Podcasts about world health care congress

First of all, let me thank those of you who have left a podcast review in 2022. There was one from Best Healthcare Podcast Around on Apple Podcasts the other day that thanked Relentless Health Value for being singularly responsible for providing a 400-level education in so many complex areas of healthcare, which I personally really appreciated because we aspire to be a master class in healthcare industry strategy, such that those looking to do right by patients understand the dynamics well enough to succeed. This also echoed a review from February of this year that said that Relentless Health Value distills complex healthcare issues into a highly intuitive and highly accessible narrative that helped the reviewer's Fortune 500 company get everybody in the C-suite the understanding needed to confidently make some pretty key healthcare-related decisions. Thanks so much to those of you who left a review for taking the time. As I have said on earlier shows, we really have a Relentless Tribe here working hard to make the healthcare industry in this country much more accountable to the patients that we serve. And you leaving a rating and a review might be the best thing that you can do if you're into helping us achieve our mission, because the ratings are so entwined with helping others find the show. If you consider yourself a listener who has gained value from this show and you haven't yet left a review or a rating, could I ask that you do me a favor and do so? If you don't know how to do that, there are instructions here for how to do so. *** In this healthcare podcast, I am talking with Al Lewis. Al has been on the show before. One thing I did not realize about Al is that he went to Harvard Law School. Today we are discussing using the Quizzify Consent Form in the emergency room. This Quizzify Consent Form quite simply gives patients convenient ways to remember the exact and specific words they need to write on any financial forms they are presented with and told to sign in the emergency room. These words negate a hospital system or ER staffing firm's claims that the patient agreed in a blanket statement to pay whatever they are charged. In the past (ie, before the surprise billing legislation that went into effect at the beginning of 2022), this Quizzify Consent Form helped prevent the old $11,000 COVID test somebody got in the emergency room or the million-dollar heart attack. For more on the legislation itself, listen to the show with Loren Adler (EP307). While it is far from perfect in a few respects, on the whole, the No Surprises Act is good for patients. It's been terribly bad news, however, for certain private equity–backed ER staffing organizations who used surprise billing as a business model, meaning specifically—and maybe there's others, but Team Health and Envision are certainly the big dogs here. This wasn't any sort of cloaked-in-the-shadows secret, by the way, as far as business models for these two entities. I recall one of them saying without equivocation that the No Surprises Act would be very detrimental to their business. And it turns out, they were right. Here's from Fierce Healthcare, quoting Moody's: “Envision ‘faces significant social risk' due to ‘significant negative publicity relating to the patients … receiving surprise medical bills' and will remain financially challenged by the No Surprises Act.” Moody's downgraded Envision's corporate debt, suggesting that they are at risk of going bankrupt over the next 12-18 months. To further attenuate my sympathies, both of these companies, Team Health and Envision, cut doctors' pay during the first COVID-19 wave while simultaneously spending millions on political ads to protect surprise billing practices. Anyway, sad … not sad. Getting back on track here, the good news in all of this is that patients don't have to worry about surprise bills either by private equity–backed entities or just your run-of-the-mill hospital down the street who, pre–No Surprises Act, were not opposed to a little surprise billing action of their own or not opposed enough to do anything about out-of-network docs sending these bills in a lot of cases. But the No Surprises Act doesn't make going to the ER a safe space from a financial standpoint for patients or their employers, and this is what I talk about today with Al Lewis. This whole conversation reminded me of something that David Contorno has said more than once: Every hospital bill, every physician bill is a surprise bill if the patient does not know ahead of time what the charges will be. You've listened to this podcast before and heard guest after guest talk about how payers … frankly not so good at negotiating with hospitals, most of whom have emergency rooms. (Listen to EP346 with Peter Hayes, for example.) If you're a patient and you go to the ER, you're gonna see this lack of great negotiating in all of its glory. So, for example, if a payer “negotiated” $10,000 for an emergency MRI or CT scan or some other test or service and the patient has cost sharing, yeah, that patient just got hit with a very, very big bill. Or the whole upcoding thing. This whole thing is what I talk about with Al Lewis today: post–No Surprises Act, what's happening in emergency rooms and how can we protect patients/members/employees from excessive financial toxicity that is still rampant when it comes to going to the emergency room in many cases. Al talks about how the employers can really help employees and members protect themselves from profiteering hospitals or physician staffing companies the patient doesn't even realize are gonna be sending bills. You can get and learn more about the Quizzify Consent Form as well as Quizzify's Doctor Visit PrepKits here. Another episode along these lines to listen to is EP328 with Marshall Allen. You can get the free version of the card by emailing al@quizzify.com. You can also connect with Al by emailing al@quizzify.com, visiting the Web site at quizzify.com, on LinkedIn, or on Twitter at @quizzify and @whynobodybeliev.   Al Lewis wears multiple hats, both professionally and also to cover his bald spot. Hat #1: Employee Health Literacy. He is the founder and “quizmeister-in-chief” of Quizzify, whose mission is to help companies teach their employees to utilize health care services appropriately, using a format best described as “Jeopardy meets Choosing Wisely meets Comedy Central.” Quizzify is the only vendor authorized to display the Harvard Medical School “Veritas” shield and has received excellent reviews from users. Quizzify is also well known for its ER Sticker Shock Prevent Consent, which has been endorsed by Dr. Marty Makary and Dave Chase, among others. It can be taped to an insurance card, used as a stand-alone card, or downloaded into your Apple or Google Wallet and will “pop up” when you enter an ER. It limits ER bills (both in- and out-of-network) to 2x Medicare, which is less than half of most “negotiated” rates. His quiz-specific background includes authorship of the best-selling Newsweek Presents the Ultimate Trivia Game, which Games magazine lauded as having the best questions of any trivia game; hosting two quiz shows on Boston network affiliates; and appearing on Jeopardy. Hat #2: Outcomes Measurement. As an author, his critically acclaimed category best-selling book on outcomes measurement, Why Nobody Believes the Numbers, chronicling and exposing the innumeracy of the health management field, was named digital health book of the year in Forbes. Cracking Health Costs, written in conjunction with Walmart alum Tom Emerick, was also a trade best seller. He was the cofounder of the World Health Care Congress's Validation Institute. His expertise in outcomes measurement got him named one of the unsung heroes changing healthcare forever. He graduated Phi Beta Kappa with honors from Harvard, where he taught economics as well. He also graduated from Harvard Law School, albeit with no honors that time—other than winning their annual trivia contest, of course. 06:34 What is the evolving problem around surprise bills? 07:08 What are the two issues with the No Surprises Act? 9:13 Why are ER bills in network still so high? 17:27 How does the Quizzify Consent Form work for patients with insurance who unexpectedly visit the hospital? 20:50 “They're basically saying, ‘We don't abide by federal law.' Good luck with that.” 22:20 “The better question is, why aren't other vendors copying it?” 23:56 How would Quizzify affect the hospital bottom line if employers start utilizing it as part of their employee healthcare? 27:35 Is there any potential downside to Quizzify? You can get the free version of the card by emailing al@quizzify.com. You can also connect with Al by emailing al@quizzify.com, visiting the Web site at quizzify.com, on LinkedIn, or on Twitter at @quizzify and @whynobodybeliev. @whynobodybeliev of @Quizzify discusses #erbilling and the #nosurprisesact on our #healthcarepodcast. #healthcare #podcast What is the evolving problem around surprise bills? @whynobodybeliev of @Quizzify discusses #erbilling and the #nosurprisesact on our #healthcarepodcast. #healthcare #podcast What are the two issues with the No Surprises Act? @whynobodybeliev of @Quizzify discusses #erbilling and the #nosurprisesact on our #healthcarepodcast. #healthcare #podcast Why are ER bills in network still so high? @whynobodybeliev of @Quizzify discusses #erbilling and the #nosurprisesact on our #healthcarepodcast. #healthcare #podcast How does the Quizzify Consent Form work for patients with insurance who unexpectedly visit the hospital? @whynobodybeliev of @Quizzify discusses #erbilling and the #nosurprisesact on our #healthcarepodcast. #healthcare #podcast “They're basically saying, ‘We don't abide by federal law.' Good luck with that.” @whynobodybeliev of @Quizzify discusses #erbilling and the #nosurprisesact on our #healthcarepodcast. #healthcare #podcast “The better question is, why aren't other vendors copying it?” @whynobodybeliev of @Quizzify discusses #erbilling and the #nosurprisesact on our #healthcarepodcast. #healthcare #podcast How would Quizzify affect the hospital bottom line if employers start utilizing it as part of their employee healthcare? @whynobodybeliev of @Quizzify discusses #erbilling and the #nosurprisesact on our #healthcarepodcast. #healthcare #podcast Is there any potential downside to Quizzify? @whynobodybeliev of @Quizzify discusses #erbilling and the #nosurprisesact on our #healthcarepodcast. #healthcare #podcast Recent past interviews: Click a guest's name for their latest RHV episode! Dan Mendelson, Wendell Potter, 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), Dr Mark Fendrick (Encore! EP308), Erik Davis and Autumn Yongchu (EP371), Erik Davis and Autumn Yongchu (EP370), Keith Hartman, Dr Aaron Mitchell (Encore! EP282), Stacey Richter (INBW34), Ashleigh Gunter, Doug Hetherington, Dr Kevin Schulman, Scott Haas    

So, let's put the last, I don't know, 300 episodes of Relentless Health Value into perspective here. The USA wastes about $1.5 trillion a year on some combination of paying way too much for low-value care, fraud, and waste—$1.5 trillion down the drain. As my guest, Dave Chase, says in this healthcare podcast, if this was a country, what we waste would be the 11th biggest GDP in the world. We could call it Healthcare-istan. Meanwhile, outcomes aren't anything to brag about on the world stage, and 41% of American adults have medical debt in this country. Also, all across the country, people making all kinds of healthcare decisions to save money that are clinically toxic. Financial toxicity is clinical toxicity, right? You know this already. You listen to this show. I just saw yet another study the other day—actually this one about cancer outcomes and how they are appreciably worse when patients are worried about how much money their treatment will cost. And a lot of people in this country—many people with a Part D plan, commercial insurance with big deductibles—there's a lot of people in this country who cannot afford tens of thousands of dollars in out-of-pocket spend every year. But let's change gears and talk about some good stuff, some inroads that are being made. Let's talk about Rosen Hotels for a moment. Rosen Hotels is a bright spot, for sure, in all of this. They are a leading indicator of what is possible. Rosen Hotels, which is a hotel chain in Florida, they saved over $450 million in healthcare costs and have healthier, happier employees. They spend 55% less per capita on health benefits despite having an employee population with significant health challenges. They saved so much money that Rosen was able to set up a scholarship fund so that not only kids of employees (and employees themselves) but also kids in the community can go to college. Turnover there is lower. Retention is higher. Employees are healthier. I mean, the ROI of a CEO and a CFO getting engaged and taking back control over their health benefits from third parties? It's huge. Check out this article about Rosen and also Dave Chase's TED Talk about Rosen.   My guest today, Dave Chase, says that what they did at Rosen Hotels was actually an inspiration for Health Rosetta, which is the organization that he founded to help employers take control of the out-of-control dysfunctional health benefits market in this country. Dave Chase says that the Health Rosetta community knows something that most don't (yet). Dave Chase has said that healthcare is fixed/fixable. He said that healthcare actually isn't expensive. Clinicians only receive $0.27 of every $1 that's ostensibly spent on healthcare. What is expensive is price gouging, profiteering, administrative bloat, fraud, and inappropriate treatment. And Dave Chase has also said that we're already investing more than enough money to not only fund world-class healthcare for everyone but also take all that money from Healthcare-istan and fund what drives 80% of health outcomes (ie, income, education, career opportunities, and clean air and water). There's so much money that is being wasted in healthcare. But all of this other stuff could be funded if we simply pay what we should be paying. (See Dave Chase's LinkedIn post to learn more about this.)   Health Rosetta currently has about five million lives stewarded through plans managed by their Health Rosetta advisors. That's probably another bright spot right there—five million lives. Another bright spot is the work of the Nuka System in Alaska. Listen to EP312 with Douglas Eby, MD, MPH, CPE. The Nuka System has won award after award for being one of the best health systems in the country, and it serves a challenging patient population for less money than most Medicaid plans.   So, here you have two entities, Rosen Hotels and the Nuka System, dealing with (on a good day) patient populations with multiple chronic conditions, high maternal mortality … At Rosen, 56% of their pregnancies are categorized as high risk, which not only has generational human consequences, of course, but is also a notorious budget-buster, as Dave Chase has said. There's substance abuse issues. These are patient populations who are doing appreciably better and cost far less than if they were covered by almost any other health plan in this country. Here's yet one more bright spot example company, and that's Pacific Steel. During our conversation, Dave Chase mentioned that the CFO of Pacific Steel said that when they went from spending $8 million in health benefits a year to spending under $3.5 million—basically cutting their healthcare costs in less than half—the CFO said that in order to make that same amount of net income, Pacific Steel would have had to raise their top-line sales revenue by 25% to 30%. So, okay … you're a CEO, and here's your choice to appease your shareholders or make your own bonus. Option A: Go out right now and figure out how to sell 30% more. Or Option B: Get your healthcare house in order, which may also improve retention if you do it right. To me, this doesn't seem like a head-scratcher. Two things that Dave Chase also brought up during our conversation that I thought were thought provoking. First, change is happening regionally and seems to adhere to the so-called “rule of three,” meaning that if three employers have worked with a qualified employee benefit consultant (EBC) and really fixed up their health benefits, then a cascade will start in that region. And secondly—and I never thought about this before—we spend over $4 trillion through various health plans (employer, ACA, Medicare, Medicaid), and yet have little to no objective mark of value for how good any given health plan is. The closest thing, as Dave Chase says, might be Medicare Advantage Star Ratings. To address this problem, Health Rosetta invested seven figures to build a Plan Grader™. This really helps employers make sure that the plan they put in place is a win-win the whole way around. You can learn more at healthrosetta.org or by emailing Dave at dave@healthrosetta.org.   Dave Chase leads the mission for Health Rosetta, which is to empower community-owned health plans (COHPs) with the vision of COHPs everywhere. Health Rosetta's purpose is creating and reinvesting the Health Rosetta Dividend (ie, redeploying the currently wasted $1.5 trillion in healthcare to a higher and better use—the social determinants of health such as income, better food, etc). Health Rosetta makes health plans local, organic, and sustainable transforming health plans from the number one driver of inflation, poverty, and bankruptcy to drivers of well-being and wealth. Health Rosetta ends the 30-year heist of stolen income from the working middle class. Health Rosetta plans have restored the American Dream for tens of thousands of people, giving them raises/bonuses and healthcare they can access without fear of bankruptcy. Individuals that had sky-high deductibles and co-pays no longer have that as a barrier (typically they are $0). School districts that once couldn't give teachers raises or had to have school levies to pay for music, art, and sports programs now have the funds (due to healthcare savings) to pay teachers more, have bigger class sizes, avoid cutting extracurricular programs, and more—all while giving teachers much better care outcomes. Health Rosetta's Plan Grader™ assesses the 40 most important attributes of a health plan “prescribing” proven strategies to transition into local, sustainable, world-class health plans. Health Rosetta community's transparency set a new industry standard and became the law of the land due to changes in laws that represent the largest change in employee health benefits since 1943. Through best-selling books, writing for various media outlets, TED Talk, and TV/film, Dave has reached over 10 million people with the goal of engaging, equipping, and empowering a broad grassroots movement designed to restore hope, health, and well-being to our communities. Dave received the Health Value Awards' Lifetime Achievement for Health Benefits Innovation at the World Health Care Congress. Prior to Health Rosetta, Dave cofounded Avado, which was acquired by and integrated into WebMD/Medscape, and founded Microsoft's $3-billion, 28,000-partner healthcare ecosystem. Outside of work, Dave coaches the next generation of leaders as a high school track and cross-country coach of state champion teams and individuals. Dave was a PAC-12 800 meter and 4×400 competitor. Most importantly, devotion to faith, family, and friends underpin a desire to be a servant leader to the five million lives (and growing) stewarded through the Health Rosetta community. 06:57 Why did Dave Chase start Health Rosetta? 07:42 EP312 with Douglas Eby, MD, MPH, CPE.07:51 How does Health Rosetta deem which health plans are succeeding? 11:07 What are the most important areas and factors for grading health plans? 11:22 EP365 with Scott Haas.11:38 “That $1.5 trillion of waste, how is that possible? Well, it's all codified in the contracts.” 12:18 “You can't manage what you can't measure.” 16:59 “What could be more disruptive than 30 years of wage gains stolen by the status quo health plans?” 17:39 “This is the last major area to modernize inside of corporate America.” 18:15 “This is not small dollars; there's a tremendous opportunity.” 19:04 “Go back to PBM. That's the first thing that starts to get at the care delivery side.” 21:52 “Can we even call it primary care if you can't get in to that doc for weeks?” 25:03 Where does Health Rosetta get their data to assess health plans? 27:00 Who are these self-insured employers, typically? 29:48 “3.5% [is] where the market flips.” 31:57 EP367 with Doug Hetherington.32:03 EP350 with Katy Talento.33:13 “We like to fetishize big in this country.” You can learn more at healthrosetta.org or by emailing Dave at dave@healthrosetta.org.   @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth Why did Dave Chase start Health Rosetta? @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth How does Health Rosetta deem which health plans are succeeding? @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth What are the most important areas and factors for grading health plans? @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth “That $1.5 trillion of waste, how is that possible? Well, it's all codified in the contracts.” @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth “You can't manage what you can't measure.” @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth “What could be more disruptive than 30 years of wage gains stolen by the status quo health plans?” @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth “This is the last major area to modernize inside of corporate America.” @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth “This is not small dollars; there's a tremendous opportunity.” @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth “Go back to PBM. That's the first thing that starts to get at the care delivery side.” @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth “Can we even call it primary care if you can't get in to that doc for weeks?” @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth Where does Health Rosetta get their data to assess health plans? @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth Who are these self-insured employers, typically? @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth “3.5% [is] where the market flips.” @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth “We like to fetishize big in this country.” @chasedave of @HealthRosetta discusses #healthplans in our #healthcarepodcast. #healthcare #podcast #digitalhealth   Recent past interviews: Click a guest's name for their latest RHV episode! Cora Opsahl (EP373), Cora Opsahl (EP372), Dr Mark Fendrick (Encore! EP308), Erik Davis and Autumn Yongchu (EP371), Erik Davis and Autumn Yongchu (EP370), Keith Hartman, Dr Aaron Mitchell (Encore! EP282), Stacey Richter (INBW34), Ashleigh Gunter, Doug Hetherington, Dr Kevin Schulman, Scott Haas, David Muhlestein, David Scheinker, Ali Ucar, Dr Carly Eckert, Jeb Dunkelberger (EP360), Dan O'Neill, Dr Wayne Jenkins, Liliana Petrova, Ge Bai, Nikhil Krishnan, Shawn Rhodes, Pramod John (EP353), Pramod John (EP352), Dr Eric Bricker, Katy Talento, Stacey Richter (INBW33)  

Health Care Plans: Get More for Less with Nelson Griswold | And so it continues…the disruption of just about everything in the way we do business, including how we attract and retain top talent. Offerings like video interviews, remote opportunities, and even full “work from home” positions are now common. These and other employee-centric modifications make a business more attractive to top talent. But in this high-stakes game of talent attraction, there is one offering that's been overlooked. And it's a valuable one…valuable to both employees and employers alike. So what is this valuable but overlooked offering? Your workplace health care plan. When it comes to health care plan, the old business model persists. And not surprisingly, it's a model that benefits the insurance companies. In a nutshell, you pay more and you get less. How much more? According to the Kaiser family foundation, premiums have tripled since 1999. Despite this increase in premiums, deductibles have gone up. And the levels of service have not gone up! So as an employer you're paying more, you're employees are paying more…and all for the same product. There's no ROI, and there's no other part of a business plan where this would be acceptable. But it's overlooked because, well, the health care industry is a behemoth and has long had the upper hand. But that changes when you find out there is an alternative to paying higher premiums and higher deductibles. And in this Business Impact Series episode, you get the insider's view of this alternative to old school health care benefits. We welcome Nelson Griswold. Nelson is a two-time bestselling author and the nationally recognized authority on delivering high-quality, affordable employer health care by disintermediating the insurance company. He's a columnist for Employee Benefit News magazine and chairman of the ASCEND conference that is disrupting employer health care. A dynamic keynote speaker, Nelson has spoken at every major industry conference, including the prestigious World Health Care Congress. Listen and learn: How your workplace health care plan repels the top talent you've worked so hard to attract The jaw-dropping truth behind the online physician directories The simple steps to take control of your workplace health care plan and control costs and quality Let's jump in to this eye-opening and empowering conversation with health care benefits visionary Nelson Griswold. BIO A two-time bestselling author, Nelson Griswold is the nationally recognized authority on delivering high-quality, affordable employer health care by disintermediating the insurance company. He's a columnist for Employee Benefit News magazine and chairman of the ASCEND conference that is disrupting employer health care. A dynamic keynote speaker, he has spoken at every major industry conference, including the prestigious World Health Care Congress. An adviser to business leaders, Nelson chairs the Employer Health Care Council of the C-Suite Network. A public policy expert in a previous career, he is committed to preventing a government takeover of health care in the U.S. Listen to part 2 of this conversation with Nelson Griswold in episode 52. ~~~~~~~~~~~~~~~ When you're ready to harness the benefits of High Performance Sleep™, clink the link below. You take this simple step, and we'll take care of the rest! For you: Find out your risk of Counterfeit Sleep®. Take the screening here: www.counterfeitsleep.com For your workplace: Bring the benefits of High Performance Sleep™ to your workplace! Learn more about high performance sleep™ and our sleep performance assessment in your workplace. Visit www.hipersleep.com ~~~~~~~~~~~~~~~

Health Care Plans: Get More for Less with Nelson Griswold | And so it continues…the disruption of just about everything in the way we do business, including how we attract and retain top talent. Offerings like video interviews, remote opportunities, and even full “work from home” positions are now common. These and other employee-centric modifications make a business more attractive to top talent.  But in this high-stakes game of talent attraction, there is one offering that's been overlooked. And it's a valuable one…valuable to both employees and employers alike. So what is this valuable but overlooked offering? Your workplace health care plan.  When it comes to health care plan, the old business model persists. And not surprisingly, it's a model that benefits the insurance companies. In a nutshell, you pay more and you get less. How much more? According to the Kaiser family foundation, premiums have tripled since 1999. Despite this increase in premiums, deductibles have gone up. And the levels of service have not gone up! So as an employer you're paying more, you're employees are paying more…and all for the same product. There's no ROI, and there's no other part of a business plan where this would be acceptable. But it's overlooked because, well, the health care industry is a behemoth and has long had the upper hand.  But that changes when you find out there is an alternative to paying higher premiums and higher deductibles. And in this Business Impact Series episode, you get the insider's view of this alternative to old school health care benefits. We welcome Nelson Griswold. Nelson is a two-time bestselling author and the nationally recognized authority on delivering high-quality, affordable employer health care by disintermediating the insurance company. He's a columnist for Employee Benefit News magazine and chairman of the ASCEND conference that is disrupting employer health care. A dynamic keynote speaker, Nelson has spoken at every major industry conference, including the prestigious World Health Care Congress. Listen and learn: How your workplace health care plan repels the top talent you've worked so hard to attract The jaw-dropping truth behind the online physician directories The simple steps to take control of your workplace health care plan and control costs and quality Let's jump in to this eye-opening and empowering conversation with health care benefits visionary Nelson Griswold. BIO A two-time bestselling author, Nelson Griswold is the nationally recognized authority on delivering high-quality, affordable employer health care by disintermediating the insurance company. He's a columnist for Employee Benefit News magazine and chairman of the ASCEND conference that is disrupting employer health care. A dynamic keynote speaker, he has spoken at every major industry conference, including the prestigious World Health Care Congress. An adviser to business leaders, Nelson chairs the Employer Health Care Council of the C-Suite Network. A public policy expert in a previous career, he is committed to preventing a government takeover of health care in the U.S. Listen to part 2 of this conversation with Nelson Griswold in episode 52. ~~~~~~~~~~~~~~~ When you're ready to harness the benefits of High Performance Sleep™, clink the link below. You take this simple step, and we'll take care of the rest! For you: Find out your risk of Counterfeit Sleep®. Take the screening here: www.counterfeitsleep.com For your workplace: Bring the benefits of High Performance Sleep™ to your workplace! Learn more about high performance sleep™ and our sleep performance assessment in your workplace. Visit www.hipersleep.com  ~~~~~~~~~~~~~~~ Learn more about your ad choices. Visit megaphone.fm/adchoices

My guest in this health care podcast, Al Lewis, was telling me before we hit record that employer customers are vastly worse at evaluating wellness and point-solution vendors today than they ever have been in the past. Let's break this down. One aspect leading up to the “worse than ever” is the proliferation of point-solutions lately and all the PE (private equity) dollars flowing into the health care space. You pick up any rock and you'll find 25 health care startups underneath it. A second aspect is this: and this is not going to be a newsflash for many, but employers really trust their brokers and their EBCs (employee benefit consultants) to put together a good benefit package on their behalf. If an EBC says, “buy it,” employers click their heels and buy it a lot of times. And with that great power comes great... opportunity. We see an uptick in brokers and employee benefit consultants, enjoying themselves a little arbitrage-ish money grab by taking money from these startups/vendors under a variety of umbrellas while at the same time they call the employers their customers. This is especially profitable and also slimy when done under the cover of darkness because, as with so many aspects of health care, these backroom deals often happen without the employer customer knowing that there's a vig involved in the recommendation process. Al Lewis says he works in the “Integrity Segment” of the market. He is well known for outing vendors for basically lies they tell in their marketing. The thing is though, if a vendor comes to Al and asks questions about how to do it right, Al is always happy to help. He has said that he wants people to learn and if you're asking questions, it means you're interested in learning. Al has been on the show before, actually multiple times, but one full episode was episode 245, and we dig into wellness that's done “to” employees, not “for” them in that episode. So, check that out after you listen to this one, if you want more Al. Al also founded the Validation Institute and he's also CEO over at Quizzify. On the show in this health care podcast, Al explains the six major logical fallacies, computational flaws, tricks, if you will, that wellness vendors or point-solution vendors may deploy to inflate their “proven cost savings.” The six “watch outs” I'd guess I say for employers are: Regression to the mean Participants vs nonparticipants or matched controls or propensity scoring The trend inflation trick Plausibility testing Actuaries and validation Overstating engagement These six things are all of the different logical fallacies some vendors employ in order to overstate their results or outcomes. The Validation Institute has a PDF write up of each of these flaws which you can find in the show notes. Bottom line? Buyer Beware. And, also, get a broker or an EBC who you know for a fact they're working for you if you're an employer because they've committed in writing to not taking payola from the vendors that they're recommending to you. One footnote is that if you haven't listened to episode 329 with Joe Connolly you might want to go back and do so. Joe gets into the trend of some services who could, potentially, start taking on risk. Said another way, if services like these create their own bundles of point solutions and take on the risk of offering said bundle to employers, that could be nice. You can learn more at the Validation Institute. You can connect with Al by emailing al@quizzify.com, visiting the website at quizzify.com, on LinkedIn, or on Twitter at @quizzify and @whynobodybeliev.  Al Lewis wears multiple hats, both professionally and also to cover his bald spot. Hat #1: Employee Health Literacy. He is the founder and “quizmeister-in-chief” of Quizzify, whose mission is to help companies teach their employees to utilize health care services appropriately, using a format best described as “Jeopardy meets Choosing Wisely meets Comedy Central.” Quizzify is the only vendor authorized to display the Harvard Medical School “Veritas” shield and has received excellent reviews from users. Quizzify is also well known for its surprise billing “Prevent Consent” solution, which was recently featured in the New York Times. It can be taped to an insurance card, used as a stand-alone card, or downloaded into your Apple Wallet. Starting in 2022, use of this language prevents forced arbitration under the Surprise Billing Act and instead allows payment of 2x Medicare for non-elective care.  His quiz-specific background includes authorship of the best-selling Newsweek Presents the Ultimate Trivia Game, which Games magazine lauded as having the best questions of any trivia game; hosting two quiz shows on Boston network affiliates; and appearing on Jeopardy. Hat #2: Outcomes Measurement. As an author, his critically acclaimed category best-selling book on outcomes measurement, Why Nobody Believes the Numbers, chronicling and exposing the innumeracy of the health management field, was named digital health book of the year in Forbes. Cracking Health Costs, written in conjunction with Walmart alum Tom Emerick, was also a trade best seller. He was the cofounder of the World Health Care Congress's Validation Institute. His expertise in outcomes measurement got him named one of the unsung heroes changing health care forever.  He graduated Phi Beta Kappa with honors from Harvard, where he taught economics as well. He also graduated from Harvard Law School, albeit with no honors that time—other than winning their annual trivia contest, of course. 04:49 Are brokers going to have to become more transparent about where their money is coming from? 07:33 Are carriers transparent? 08:09 What's the goal of the Validation Institute? 08:55 “You either get a true statement put up or learn what you have to do in order to get a true statement put up.” 11:18 How is Regression to the Mean (RTM) used in a flawed way? 16:32 “If you do wellness for employees instead of to employees, the people who want the wellness will be able to access it.” 21:13 What is plausibility testing? 23:17 What about actuaries and validation? 23:40 “That's one of the reasons the Validation Institute exists, is because actuaries are easily corrupted.” 25:18 What is a prime example of population health economics? 26:20 What does it mean to overstate engagement? 27:15 “How often did you use this and was it useful?” 28:55 “Are you validated by the Validation Institute, and if not, why not?” You can learn more at the Validation Institute. You can connect with Al by emailing al@quizzify.com, visiting the website at quizzify.com, on LinkedIn, or on Twitter at @quizzify and @whynobodybeliev.  @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth Are brokers going to have to become more transparent about where their money is coming from? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth Are carriers transparent? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth What's the goal of the Validation Institute? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth “You either get a true statement put up or learn what you have to do in order to get a true statement put up.” @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth How is Regression to the Mean (RTM) used in a flawed way? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth “If you do wellness for employees instead of to employees, the people who want the wellness will be able to access it.” @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth What is plausibility testing? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth What about actuaries and validation? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth “That's one of the reasons the Validation Institute exists, is because actuaries are easily corrupted.” @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth What is a prime example of population health economics? @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth “How often did you use this and was it useful?” @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth “Are you validated by the Validation Institute, and if not, why not?” @whynobodybeliev of @quizzify discusses #wellnessvendors and #pointsolutionvendors on our #healthcarepodcast. #healthcare #podcast #employerhealthcare #digitalhealth

In this episode of the Perspectives podcast, sponsored by Artemis Health and hosted on BenefitsPRO, we’ll hear highlights from the April 14th presentation titled, Create holistic benefits strategies: Tips for partnering with the C-Suite and HR. As businesses shift the way they view benefits in light of the past year, CFOs and other members of the C-suite continue to become more involved in benefits decision-making. This emerging trend is good news for advisors who are prepared to take advantage of it. Engaging with more decision makers presents opportunities for education and innovation, but also requires data and transparency to generate buy-in and create more impactful plans. The panelists — Steve Watson, CFO & CHRO at Trendbreakers; Kim Eckelbarger, Founder of Tropical Benefits; James Froschmayer, Director of Product Analytics at Artemis Health; and Paul Wilson, Editor-In-Chief of BenefitsPro — discuss why companies that have a more engaged C-suite tend to be more progressive in managing their benefits plans, as well as how to leverage benefits analytics to identify opportunities, and much more.  The full on-demand webcast can be found here: https://www.benefitspro.com/2021/03/10/partnering-with-the-c-suite-and-hr-to-create-holistic-benefits-strategies/ Steve Watson, CPA, SHRM-SCP |CFO & CHRO | Trendbreakers Steve Watson has a diverse background and a lot of titles that can be put after his name – CEO, CFO, CHRO, and CPA. It could be intimidating, until you meet him. Rather than riding the wave and seeking ever more important positions, Steve looks for ways to give back. He grew up on a sheep farm in Utah, earned his degree in business and international finance at BYU, got married, worked in accounting, and at the age of 26, moved to Brazil and took a job as finance director for a publicly traded company. Five years later, in 2009, he moved his growing family back to the U.S and took a position as a CFO at a mid-sized social work company in Phoenix, Arizona. It wasn’t long before they asked him to take on the role of Chief Human Resources Officer (CHRO). All the different titles he wears could be confusing, but Steve has found a unique way to put them all together and complement each other. This is especially true in his role as CEO of TrendBreakers, a consulting business where his extensive knowledge and skills meet to help other companies break the trend of rising healthcare costs. He is also a nationally known speaker, hosts a podcast three times each week, is a married father of seven, and is bilingual in Portuguese. Kim Eckelbarger | Founder | Tropical Benefits Kim participated in the NextGen Benefits Mastermind Partnership, as well as Health Rosetta and serves as Founder & President of Tropical Benefits in the Tampa/St. Petersburg area.She has been profiled in Employee Benefit Adviser (EBA) magazine and was the cover story in their August 2018 edition. Kim was named “NextGen Benefits Adviser of the Year” at the 2019 ASCEND conference. Kim has been invited to share learned expertise at prestigious industry conferences, including the Workplace Benefits conference, the BenefitsPRO Broker Expo and the World Health Care Congress 2019. Kim is a co-author of the Amazon bestselling book, Breaking Through the Status Quo, which outlines some of the cutting-edge strategies she and other NextGen Benefits Advisers are using to control and lower healthcare costs.She is an early adopter of innovative strategies, including Healthcare Abroad, Direct Primary Care, Second Opinions, and RBP, and has implemented these employer solutions with successful outcomes. Her clients outcomes have been published in industry specific publications and the outcomes are accomplished with data and transparency. James Froschmayer | Director of Product Analytics | Artemis Health As a Director of Product Analytics, James Froschmayer works with product management, user experience, and health analytics experts to meet the needs of benefits teams today and anticipate their needs in the future. James is responsible for developing leading-edge analytic methodologies embedded within the Artemis reporting system. He also performs analyses and supports clients in the implementation of their integrated health, attendance and disability management programs. Having come from the consulting world, James has seen the landscape of employee benefits become increasingly complex. As an analytics expert, he helps self-insured employers to identify opportunities within their data to manage costs, improve program value, and boost employee health and well-being. James is passionate and committed to using industry best practices and technologies to improve the healthcare system from both the patient, provider, and payer perspectives. Paul Wilson | Editor-In-Chief | BenefitPro | Webcast Moderator Paul Wilson is the editor-in-chief of BenefitsPRO Magazine and BenefitsPRO.com. He has covered the insurance industry for more than a decade, including stints at Retirement Advisor Magazine and ProducersWeb.

Dave Chase leads the vision for Health Rosetta which is to empower community-owned health plans. Health Rosetta’s blueprint and platform powers the health plans of your dreams: high quality, trustworthy, local, affordable care -- that you thought had disappeared forever -- from caregivers we know & trust. We free up compassionate, well-trained, community-based caregivers to rediscover love in medicine so they can do what they have always been called to do: serve their patients not just in disease, but toward their fullest health. A trusted & sacred caregiver-patient bond is built through transparency & openness that equips and empowers patients wherever they can best achieve their unique health goals -- at home or any setting best optimizing their well-being. By avoiding the 50% wasted healthcare spending, we can ensure our caregivers have the independence & resources to address the psychosocial and medical issues their patients face. Human-centered health plans restore health, hope & well-being. Through best-selling books & The Resident (on FOX), where Chase serves as a consultant, collateral damage from the Extractive Era of healthcare is highlighted as well as the tremendous successes & opportunities with Health Rosetta-type health plans. The books, writing for various media outlets, TED talk, and TV/film have reached over 10 million people with the goal of informing, enraging, empowering, and activating a broad grassroots movement designed to restore hope, health & well-being to our communities. Chase received the Health Value Awards' Lifetime Achievement for Health Benefits Innovation at the 2020 World Health Care Congress. EXTRA: Rx for Success Podcast listeners can attend the Health Rosetta Summit: Community Dividends, for FREE as Dave's guests! Feb 24, 6:30PM to Feb 26, 6:00PM EST Use this link and scroll to "Health Rosetta Invited Guests" to register... https://rxforsuccesspodcast.com/summit Show notes at https://rxforsuccesspodcast.com/39 Report-out with comments or feedback at https://rxforsuccesspodcast.com/report  

Friends,Our topic this episode may be one of the most misunderstood and challenging issues in healthcare delivery - with significant potential for lowering costs and improving outcomes. The topic is employer-based healthcare; and as many of you know, employers pay for 50% of all the healthcare costs in the US.Escalating healthcare costs over the past few decades have imposed a major strain on corporate America and its employees. The Kaiser Family Foundation reported that in 2018, employers paid approximately $20,000 per year for healthcare for a family of four, $6000 of which the employee paid. They also reported that since 2006, employee healthcare premiums have risen twice as fast as wages. As a result, Corporate America has been increasingly focused on right-sizing healthcare costs - from Apple and Amazon launching their own employee primary care; to Walmart providing ‘centers of excellence’ to its employees; to companies such as Comcast who have partnered with vendors to put alternative healthcare solutions in place for its employees. But, the situation is challenging, as evidenced by the recently failed attempt of Haven, an employer-based healthcare initiative launched by JP Morgan, Berkshire Hathaway and Amazon. It’s a complex ecosystem involving employer-based HR & health benefits managers, employer benefit brokers & benefits consulting companies, insurance companies, provider groups & hospital systems, direct to employer providers, and collaboratives such as the Business Group on Health.Our guest this week is a passionate expert who has a discerning handle on the ecosystem, the fundamental problems, and the proven solutions in employee-based healthcare. Dave Chase founded & leads Health Rosetta, whose goal is to empower community-owned health plans. Health Rosetta has created a blueprint and platform that empowers health plans to deliver high quality, affordable care. Dave has authored a number of insightful books including The CEO's Guide to Restoring the American Dream: How to deliver world class healthcare to your employees at half the cost. He received the Health Value Awards' Lifetime Achievement for Health Benefits Innovation at the 2020 World Health Care Congress. Prior to this work, Dave Chase co-founded Avado which was acquired by and integrated into WebMD/Medscape.  He also founded Microsoft's $2B, 28,000 partner healthcare ecosystem.In this episode, we’ll cover:Dave’s unique perspective on the fundamental problems in the American healthcare system.What Dave describes as epidemic healthcare ‘financial toxicities’ and ‘financial comorbidities’, which is denying the American dream to the majority of employees.Five major solutions that employers can leverage to reset and radically improve their employee health benefits plans. Examples of employers who have saved a significant and sustained percentage of their healthcare costs while improving healthcare outcomes for their employees.Dave makes some amazing claims in terms of dramatically lowering healthcare costs for employers and employees; and he’s got numerous examples to support those claims. There is no question that the solutions he proposes are disruptive to the status quo. But, rather than view them as disruptive, we can learn from these successful models and deploy the proven blueprints that he and his colleagues at Health Rosetta have catalogued and created. One thing is abundantly clear.  The American healthcare system is not working for the vast majority of employed Americans. Dave’s facts and statistics are disturbing. What he reveals is that escalating healthcare costs are levying a hidden tax that is destroying the economic health and well-being of working American families. It’s a striking reframing of the problem that makes it very personal and very real. Once we understand this, one wonders why more employers aren’t adopting the tools and techniques that Dave and his colleagues at Health Rosetta outline so clearly. Until next time, be safe and be well.Zeev Neuwirth, MD

In this episode, we explore what is going on with our health care system. Increasing costs. Hidden prices. Frustrated patients and providers. We discuss the possibility that health care costs are stealing away the American dream. Our guest is Dave Chase. Dave leads the vision for Health Rosetta -which is to empower community-owned health plans. We have five mantras from the show: Mantra #1: Get empowered as a consumer in this irrational and overwhelming healthcare industry. Mantra #2: Consider cash pay for medical procedures as the cost may be less than going through insurance. Mantra #3: Employers can get better results for lower prices by working with the right advisors. Mantra #4: Don’t pay cadillac prices for a “pinto” product/service. Mantra #5: Go LOCAL: Learn how to be liberated from the status quo Optimize health plan infrastructure Carve our Pharmacy Benefit Manager (PBM) Add value-based primary care Leave behind value extracting PPO networks Interesting data points from the interview: 1. Healthcare itself isn't expensive (clinicians only receive $0.27 of every $1 ostensibly spent on healthcare). What's expensive is profiteering, price-gouging, and misaligned incentives 2. Business owners can spend 20-40% of current spending on health benefits and get superior health outcomes by following a more “grassroots” approach (see LOCAL, above). 3. COVID-19 is accelerating the process of health being relocalized, similar to how the local/healthy food movement greatly improved the health of families and the livelihoods of farmers. More about Dave Chase Chase leads the vision for Health Rosetta which is to empower community-owned health plans. Health Rosetta’s blueprint and platform powers the health plans of your dreams: high quality, trustworthy, local, affordable care -- that you thought had disappeared forever -- from caregivers we know & trust. We free up compassionate, well-trained, community-based caregivers to rediscover love in medicine so they can do what they have always been called to do: serve their patients not just in disease, but toward their fullest health. A trusted & sacred caregiver-patient bond is built through transparency & openness that equips and empowers patients wherever they can best achieve their unique health goals -- at home or any setting best optimizing their well-being. By avoiding the 50% wasted healthcare spending, we can ensure our caregivers have the independence & resources to address the psychosocial and medical issues their patients face. Human-centered health plans restore health, hope & well-being. Through best-selling books & The Resident (on FOX), where Chase serves as a consultant, collateral damage from the Extractive Era of healthcare is highlighted as well as the tremendous successes & opportunities with Health Rosetta-type health plans. The books, writing for various media outlets, TED talk and TV/film have reached over 10 million people with the goal of informing, enraging, empowering and activating a broad grassroots movement designed to restore hope, health & well-being to our communities. Chase received the Health Value Awards' Lifetime Achievement for Health Benefits Innovation at the 2020 World Health Care Congress. Chase co-founded Avado which was acquired by & integrated into WebMD/Medscape and founded Microsoft's $2B, 28,000 partner healthcare ecosystem. Outside of work, Chase is an oxygen-fueled mountain athlete and volunteer high school track & cross country coach. Once upon a time, Chase was a PAC-12 800 Meter & 4x400 competitor. Most importantly, devotion to faith, family and friends underpin a desire to be a servant leader to the 4 million lives (& growing) stewarded through the Health Rosetta community. LINKS www.healthrosetta.org (please see Dave’s books at the site) Twitter: @chasedave

David Berg is the President and Co-Founder of Redirect Health, a company that uses unique healthcare strategies and affordable plans to help businesses attract and retain the employees they need.  With over 20 years of healthcare leadership experience, David Berg is committed to helping everyone have meaningful access to easy and truly affordable healthcare on their terms. David was a finalist for three Best-in-Class awards at the 2018 World Health Care Congress in Washington DC, as well as the winner of the Phoenix Business Journal 2017 Health Care Innovator Award. He is also the best-selling author of The Business Owner’s Guide to Fighting Healthcare. In this episode… With over 50% of Americans making only $15 an hour, the healthcare system as we know it is overpriced and overcomplicated. But does it have to be?  According to healthcare leader David Berg, we could eliminate as much as 40% of healthcare costs just by removing copays. The result: a more affordable and efficient system that benefits everyone. With this in mind, David founded Redirect Health, a company that has transformed the healthcare system with the idea that everyone should have meaningful access to easy and affordable healthcare.  In this episode of The Growth to Freedom Podcast, host Dan Kuschell interviews David Berg, President and Co-Founder of Redirect Health, about how he used his business mind and efficiency-first perspective to transform the healthcare system. Keep listening as David talks about why the concept of laziness isn’t always a bad thing, how to navigate our economy of fear, and the importance of always making your own decisions.

In this health care podcast, I’m talking to Al Lewis from Quizzify. This episode also guest stars Rachel Miner from Thrive Benefits, David Contorno from E Powered Benefits, and Doug Aldeen, a health care attorney in Texas. This episode started out being about surprise billing in the emergency room (ER) and a potential defense strategy that patients and employees can use to protect themselves from egregious billing practices. Surprise bills are when a patient gets “balance billed” for a sum above what their insurance carrier will pay. Usually this transpires when an out-of-network provider somehow or another gets involved in their care. Usually the patient has no idea this happens until after the bill comes—the big bill, in many cases, thus the surprise. But here’s where surprise billing and COVID-19 connect. You might not have thought of this because you might know that patients who present in the ER with COVID-19 and then test positive are protected from surprise bills, for the most part, by the CARES Act. But there’s a couple of wrinkles. What if the patient does not actually have COVID-19? Then whatever treatment they wind up getting in the notoriously expensive ER is business as usual. Here’s another wrinkle: The cost of treatment for COVID-19 is not like it’s capped. So even if an employee doesn’t get a surprise bill, the self-insured employer or health plan might. And the CARES Act explicitly states that the employer or plan is on the hook to pay for it. And one last wrinkle: Dealing with this pandemic among other things leaves about 0.0 chance that the national surprise billing legislation is gonna happen this year. But it’s not like kids have stopped running into the side of the pull-out couch and needing stitches, or drug overdoses or heart attacks have suddenly vanished. There was a news article just the other day about a private equity–run ER in the Midwest continuing to dish out nasty surprise bills to their community of taxpayers at the exact same time that they were lobbying to get a piece of the federal bailout paid by taxpayers. Al Lewis and his team over at Quizzify created this handy wallet card that patients or employees can use when they have the unfortunate experience of going to the ER themselves or with a loved one. It protects them from egregious surprise bills, thus its moniker, the surprise billing defense strategy. But nothing for nothing, this wallet card, this surprise billing defense strategy, also protects employers and health plans from these large bills in the age of COVID-19.  Al Lewis and I start our conversation talking about a New York Times article (also available here for those who don’t subscribe to the New York Times) that came out recently featuring Al as well as myself and chronicles my visit to an emergency room wherein I deployed the surprise billing defense strategy/wallet card.  You can learn more at quizzify.com or connect with Al on LinkedIn. You can also connect with Al on Twitter at @quizzify and @whynobodybeliev.   You can also connect with Rachel and David on LinkedIn and with Doug on Twitter at @AldeenDoug and on LinkedIn.  Al Lewis wears multiple hats, both professionally and also to cover his bald spot. Hat #1: Employee Health Literacy. He is the founder and “quizmeister-in-chief” of Quizzify, whose mission is to help companies teach their employees to utilize health care services appropriately, using a format best described as “Jeopardy meets health benefit education meets Comedy Central.” Quizzify is the only vendor authorized to display the Harvard Medical School “Veritas” shield and has received excellent reviews from users.  Quizzify is best known today for its employee coronaquizzes (now exceeding 100,000 plays!) and its surprise billing “Prevent Consent” solution, which was recently featured in the New York Times. It can be taped to an insurance card, used as a stand-alone card, or downloaded into your Apple Wallet.  His quiz-specific background includes authorship of the best-selling Newsweek Presents the Ultimate Trivia Game, which Games magazine lauded as having the best questions of any trivia game; hosting two quiz shows on Boston network affiliates; and appearing on Jeopardy. Hat #2: Outcomes Measurement. As an author, his critically acclaimed category best-selling book on outcomes measurement, Why Nobody Believes the Numbers, chronicling and exposing the innumeracy of the health management field, was named digital health book of the year in Forbes. Cracking Health Costs, written in conjunction with Walmart alum Tom Emerick, was also a trade best seller. Surviving Workplace Wellness has also received great accolades, and excerpts appeared in Harvard Business Review and elsewhere.  He was the cofounder of the World Health Care Congress’s Validation Institute.  His expertise in outcomes measurement got him named one of the unsung heroes changing health care forever.  He graduated Phi Beta Kappa with honors from Harvard, where he taught economics as well. He also graduated from Harvard Law School, albeit with no honors that time—other than winning their annual trivia contest, of course. David Contorno is founder of E Powered Benefits. As a native of New York, David began his career in the insurance industry at the age of 14 and has since become a leading expert in the realm of employee benefits over the last 22 years. Most recently, David was Benefits Selling magazine’s 2015 Broker of the Year; and in March 2016, Forbes deemed him “One of America’s Most Innovative Benefits Leaders.” David is a member of the board of directors for both the Charlotte Association of Health Underwriters and HealthReach Community Clinic. He served on the NC Insurance Commissioners Life and Health Agent Advisory Committee, as well as participated in the Technical Advisory Group that helped with the market reforms required under the Affordable Care Act in North Carolina. He is a longtime member of the Lake Norman and South Iredell Chambers of Commerce as well as the National, North Carolina, New York, and Long Island Associations of Health Underwriters. David contributes to numerous publications, including Forbes, Benefits Selling magazine, Business Leader magazine, and Insurance Thought Leadership. David is committed to giving back to his community and actively participates in the membership drive for the United Way, assisting the local chapter of Habitat for Humanity, and supporting The Dove House Child Advocacy Center. When he is not working, he enjoys boating, traveling, and being with his wife, Heather, and their two children, Hannah and Ethan. Rachel Miner became engaged with the health care system seven years ago as her son, Jackson, was consistently ill. Her frustration with the complexity of the health care system and expensive bills made her think about how helpless employees must feel. So, she set out to find a benefits firm that helped employees understand how to be educated consumers of health care year-round—and she didn’t find one. Thus, Thrive Benefits was born. Her mission is twofold: to help employers and employees. Rachel understands that companies need to have good benefits to attract and retain employees and makes it her mission to help employers save money so they can offer good benefits year over year. In addition, she helps employees to navigate the health care system so that they can have the highest quality of care at the lowest possible cost. Rachel says that her true passion is helping people and her purpose is to challenge the mindset of others so that they can overcome adversity, take risks, and achieve their goals. Health care is confusing, but it doesn’t have to be. For organizations to thrive, employees must thrive, too. Doug Aldeen is an Austin, Texas–based health care and Employee Retirement Income Security Act (ERISA) attorney who recently served as ERISA counsel on behalf of the Berkeley Research Group in New York City to the $7.7 billion May 2016 acquisition of Multiplan and its medical bill repricing product Data iSight by the private equity firm Hellman and Friedman. Since 1997, he has represented reference base pricing organizations, a bundled payment software platform, PPO networks, medium to small self-funded plans, third-party administrators, and provider-sponsored health maintenance organizations in various capacities, including Herdrich v. Pegram, which was argued before the US Supreme Court in 2001. Moreover, he serves as a resource to national news organizations regarding issues on health care and as a consultant with the Governmental Relations Committee at the Self-Insurance Institute of America in Washington, DC, and as an adviser to RIP Medical Debt, which has abolished over $1.2 billion in medical debt. Doug received his JD from the University of Illinois. 04:26 What is the likelihood of a surprise bill in the time of coronavirus? 07:41 What the surprise billing wallet card looks like and what it does when you use it.09:55 Rachel Miner’s experience with the Quizzify surprise billing wallet card. 14:42 EP249 with Dale Folwell.15:33 Should employers be advocating for the use of the Quizzify wallet card? 16:22 How an employer should get the wallet card out to their employees. 17:29 David Contorno explains the inspiration behind the Quizzify wallet card. 19:29 “Because of that federal law, you do not need to sign that financial consent.”—David 19:42 “Don’t obligate yourself financially to some unknown amount.”—David 19:56 The legal standard: a battlefield consent. 21:18 Negotiating vs not negotiating. 22:38 Why employers should care about surprise billing. 22:58 Best practices for employers educating employees on why this wallet card is important. 24:19 “This is not something your employer is doing to you; this is something your employer is doing for you.”—David 24:25 EP186 with David Contorno.27:19 Doug Aldeen on what happens after using the wallet card and then gets the balance bill. 30:47 What happens after you sign the financial contract after editing. 32:01 Asking for the director of revenue cycle management after getting your surprise bill. 36:36 “It’s not as daunting as people think.”—Doug 36:56 “The general rule … is that the more you do in advance, the better.”—Al 37:49 Why 2x Medicare is the sweet spot for reasonable price. 38:38 What employers should be doing right now to distribute these Quizzify wallet cards. You can learn more at quizzify.com or connect with Al on LinkedIn. You can also connect with Al on Twitter at @quizzify and @whynobodybeliev.   You can also connect with Rachel and David on LinkedIn and with Doug on Twitter at @AldeenDoug and on LinkedIn. Check out our #healthcarepodcast with @whynobodybeliev of @quizzify and featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling What is the likelihood of a #surprisebill in the time of #coronavirus? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling What does the #surprisebill #walletcard look like and what does it do? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling Should #employers be advocating for the use of the Quizzify wallet card? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling How should an #employer distribute the wallet card to his/her #employees? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling What was the inspiration behind the Quizzify wallet card? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling “Because of that federal law, you do not need to sign that financial consent.” @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling “Don’t obligate yourself financially to some unknown amount.” @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling What is battlefield consent? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling Negotiating vs not negotiating surprise bills. @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling Why should employers care about surprise bills? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling “This is not something your employer is doing to you; this is something your employer is doing for you.” @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling What happens when you use the Quizzify wallet card? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling “It’s not as daunting as people think.” @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling “The general rule … is that the more you do in advance, the better.” @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling Why is 2x the Medicare rate the sweet spot for reasonable price? @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling What employers should be doing right now. @whynobodybeliev of @quizzify discusses on our #healthcarepodcast featuring Rachel Miner of @BenefitsThrive, @dcontorno, and @AldeenDoug. #healthcare #podcast #digitalhealth #covid19 #surprisebilling

Let’s talk today specifically about primary care physicians (PCPs) and family medicine doctors. Data was reported in USA Today, saying that an estimated 60,000 family practices will close and 800,000 of their employees will lose their jobs by the end of June. It’s hard for any practice to just snap its fingers and transfer patients over to telemedicine regardless of the reimbursement rate and/or how many payers are actually paying any reimbursement for telemedicine or remote patient monitoring. It’s a thing to go virtual. It requires new processes, different staffing training, different workflows. Plus, a lot of what a PCP does (ie, fielding phone calls with quick questions, for example) aren’t reimbursable; and if they were, no one’s gonna, like, spend half an hour trying to send a bill for $12. What are the consequences of all, let’s just say, independent PCPs going out of business? Well … first, logically, all patients served by these doctors and their teams now no longer have a place to go to get care, right in the middle of a pandemic. Second, let’s just say in a thought experiment that a lot of independent physicians do go out of business and do wind up going to work in an employed model. That might very well happen. Private equity and payers like Humana and Optum have been buying up PCP practices all over the place. Why? So they can have captive populations. Patients come in the door at their PCP, and everywhere they go from there can be controlled by the vertically integrated entity. This has been stated openly. It’s also pretty clear at this point that that model increases costs for any ultimate purchaser of health care like, for example, an employer. There’s also other, let’s just say, more unseemly motivations if you start to think about what a company who owns patient relationships with their PCPs can manage to perpetuate. It’s great if you’re a shareholder. It might be less great if you’re a citizen of this country. In this health care podcast, I speak with Dave Chase, cofounder and CEO of Health Rosetta. Health Rosetta empowers community-owned health plans like, for example, employers and states’ and town governments. Dave talks about Health Rosetta’s Marshall Plan, which is an action plan right now to minimize the negative impact of COVID-19 by ensuring that family and primary care practices can stay in business. The Marshall Plan is a call to action for self-insured employers and commercial health plans. You can learn more about the Marshall Plan at healthrosetta.org/marshallplan. You can also connect with Dave on Twitter at @chasedave and follow Health Rosetta at @HealthRosetta.  Dave Chase leads the vision for Health Rosetta, which is to empower community-owned health plans. Health Rosetta’s blueprint and platform power the health plans of your dreams: high-quality, trustworthy, local, affordable care—that you thought had disappeared forever—from caregivers we know and trust. They free up compassionate, well-trained, community-based caregivers to rediscover love in medicine so they can do what they have always been called to do: serve their patients not just in disease but toward their fullest health. A trusted and sacred caregiver-patient bond is built through transparency and openness that equips and empowers patients wherever they can best achieve their unique health goals—at home or any setting best optimizing their well-being. By avoiding the 50% wasted health care spending, we can ensure our caregivers have the independence and resources to address the psychosocial and medical issues their patients face. Human-centered health plans restore health, hope, and well-being. Through best-selling books and The Resident (on FOX), where Dave serves as a consultant, collateral damage from the Extractive Era of health care is highlighted as well as the tremendous successes and opportunities with Health Rosetta–type health plans. The books, writing for various media outlets, TED Talk, and TV/film have reached over 10 million people, with the goal of informing, enraging, empowering, and activating a broad grassroots movement designed to restore hope, health, and well-being to our communities. Dave proudly received the Health Value Awards’ Lifetime Achievement for Health Benefits Innovation at the 2020 World Health Care Congress. Dave cofounded Avado, which was acquired by and integrated into WebMD/Medscape, and founded Microsoft’s $2 billion, 28,000-partner health care ecosystem. Outside of work, Dave Chase is an oxygen-fueled mountain athlete and volunteer high school track and cross-country coach. Once upon a time, Dave was a PAC-12 800 meter and 4x400 competitor. Most importantly, his devotion to faith, family, and friends underpins a desire to be a servant leader to the four million lives (and growing) stewarded through the Health Rosetta community. 03:15 The state of independent fee-for-service PCPs during COVID-19. 03:57 CMS and telehealth, and why these aren’t really aiding PCP revenue. 05:52 Worst-case scenario of where COVID-19 is going to leave our PCPs. 06:58 Looking to Optum’s PCPs and what’s happening there. 08:46 “There’s a biological virus that’s running rampant in our country, but there’s been a metaphorical virus running through our health care system.” 09:33 The incredibly fast transition to digital health because of COVID-19. 10:56 CMS’s prospective payment model. 14:43 “In my view, we are not returning to normal.” 15:21 Dave’s call to action for saving PCPs during COVID-19. 22:07 Dave’s advice for what PCPs should be doing right now. 24:01 “Here’s the egg; crack it open.” You can learn more about the Marshall Plan at healthrosetta.org/marshallplan. You can also connect with Dave on Twitter at @chasedave and follow Health Rosetta at @HealthRosetta.  Check out our newest #healthcarepodcast with @chasedave of @HealthRosetta. #healthcare #podcast #digitalhealth #PCP #covid19 #coronavirus What is the state of independent fee-for-service #PCPs right now? @chasedave of @HealthRosetta discusses on our #healthcarepodcast. #healthcare #podcast #digitalhealth #ffs #PCP #covid19 #coronavirus Why isn’t #telehealth really aiding revenue for #PCPs? @chasedave of @HealthRosetta discusses on our #healthcarepodcast. #healthcare #podcast #digitalhealth #PCP #covid19 #coronavirus What is the worst-case scenario of where this #pandemic is leading our #PCPs? @chasedave of @HealthRosetta discusses on our #healthcarepodcast. #healthcare #podcast #digitalhealth #PCP #covid19 #coronavirus “There’s a biological virus that’s running rampant in our country, but there’s been a metaphorical virus running through our health care system.” @chasedave of @HealthRosetta discusses on our #healthcarepodcast. #healthcare #podcast #digitalhealth #PCP #covid19 #coronavirus What is the fast transition to digital health looking like for #PCPs? @chasedave of @HealthRosetta discusses on our #healthcarepodcast. #healthcare #podcast #digitalhealth #PCP #covid19 #coronavirus #CMS’s prospective payment model, and what this means for #PCPs. @chasedave of @HealthRosetta discusses on our #healthcarepodcast. #healthcare #podcast #digitalhealth #PCP #covid19 #coronavirus “In my view, we are not returning to normal.” @chasedave of @HealthRosetta discusses on our #healthcarepodcast. #healthcare #podcast #digitalhealth #PCP #covid19 #coronavirus What should #PCPs be doing right now? @chasedave of @HealthRosetta discusses on our #healthcarepodcast. #healthcare #podcast #digitalhealth #PCP #covid19 #coronavirus “Here’s the egg; crack it open.” @chasedave of @HealthRosetta discusses on our #healthcarepodcast. #healthcare #podcast #digitalhealth #PCP #covid19 #coronavirus

On Friday, March 27, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security Act—otherwise known as CARES. This CARES Act covers the whole $2 trillion megillah stimulus package, but in this health care podcast episode, we’re talking quickly about a provision in that Act. I speak first with Doug Aldeen, an attorney specializing in helping employers settle hospital bills. Doug works with clients across the country. And then at the end of the episode, you will also hear from Al Lewis, who is a founder over at Quizzify. Al Lewis, as many of you may or may not know—but if you don’t know, you should—created a “surprise billing wallet card” that is actually super relevant to this discussion as you will see. There’s actually going to be a whole surprise billing episode coming up soon where we discuss this wallet card, so you can consider Al’s short commentary today as kind of a coming attraction. The provision that we’re going to talk about in this episode is the No Cost Sharing for COVID-19 Testing and Vaccines provision. This is where insurers are required to cover testing for COVID-19 without cost sharing to their enrollees, and they must pay for the tests based on contracts or the posted pricing of labs. So, the thing is, hospitals and diagnostic testing companies can essentially basically name their price on COVID-19 tests; and employers and insurers will be required to pay for it. This is in Section 3202, the Price of Diagnostic Testing, in that CARES Act. The plot thickens this week as health insurers—including Aetna, Cigna, and Humana—are now waiving patient cost sharing on all treatment for coronavirus, not just the testing, including hospitalizations and ambulance transfers. And they’re doing this for their insured members and employer plans at their in-network health systems—emphasis intended on the “in-network” part. So, you might be thinking, “Great … no costs to anybody!” But I did emphasize that last part for a reason. If you think for a minute about this, just because patients are not paying co-pays for COVID treatments first of all doesn’t mean that while they’re in the hospital that their diabetes won’t flare up … or their MS or their RA. COVID-19 is just one thing, and the US has a patient population that has, let’s just say, no shortage of chronic conditions—otherwise known as underlying conditions, otherwise known as the people most likely to be in the ICU. My concern is that there’s nothing to say that co-pays and coinsurance for treatment of other things while being treated for COVID are going to suddenly vanish, too, even if it’s an in-network health system. Furthermore, there is that problem of a patient going to a hospital that’s not contracted with the employer plan or the patient’s insurance carrier. At that point, I’m not seeing anything that would suggest that patients with COVID-19 are going to get any different treatment billing-wise than patients with anything else. We’ve seen COVID-19 bills that are, for uninsured patients, $34,000 and $73,000 in the press. What if the patient doesn’t have out-of-network coverage, for example? What if the patient’s out-of-network deductible is tens of thousands of dollars like some of them are? I don’t see anything in this bill to suggest that those are suddenly going to go away. And, oh, by the way, exactly as the bill pretty much states explicitly, regardless of what the patient pays, the employer’s on the hook to pay for whatever the hospital chooses to charge—at least as far as testing goes. You can connect with Doug on Twitter at @AldeenDoug and on LinkedIn.  You can learn more at quizzify.com or connect with Al on LinkedIn. You can also connect with Al on Twitter at @quizzify and @whynobodybeliev.   Doug Aldeen is an Austin, Texas–based health care and Employee Retirement Income Security Act (ERISA) attorney who recently served as ERISA counsel on behalf of the Berkeley Research Group in New York City to the $7.7 billion May 2016 acquisition of Multiplan and its medical bill repricing product Data iSight by the private equity firm Hellman and Friedman. Since 1997, he has represented reference base pricing organizations, a bundled payment software platform, PPO networks, medium to small self-funded plans, third-party administrators, and provider-sponsored health maintenance organizations in various capacities, including Herdrich v. Pegram, which was argued before the US Supreme Court in 2001. Moreover, he serves as a resource to national news organizations regarding issues on health care and as a consultant with the Governmental Relations Committee at the Self-Insurance Institute of America in Washington, DC, and as an adviser to RIP Medical Debt, which has abolished over $1.2 billion in medical debt. Doug received his JD from the University of Illinois. Al Lewis wears multiple hats, both professionally and also to cover his bald spot. Hat #1: Employee Health Literacy. He is the founder and “quizmeister-in-chief” of Quizzify, whose mission is to help companies teach their employees to utilize healthcare services appropriately, using a format best described as “Jeopardy meets health benefit education meets Comedy Central.” Quizzify is the only vendor authorized to display the Harvard Medical School “Veritas” shield and has received excellent reviews from users.  Quizzify is best known today for its employee coronaquizzes (now exceeding 100,000 plays!) and its surprise billing “Prevent Consent” solution, which was recently featured in the New York Times. It can be taped to an insurance card, used as a stand-alone card, or downloaded into your Apple Wallet. His quiz-specific background includes authorship of the best-selling Newsweek Presents the Ultimate Trivia Game, which Games magazine lauded as having the best questions of any trivia game; hosting two quiz shows on Boston network affiliates; and appearing on Jeopardy. Hat #2: Outcomes Measurement. As an author, his critically acclaimed category best-selling book on outcomes measurement, Why Nobody Believes the Numbers, chronicling and exposing the innumeracy of the health management field, was named digital health book of the year in Forbes. Cracking Health Costs, written in conjunction with Walmart alum Tom Emerick, was also a trade best seller. Surviving Workplace Wellness has also received great accolades, and excerpts appeared in Harvard Business Review and elsewhere.  He was the cofounder of the World Health Care Congress’s Validation Institute.  His expertise in outcomes measurement got him named one of the unsung heroes changing health care forever.  He graduated Phi Beta Kappa with honors from Harvard, where he taught economics as well. He also graduated from Harvard Law School, albeit with no honors that time—other than winning their annual trivia contest, of course. 04:12 Hospital billing as it relates to COVID-19. 05:45 Who is “on the hook” for paying these COVID-19 bills. 08:17 “Reasonable payment” in the case of COVID-19. 08:45 Is COVID-19 different than every other billing situation? 10:12 What’s going to come out of the out-of-network COVID-19 costs? 11:29 What employers should be doing right now. 12:50 The takeaway for everyone “bankrolling” COVID-19. 13:26 “This whole thing is tilting towards, ‘Who’s going to pay for all this stuff?’” 13:53 Connecting the dots with COVID-19 billing. 15:25 Using the Quizzify wallet card, and how this can help avoid COVID-19 surprise billing. 16:17 Download the wallet card at quizzify.com.  You can connect with Doug on Twitter at @AldeenDoug and on LinkedIn.  You can learn more at quizzify.com or connect with Al on LinkedIn. You can also connect with Al on Twitter at @quizzify and @whynobodybeliev.   Check out our newest #AnExpertExplains #healthcarepodcast with @AldeenDoug and @whynobodybeliev of @quizzify as they discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling Who is on the hook for #coronavirus billing? @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast What is #reasonablepayment in the age of #coronavirus? @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast Is billing for #coronavirus different than all other billing? @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast What’s going to come out of the out-of-network COVID-19 costs? @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast “This whole thing is tilting towards, ‘Who’s going to pay for all this stuff?’” @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast Connecting the dots with #covid19billing. @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast

In this podcast originally published early last year, Alex Akers and I had a chance to speak with Dr. Robert Pearl about his book Mistreated: Why We Think We’re Getting Good Health Care—And Why We’re Usually Wrong. Besides being an author, Dr. Pearl is former CEO of the Permanente Medical Group; he’s a frequent keynote speaker; and he is also the host of a podcast called Fixing Healthcare.  Here’s what Dr. Pearl said at the recent HLTH conference in Vegas, and I’m editorializing a little bit here. Dr. Pearl said day after day, patients and their families experience the unnecessary frustrations and heartaches that are so rife in American health care. Mistreatment is certainly a continuum, but in all of its manifestations, it’s pretty much nothing less than rampant. I mean, how else do Americans manage to pay more than twice as much per patient for a health system that ranks 37th in the world? There are definitely bright spots, and there are definitely great men and women working within health care. So, I do not—and I’m certain Dr. Pearl does not—mean to be all doom and gloom. But we’ve got some realities to deal with here. There’s a simple answer to the question, “What happens if we fail to change?” Disruption will happen. While the pace of health care disruption in many sectors hasn’t exactly set world speed records, it’s inevitable. And, according to Dr. Pearl, status quo health care providers will lament their decision not to have embraced change sooner. To wrap our heads around this, Dr. Pearl suggests that there are four must-haves, four pillars to get the American health care industry back on track. Spoiler alert: Those four pillars are (1) integration, (2) pay-for-value, (3) modernize our approach to technology, and (4) clinician- and physician-led organizations. You can learn more by connecting with Dr. Pearl on Twitter at @RobertPearlMD.  Register here for the 2019 NODE.Health Digital Medicine Conference and get 20% off with our promo code: RELENTLESS20  Robert Pearl, MD, is the former CEO of the Permanente Medical Group (1999-2017), the nation’s largest medical group, and former president of the Mid-Atlantic Permanente Medical Group (2009-2017). In these roles, he led 10,000 physicians and 38,000 staff and was responsible for the nationally recognized medical care of 5 million Kaiser Permanente members on the west and east coasts. Named one of Modern Healthcare’s 50 most influential physician leaders, Dr. Pearl is an advocate for the power of integrated, prepaid, technologically advanced, and physician-led health care delivery. He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership and lectures on information technology and health care policy. In 2017, he authored Mistreated: Why We Think We’re Getting Good Health Care—And Why We’re Usually Wrong, a Washington Post bestseller that offers a road map for transforming American health care. All proceeds from the book benefit Doctors Without Borders. As a regular contributor to Forbes, Dr. Pearl covers the business of health care and the culture of medicine. He has been featured on CBS This Morning, CNBC, and NPR, and in Time, USA Today, and Bloomberg News. He has published more than 100 articles in various medical journals and contributed to numerous books. He is a frequent keynote speaker at health care and medical technology conferences. Dr. Pearl has addressed the Commonwealth Club, the World Health Care Congress, and the Institute for Health Care Improvement’s National Quality Forum. Board certified in plastic and reconstructive surgery, Dr. Pearl received his medical degree from the Yale University School of Medicine, followed by a residency in plastic and reconstructive surgery at Stanford University. From 2012 to 2017, he served as chairman of the Council of Accountable Physician Practices (CAPP), which includes the nation’s largest and best multispecialty medical groups, and participated in the Bipartisan Congressional Task Force on Delivery System Reform and Health IT in Washington, DC. When not hosting the show, Stacey Richter is co-president of Aventria Health Group, a marketing agency and consultancy. Aventria specializes in helping pharmaceutical, employer, pharmacy, and health system clients improve patient outcomes by creating and leveraging collaborations with other health care organizations. For more than 20 years, Stacey has innovated better-coordinated health solutions benefiting all stakeholders, and, most of all, the patient. Alex Akers is vice president for business development with Health Catalyst, a Utah-based, next-generation data, analytics, and decision-support company. He has been with Health Catalyst since 2015. Alex began his career in health care consulting, working for KPMG and Accenture in their health care strategy practices, and then shifting to revenue cycle reengineering with Stockamp & Associates. His passion for technology in health care really took off after he joined Microsoft and was responsible for health care strategy in their payer segment. After a stint with Grand Rounds in San Francisco, Alex landed at Health Catalyst. 02:26 Dr. Robert Pearl, author of Mistreated: Why We Think We’re Getting Good Health Care—And Why We’re Usually Wrong.02:44 How bad is the problem in American health care? 05:25 How our health system lags in overall health, according to third-party, objective data analysis. 06:02 Rampant overtreatment, and how this adds to the problem. 09:11 How can context improve health care? 09:19 The four pillars of improving health care outcomes. 13:06 Integration as a crucial step to maximizing quality. 13:24 Pay-for-value as the second pillar of improving health outcomes. 17:39 Technology as the third pillar. 17:55 How current health care tech being utilized is 50+ years old. 19:38 Why video isn’t utilized more in health care, despite being relatively inexpensive. 21:32 Do doctors hate technology? 22:52 “All of medicine is probability.” 23:18 EP157 with Dr. Ethan Basch.25:12 “We fail to do the things that we know we should do.” 27:10 Physician- and clinician-led organizations as the fourth pillar. 29:00 “We don’t have a system; we don’t have a structure.” 29:35 “To do that will require leadership.” 29:56 Dr. Pearl’s advice for actionable change. 31:10 “This is the time to change; don’t wait for disruption to occur.” You can learn more by connecting with Dr. Pearl on Twitter at @RobertPearlMD.  Register here for the 2019 NODE.Health Digital Medicine Conference and get 20% off with our promo code: RELENTLESS20  Check out our encore #healthcarepodcast with @RobertPearlMD of @FixingHCPodcast and co-host @alexhakers of @HealthCatalyst. #healthcare #podcast #digitalhealth #healthvalue How bad is the problem in #Americanhealthcare? @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue Why and how does our #healthsystem lag in overall health? @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue How #overtreatment actually adds to the problem. @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue What are the four pillars to improving #healthoutcomes? @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue Why #integration is important to maximizing #healthquality. @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue How #payforvalue improves #healthoutcomes. @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue How #healthtech factors into #healthoutcomes. @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue Why isn’t video utilized more in improving #healthcareoutcomes? @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue “All of medicine is probability.” @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue “We fail to do the things that we know we should do.” @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue “We don’t have a system; we don’t have a structure.” @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue Creating #actionable change. @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue “This is the time to change; don’t wait for #disruption to occur.” @RobertPearlMD of @FixingHCPodcast discusses with co-hosts Stacey and @alexhakers of @HealthCatalyst. #healthcarepodcast #healthcare #podcast #digitalhealth #healthvalue

The Washington Post reported Tuesday night that special counsel Robert Mueller warned President Trump's legal team back in March that he could subpoena the president and bring him before a grand jury if he won't agree to sit down for an interview. Legal experts began debating and discussing whether a sitting president could be subpoenaed at all, let alone by the special counsel. Former federal prosecutor Doug Burns talks to Rick and guest co-host Rick Tyler about whether Mueller can and will subpoena President Trump. He also shares his thoughts on the potential interview questions that were leaked earlier this week. Former Health and Human Services Secretary Tom Price acknowledged in a speech Tuesday to the 15th annual World Health Care Congress that repealing the Affordable Care Act's individual mandate will increase premiums for all Americans. It was a surprising admission from a long-time opponent of Obamacare. The guys discuss what this hypocrisy says about our politics and our policies.

Live from the World Health Care Congress 2018 is on site on Washington, D.C., April 30th an May 1st, 2018. We're broadcasting from 11:00AM to 1:00PM Eastern/8:00AM to 10:00AM Pacific. Guests include: @ceciconnolly @chasedave @minahealth @kibbedavid @drnic1 @bklepper1 @glfFEO @jessicaBrooks @PBGHPA For Congress agenda, click here. For faculty, click here. Join co-hosts Fred Goldstein and Gregg Masters as they chat with a range of confernce luminaries. 

Dr. Robert Pearl is the former CEO of the Permanente Medical Group (1999-2017), the nation's largest medical group, and former president of the Mid-Atlantic Permanente Medical Group (2009-2017). In these roles, he led 9,000 physicians, 35,000 staff, and was responsible for the nationally recognized medical care of 4 million Kaiser Permanente members on the west and east coasts. Recently named one of Modern Healthcare's 50 most influential physician leaders, Robert is an advocate for the power of integrated, prepaid, technologically advanced, and physician-led health care delivery. He serves as a clinical professor of plastic surgery at Stanford University School of Medicine and is on the faculty of the Stanford Graduate School of Business, where he teaches courses on strategy and leadership, and lectures on information technology and health care policy. In 2017, he authored Mistreated: Why We think We're Getting Good Health Care—And Why We're Usually Wrong, a Washington Post bestseller that offers a road map for transforming American health care. All proceeds from the book benefit Doctors Without Borders. As a regular contributor to Forbes, Robert covers the business of health care and the culture of medicine. He has been featured on CBS This Morning, CNBC, NPR, and in TIME, USA Today and Bloomberg News. He has published more than 100 articles in various medical journals and contributed to numerous books. He is a frequent keynote speaker at health care and medical technology conferences, Robert has addressed the Commonwealth Club, the World Health Care Congress, and the Institute for Health Care Improvement's National Quality Forum. Board certified in plastic and reconstructive surgery, Robert received his medical degree from the Yale University School of Medicine, followed by a residency in plastic and reconstructive surgery at Stanford University. From 2012 to 2017, he served as chairman of the Council of Accountable Physician Practices (CAPP), which includes the nation's largest and best multispecialty medical groups, and participated in the Bipartisan Congressional Task Force on Delivery System Reform and Health IT in Washington, DC. Stacey Richter is Co-President of Aventria Health Group, a marketing agency specializing in helping pharmaceutical, device, and pharmacy clients gain access to patients by creating and leveraging partnerships with other health care organizations. For 20 years, Stacey has innovated better-coordinated health solutions benefiting all stakeholders, and, most of all, the patient.   Alex Akers is Vice President for Business Development with Health Catalyst, a Utah-based, next-generation data, analytics, and decision-support company. He has been with Health Catalyst since 2015. Alex began his career in health care consulting, working for KPMG and Accenture in their health care strategy practices, and then shifting to revenue cycle reengineering with Stockamp & Associates. His passion for technology in health care really took off after he joined Microsoft and was responsible for health care strategy in their payer segment. After a stint with Grand Rounds in San Francisco, Alex landed at Health Catalyst.   00:00 Dr. Robert Pearl, author of Mistreated: Why We think We're Getting Good Health Care—And Why We're Usually Wrong. 01:30 How bad is the problem in American health care? 04:35 How our health system lags in overall health, according to third-party, objective data analysis. 05:20 Rampant overtreatment, and how this adds to the problem. 08:30 How can context improve health care? 09:00 The 4 pillars of improving health care outcomes. 12:40 Integration as a crucial step to maximizing quality. 13:00 Pay-for-value as the second pillar of improving health outcomes. 17:20 Technology as the third pillar. 17:45 How current health care tech being utilized is 50+ years old. 19:30 Why video isn't utilized more in health care, despite being relatively inexpensive. 21:20 Do doctors hate technology? 22:30 “All of medicine is probability.” 24:50 “We fail to do the things that we know we should do.” 27:00 Physician and clinician-led as the fourth pillar. 28:45 “We don't have a system; we don't have a structure.” 29:35 “To do that is going to require leadership.” 30:00 Dr. Pearl's advice for actionable change. 31:00 “This is the time to change; don't wait for disruption to occur.”

Christopher Kennedy with Heritage Biologics interviews Thomas G. Emerick, President of Emerick Consulting, LLC, a firm engaged in providing consulting services to a broad spectrum of clients. The discussion centers around specialty pharmacy & Direct-to-Employer Program Opportunities.  About Tom´s years with Wal-Mart Stores, Inc., Burger King Corporation, British Petroleum, and American Fidelity Assurance Company have provided an excellent blend of experience and contacts. His last position with Wal-Mart was Vice President, Global Benefit Design. Tom has served on a variety of employer coalitions and associations, including being on the board of the influential National Business Group on Health, the U. S. Chamber of Commerce Benefit Committee, and many others. In the year 2000 Tom was given the prestigious “Distinguished Former Student” award from the University of Central Oklahoma from which he has both BBA and MBA degrees. Tom has also been on the Arkansas State and Public School Life and Health Insurance Board, and served as a member of the Murphy Commission in Arkansas. Frequently in demand as a speaker for benefits and health care conferences, such as the internationally known World Health Care Congress, Tom´s topics include strategic health plan design, global health care challenges, health care economics, and evidence-based medicine. Specialty Pharmacy Podcast Host: Christopher W. Kennedy, MSM Chief Operating Officer Heritage Biologics, Inc. See omnystudio.com/listener for privacy information.