles across the country with lexin!  ⚡️www.lexin-moto.com Offer code “fastlife” for 15% off     @luckydaves I have been riding with Lucky Daves seats and handle bars on almost all of my bikes since 2016! From seats to handle bars LD has you covered! Head on over to www.Luckydaves.com to check out all the options for your HD and grab yourself some swag while your there!  

Our heroes return for the 4th Annual Dawgs of War Draft Special featuring our friend Conard. Conard does mock drafts nearly every morning of the calendar year (no lies), and probably dreams about NFL stats and schemes, so he always brings insight (and usually correct Browns guesses) each year. We also discuss news with Deshaun, the Browns new sports betting partnership, and Kevin and Rawley declare their respective “Songs of the Summer 2022”. See omnystudio.com/listener for privacy information.

Today we switched thing's up a bit, As James Pinard Jr deals with headaches caused from our old friend, Chris Williams from Trill Talk, Jesse decided to give him a week off, and "The Network Gives the HOT TAG to Great Personal friend, Conrad Kushman from the Famous YouTube Podcast, EVERYTHING PRO WRESTLING! Trill Talk was postponed in Portland at the Roseland Theater due to weather, and will return next week. Jesse, and Conrad talk WWE, AEW, and so much more! MAIN EVENT is Jesse, and Conard diving deep in the WHAT IF..? Segment, as we due a beautiful Tribute to The late Eddie Guerrero, and Fantasy book what it could look like, if Eddie was still with us today. Happy New year everyone! Follow our Facebook, and Instagram @theprowrestlingshoot, and our Twitter @TPWSpodcast Subscribe to us on YouTube The Pro Wrestling Shoot. Click the link below to find everywhere we do our podcast, as well as our Merch stores, and Facebook Group https://drum.io/theprowrestlingshoot Follow Everything Pro Wrestling on Facebook, Instagram, and Twitter @EPWshow, and Subscribe to them on YouTube Everything Pro Wrestling Click the link below to their drum page to find everywhere they do podcasts, Merch Stores, and Facebook group https://drum.io/epwshow --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

In this episode, we are joined by Dr. Gillian Wong, who is an Adjunct Professor of Anthropology at Metropolitan Community College in Kansas City, Missouri, and a postdoctoral researcher at the University of Tuebingen. Dr. Wong chats with us about her early outdoor days, experiences at UC Davis, and how learning French has been useful for her in archaeology. We then delve into her thesis/dissertation work at the University of Utah and then in Germany. She pronounces the name of the site she worked on and Connor/Carlton fails to replicate her pronunciation. Dr. Wong then talks about her experiences being a military spouse and also some advice for those who are military spouses. Literature Recommendations 2008 The Archaeology of Animal Bones by Terry O'Connor 2017 Human Subsistence and Environment during the Magdalenian at Langmahdhalde: Evidence from a new Rock Shelter in the Lone Valley, Southwest Germany by Wong, Gillian L., Starkovich, B. M., Conard, N. J. 2018 An Introduction to Zooarchaeology by Diane Gifford-Gonzalez 2016 Taphonomy for Taxonomists: Implications of predation in small mammal studies by Fernández-Jalvo, Y., Andrews, P., Denys, C., Sesé, C., Stoetzel, E., Marin-Monfort, D., Pesquero, D. 2019 Mothering from the Field: The Impact of Motherhood on Site-Based Research edited by Bahiyyah M. Muhammad and Melanie-Angela Neuilly 2020 New perspectives on human subsistence during the Magdalenian in the Swabian Jura, Germany by Wong, Gillian L., Starkovich, B. M., Drucker, D. G., Conard 2020 Latest Pleistocene paleoenvironmental reconstructions from the Swabian Jura, southwestern Germany: evidence from stable isotope analysis and micromammal remains by Wong, Gillian L., Drucker, D. G., Starkovich, B. M., Conard, N. J. Dr. Wong's Recorded lecture on her work at Langmahdhalde Holding down the Fort Podcast Guest Contact Twitter @GillianLWong Email: gillian.wong368@gmail.com Contact Email: alifeinruinspodcast@gmail.com Instagram: @alifeinruinspodcast Facebook: @alifeinruinspodcast Twitter: @alifeinruinspod Website: www.alifeinruins.com Ruins on APN: https://www.archaeologypodcastnetwork.com/ruins Store: https://www.redbubble.com/people/alifeinruins/shop ArchPodNet APN Website: https://www.archpodnet.com APN on Facebook: https://www.facebook.com/archpodnet APN on Twitter: https://www.twitter.com/archpodnet APN on Instagram: https://www.instagram.com/archpodnet Tee Public Store Affiliates Wildnote TeePublic Timeular

Our heroes return with reoccurring guest/resident fantasy football expert, Conard. The THIRD ANNUAL Dawgs of War Fantasy Guide has arrived. Fantasy basics, what is a PPR vs. standard, sleepers, how to draft, and more. The last two years, this episode has produced many league champs, so hop in. See omnystudio.com/listener for privacy information.

Special Guest Tik Toker Cam Conard and Jayke talk about the hottest men and women acording to Jayke's coworkers. Find Cam Conard on:INSTAGRAM: @CamConardTIKTOK: @CamBConardYOUTUBE: Cam ConardTWITCH: @CamConard We want to hear your stories.Call our Voicemail Line at (240) 34-DADDY or email: ThisGayDaddy@Gmail.com  Find Jayke's Books on Amazon.com  Recorded live with Riverside.fmThe easiest way to record podcasts and videointerviews in studio quality from anywhere. All from the browser.  

Our heroes return and recorded their first-ever podcast while both being in Cleveland at the same time. Rawley went to the barber and got 70's "film star" facial hair. Kevin met Eric Metcalf at a Lakewood bar. Adam Conard joins to break down the Browns draft picks and what he sees us doing in the first few rounds. Long-time listeners know Conard as the official Dawgs of War Draft & Fantasy Expert who comes on prior to the start of each season to help us draft our fantasy squads. Draft confirmed, Browns confirmed. Instagram: @AngryBrownsFans Twitter: @DoWPodcast See omnystudio.com/listener for privacy information.

Today's thought leader is Ben Conard, founder of Five North Chocolate, a healthy chocolate snack company empowering farmers and celebrating diversity by committing to fair-trade. Ben has been named one of the Top 10 Biggest Fair Trade Advocates in the World and 40 LGBT Leaders Under 40. Ben is passionate about making an impact in the way people buy and how companies produce. Let's jump right into this episode and learn from Ben how educating the consumer can give them the power to make better decisions and make lasting change in the market. [00:01 - 03:44] Opening Segment Let's welcome our guest for today, Ben Conard Founder of Five North Chocolate Ben talks a bit about himself Passionate about helping farmers and bringing them out of poverty [03:45 - 11:22] See a Problem, Go and Solve it Ben shares his story and the origins of FNC Why chocolate? Just a desire to design a healthy candy company You shouldn't have to feel guilty for eating something A need to help farmers who are being taken advantage of “I was a consumer who didn't like what they saw on the shelf and wanted to change it.” I share how I started seeing a lot of people take on fatalism I saw a problem and I went in to fix it Ben shares his 20 seconds of bravery moment Farm in Ecuador in 2017 So much work goes into one end product, they just want to know the consumer appreciates it Somebody needs to manifest this message through From curiosity to a calling [11:23 - 22:15] Educate the Consumer and Optimize the Food Industry Ben talks about some of the misconceptions of chocolate we need to re-think Positivity was the fuel to our fire Chocolate does not have to be a ‘guilty' pleasure Ben shares about stamping certified LGBT on the products You have a choice of what you give your attention to everyday Ben talks about the problems that need solving in the world of chocolate Farmers are severely underpaid and see no future in cacao We will see supply of cacao drop drastically Chocolate can be a medicine or a downfall Farmers need to be a central voice Ben talks about his vision for the chocolate industry for the future Let's optimize and democratize the food industry and the products we see on the market today for consumers Give the knowledge and education then give the power to make better choices The Three C's Consumer Company Country [22:16 - 33:50] Practical Tips to Educate Consumers and Yourself Ben gives advice how to best educate the consumer Encouraging people to read the ingredients first Ex. If the first ingredient is sugar, then it isn't dark chocolate anymore The first ingredient in Ben's chocolate is 100% cacao Make sure you're getting products that are fair-trade “As a consumer we should be doing are own research” Google is your friend Voice your opinions to the company They should know what you like and don't like I talk about my future book and how it applies Know the people behind the brand “We usually have better judgement in how we trust people then how we do things and brands and statements, so look for the people first.” - Ben [33:51 - 46:06] Closing Segment Advice to people who want to start doing good in the world? “The work is there, celebrate the work and effort, and the success you do make you need to celebrate.” Story of your struggles? Spending 8 hours in a kitchen making the product messing up along the way “Consistency kept me alive… I wasn't ready to give up.” What reminded you everyday that it's still an amazing world? “The people that I keep around me” Interconnection of the world - ex. Coffee These are the things we are trying to celebrate What reminds you every day that it is still an amazing world? "The Sun still rises. Every time the sunrise every day, we got a chance to fix whatever we didn't fix before." How can we find you? See links below Final words from me and Ben Resources Mentioned: DoneGood.co You can connect with Ben on LinkedIn, Instagram, and Twitter or by emailing ben@fivenorthchocolate.com. Visit https://www.fivenorthchocolate.com/ to learn more. Articles with Five North Chocolate: https://everwideningcircles.com/2019/11/26/2019-conspiracy-of-goodness-holiday-gift-guide/ Ever Widening Circles Link: https://everwideningcircles.com/ EWC Ed: https://ed.everwideningcircles.com/ Conspiracy of Goodness Summit Oct 4th: https://www.cogsummit.com/ Donate! https://www.paypal.com/donate/?token=I-nvmUrlbDfU67bRoWWdOhFxiAM_W81jtIFBGCYzfCL6fG8oSUOg9ONIL9WR8LDjLEeYj0&country.x=US&locale.x=US EWC APP: https://everwideningcircles.com/good-news-app-ever-widening-circles-app/ Dr. Lynda's Book: https://www.dr-lynda.com/book/happiness

In this episode, Krista talks to Ben Conard, social entrepreneur and founder of Five North Chocolate. Five North Chocolate is a LGBT certified business enterprise which uses cacao sourced from Fair Trade farmers to create delicious, vegan and ethical chocolate flavored organic superfoods. Ben reveals how his business was born from his intention to create guilt-free confectionery and describes how it has grown into an award-winning company. His brand's name references the fact that most of the world's cacao is grown in West Africa, a place where small farmers face poverty and exploitation.As an ethical entrepreneur, Ben encourages consumers to buy responsibly sourced chocolate in order to help prevent child labor and raise the living standards of cacao farmers and their families. He is passionate about his product, committed to supporting Fair Trade farmers and proud to celebrate diversity. He is also interested in starting conversations about where our food comes from and how it is produced. To learn more about Ben, visit www.fivenorthchocolate.com or follow @bconard on Instagram. Our GDPR privacy policy was updated on August 8, 2022. Visit acast.com/privacy for more information.

We take you back on a journey. A journey 35 years (can you believe it?) in the past. When things were much simpler. No pay per views, just closed circuit TV. The match: Ric Flair vs Dusty Rhodes. The prize: the NWA World title and $1,000,000. The referee: Smokin' Joe Frazier. Ah, but there is more: Wahoo McDaniel vs Superstar Billy Graham, a tuxedo match between Paul Jones and Jimmy Valiant, Ricky Steamboat against Tully Blanchard and many. many other legendary wrestlers. Conard does not always love going this far back, but Tony certainly does. Maybe it's because he looks so young in these clips. Back we go to Thanksgiving night, November 22, 1984. Courtesy of Jim Crockett Promotions and WHW!  Support us on Patreon, get this show early and ad free, plus TONS of BONUS content: patreon.com/WHWMonday Like us on Facebook: facebook.com/WHWMonday Check out all the new cool merchandise at BoxOfGimmicks.com Buy a shirt and Tony will call you (eventually!) at LoisRules.com Subscribe to our YouTube channel: youtube.com/whw Save thousands at SaveCade.com Learn more about your ad choices. Visit megaphone.fm/adchoices

On how we can sustain economic growth, spur innovation, improve productivity, and ensure greater prosperity for the middle class. In this Conversation, businessman and best-selling author Edward Conard shares his perspective on how America can achieve these objectives. Conard counters the commonplace view, today, that the American middle class has been hollowed out and that economic mobility has stagnated. While recognizing a slowdown in productivity and growth in recent years, Conard considers the overall strength and diversity of the American economy, and the relative growth in middle-class incomes in America compared to peer groups in Europe as well as Japan. According to Conard, we must prioritize innovation and growth in order to meet today's challenges—and he cites America's opportunity to increase high-skilled immigration as the single best way to jumpstart innovation and productivity now and in the years to come.