Podcast
Reconstructing Healthcare: Innovative Solutions For Employers To Lower Their Healthcare Costs
Hosted by Reconstructing Healthcare: Innovative Solutions For Employers To Lower Their Healthcare Costs · EN
Our Healthcare and Health Insurance System is broken. Healthcare costs continue to rise at the expense of employers and employees who often end up paying more each year for reduced levels of benefit and service. If you’ve had enough, then you’ve come to the right place. In this show, we explore what is wrong with the current system and examine what drives higher healthcare costs. We interview companies that are providing innovative services and solutions designed to not only disrupt the health insurance marketplace but deliver lower costs and better value for your employees.
Who is this show for? It’s for employers, CEO’s, CFO’s, HR Directors and Benefit Managers and anyone else who is tired of the same poor results that we continue to get from our Health Insurance and Healthcare System. It’s for those who are suspect of the same old answers for why healthcare costs go up and want actionable strategies to get better results.
Join us! Get educated and get ready to take action!
11episodes
Episodes
Newest firstAll episodes
Colin Quinn | Included Health Communities
Jun 20, 202200:38:03Tap to summarizeColin Quinn, President of Included Health Communities, joins Michael in this episode of the Reconstructing Healthcare podcast to discuss how Included Health offers tailored care navigation and advocacy solutions to employers and health plans to support their diverse employees and members.Included Health’s aim is to create equity in healthcare, with their first solution creating ways to help support the LGBTQ+ community. As President, Colin strives to raise the standard of healthcare for everyone, no matter what group you belong to or what industry you work in. Colin Quinn received an MBA from Stanford University’s Graduate School of Business and went on to work in the finance and sales side of the pharmaceutical industry prior to launching Included Health. In 2021, Included Health was acquired by Grand Rounds and Doctor on Demand which has created a robust navigation and advocacy platform to support Employers in raising the bar in their recruitment and retention efforts. Here’s a glance at what you’ll learn from Colin in this episode: Why Included Health was launchedHow Included Health’s broad service offering can improve equity in healthcareHow Included Health reached an NPS score of 98%Timestamps:0:00 – Introduction and welcoming Colin to the show1:15 – Who is Colin Quinn and what is Included Health Communities?2:30 – How Colin pivoted from working in finance & sales in the pharmaceuticals industry to launching Included Health7:15 – How the acquisition of Included Health will allow the company to get to the next level and better serve employers and employees9:30 – What differentiates Included Health from the marketplace when it comes to healthcare navigations?12:20 – How will virtual care, digital solutions, and navigation increase the level of equity in healthcare & why is Included Health leading the way?20:30 – Why Included Health’s approach to equity can help multiple diverse groups22:15 – How does Included Health drive organizations forward in recruiting and retaining ...
Transcribe →Denise Shiffman | GroupWell
May 9, 202200:46:46Tap to summarizeDenise Shiffman, Founder and CEO of GroupWell, joins Michael in this episode of the Reconstructing Healthcare podcast to discuss how their data-driven, online group therapy platform is providing employers with a ground-breaking way to approach mental health.Group Therapy combines the treatment of both mental health and social health to reduce clinical symptoms. GroupWell leverages technology to provide a platform where clinician-led group therapy can be accessed for specific groups of individuals dealing with similar issues and challenges. In addition, GroupWell provides wellness affinity groups led by certified behavioral coaches that can help people with sub-clinical levels of stress and anxiety as well as nutrition, weight loss, parenting, and other topics to support people’s emotional well-being. Denise Shiffman held multiple executive roles at tech start-ups and at multi-billion-dollar tech and healthcare companies prior to starting GroupWell. This previous experience has helped her build a dynamic platform that can increase access to a mode of therapy that can help people learn the skills and behaviors to build connections and quality relationships and aid in the recovery from mental health conditions. Here’s a glance at what you’ll learn from Denise in this episode: The personal experiences that led Denise to start GroupWellHow Group Therapy works and is proven to be as or even more effective than individual therapyHow GroupWell leverages technology to deliver evidence-based group therapy for Affinity GroupsWhy employers and care providers must pay more attention to mental healthTimestamps:0:00 – Introducing and welcoming Denise to the show1:10 – Who is Denise Shiffman and what is GroupWell?2:35 – How Denise’s experience with chronic anxiety led her to create GroupWell5:45 – Making it through the pandemic, the state of mental health, and what lessons should employers be taking from the last two years? 11:00 – The issues that people with mental health issues face with current healthcare providers12:30 – Why is group therapy ...
Transcribe →Veeneta Lakhani | Vida Health
Feb 15, 202200:42:55Tap to summarizeVeeneta Lakhani, the Chief Growth Officer for Vida Health joins Michael in this episode of the Reconstructing Healthcare podcast to discuss how Vida Health is providing care for over 2 Million people through their digital platform that aims to treat both physical and mental illnesses in a combined effort. Vida Health is a modular platform that aims to prevent, manage and even reverse chronic conditions by bringing together mental and physical healthcare through a ground-breaking digital platform that connects patients to therapists and coaches. Vida Health’s clinical outcomes have led them to receive some of the highest customer satisfaction scores that we’ve seen on this podcast. Veeneta joined Vida Health to ensure her work in the healthcare industry leads to a future of care where people are looked after day to day through combining physical and mental health work to achieve sustainable outcomes. Veeneta previously held multiple senior executive positions at Anthem Blue Cross and began her career in the insurance sector with McKinsey and company.Here’s a glance at what you’ll learn from Veeneta in this episode: How Veeneta is working to make an impact on people’s lives every day instead of just when they go to the doctor, and why she couldn’t achieve this at a major national carrierHow & why Vida Health combine both physical & mental health treatmentsWhy the healthcare industry made significant progress during COVID-19 as it pertains to mental health, diversity, equity & inclusion.How Vida Health provides instant care when their clients sign up to their service by leveraging their digital platformThe secrets behind Vida Health’s high customer satisfaction scores and why digital healthcare may be the way forwardTimestamps:0:00 – Introduction1:10 – Who is Veeneta Lakhani and what is Vida Health?2:20 – Why did Veeneta leave a national carrier (Anthem) to join a digital health start up?4:40 – What are the positive outcomes that can be taken from COVID-19?9:20 – What is Vida Health and what problems are they attempting to solve?</s...
Transcribe →Wally Gomaa | SimplePay Health
Jan 18, 202200:50:49Tap to summarizeWally Gomaa, CEO and Co-Founder of SimplePay Health, joins Michael in this episode of the Reconstructing Healthcare podcast to discuss how they’re empowering employees with high-quality care through easy-to-understand benefit design structures.SimplePay Health aims to disrupt the healthcare industry by making the complicated elements of traditional health plans (deductible, coinsurance, confusing bills) a thing of the past while providing their members with the highest level of care. Based out of Dallas, Texas, SimplePay Health is taking on the status quo to reward employees for making choices that actually help lower overall costs.As a former President of a national insurance carrier, CFO of a healthcare provider and a benefits consultant, Wally has gained unique insight into the healthcare industry and leverages the SimplePay Health platform to address some of the problematic issues within our healthcare delivery and payment system. Here’s a glance at what you’ll learn from Wally in this episode: The payment system that SimplePay uses to make healthcare a breezeWhy Wally wants price transparency to become price CERTAINTYHow virtual care providers can provide higher quality careWhy simplifying complexities could bring the largest change to the healthcare industryTimestamps:0:00 – Introduction & welcoming Wally to the show1:05 – Who is Wally Gomaa and what is SimplePay Health?2:35 – The Bike Accident: How being hit by a car changed Wally’s perspective on the healthcare industry4:10 – Why haven’t price transparency tools & high-deductible health plans driven meaningful results? 7:10 – What is SimplePay Health doing to simplify health insurance?11:20 – How to show patients the disconnect between quality and price for commodity healthcare services13:35 – Using data to drive down costs whilst providing a higher quality service17:45 – SimplePay Health’s approach to using networks<span style="...
Transcribe →Harris Rosen + Ashley Bacot | Rosen Hotels & Resorts
Aug 12, 202100:47:13Tap to summarizeHarris Rosen and Ashley Bacot of Rosen Hotels & Resorts join Michael in this episode of the Reconstructing Healthcare podcast to discuss how they’ve saved over $450 million in healthcare costs by implementing their own self-insured healthcare model.Rosen Hotels and Resorts has over 4,500 employees and turns over $350 million in revenue per year through their multiple hotels and resorts throughout Orlando, Florida. Harris and Ashley have created a healthcare model that not only saves the company in healthcare costs, but also provides healthier lifestyles for their employees, as they can choose their health over their wallet via the cost savings.Harris Rosen is the President and COO of Rosen Hotels & Resorts and has not only seen the growth of his hotel business, but through the success of his healthcare program, has created ProvInsure to implement their healthcare model into other companies.Ashley Bacot is the President of ProvInsure and Risk Manager for Rosen Hotels & Resorts. Ashley was integral in creating the self-insured healthcare model for Rosen that has helped save nearly half a billion dollars in healthcare costs since inception.Here’s a glance at what you’ll learn from Harris and Ashley in this episode:How Rosen Hotels & Resorts implemented their own self-insured healthcare model to save over $450 million since inception.The lessons taken from the Great Depression to survive COVID-19.How to remove the barriers within your healthcare plan to have healthier employees and reduce costs.The steps you can implement to allow your employees to choose their health over their wallet.Timestamps:0:00 – Introduction0:20 – Welcoming Harris and Ashley to the show1:12 – Who is Harris Rosen?1:50 – Who is Ashley Bacot?3:00 – The history of Rosen Hotels & Resorts and how they grew into a $361 million per year company.7:30 – How Rosen’s grandparents lessons on debt helped Rosen Hotels & Resorts survive through COVID-19.10:30 – Trying an alternate path: How an increase in healthcare costs led Harris to explore ways to provide primary care to his own employees.15:00 – “Rosen Care”: The initial success that led to over $450 million in healthcare savings.17:30 – Primary Care: Increasing access to quality primary care to employees via clinic access, benefit design & removing barriers.23:10 – How having an onsite clinic has impacted the health of employees and has lowered healthcare costs24:20 – Living by K.I.S.S and P.P.P.P.P.P – Keep It Simple Stupid and Prior Planning Prevents Piss Poor Performance25:50 – Encouraging Compliance: How to allow your employees to choose health over saving money29:10 – Why hospitals aren’t interested in competition and why the government and employers should get tough31:...
Transcribe →Marshall Allen
Jul 12, 202100:52:09Tap to summarizeMarshall Allen is an investigative journalist that has spent more than fifteen years exposing the ways that the health care industry preys on vulnerable Americans. Marshall currently writes for ProPublica and was part of the team to be a Pulitzer finalist for their work in covering COVID-19. In this episode, Marshall discusses how his time investigating the American healthcare system has led to writing his new book, titled “Never Pay the First Bill: and Other Ways to Fight the Health Care System and Win.”Marshall’s career has seen him honoured with multiple journalism awards, such as the Harvard Kennedy School’s 2011 Goldsmith Prize for Investigative Reporting and coming in as a finalist for the Pulitzer for his work at the Las Vegas Sun, where he worked before writing at ProPublica in 2011.In this episode, you’ll hear about real-life victories as employers and employees fight the healthcare industry. From dealing with price gouging, errors in billing, fraud and unnecessary treatments, Marshall has seen it all. Tune in to hear how employers and employees can fight back and protect themselves from being taken advantage of by the healthcare delivery and payment system.Here’s a glance at what you’ll hear from Marshall in this episode:Why Americans pay so much for healthcare whilst getting so little in returnHow Marshall’s career in investigative journalism led to him writing ‘Never Pay the First Bill’Why the business side of healthcare was designed to exploit both clinicians and patientsHow hospitals and insurance companies look after each other rather than the employee/employer.The inefficiencies and errors presented in the majority of medical bills and how to fight backTimestamps:0:20 – Introduction to Marshall Allen2:20 – Why did Marshall write: ‘Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win’7:08 – “The business side of healthcare was designed to exploit both clinicians and patients” – How the healthcare system takes advantage of Americans9:00 – The price variation patients deal with when going to hospital11:35 – Why aren’t hospitals showing transparent pricing and why aren’t insurance companies loyal to the employer/employee?15:15 – Employers are passing costs onto their employees16:30 – Increasing health literacy for employees and employers17:20 – How common are errors in medical bills?19:20 – The medical debt collecting industry21:30 – How to deal with medical debt22:18 – Why would you sue a medical provider for an unfair bill24:20 – The open price contract rule: Don’t pay more than Medicare would26:04 – How a hospital would react to a lawsuit in Small Claims Court28:00 – Using a referenced based pricing plan and why hospitals don’t like it30:20 – Share your medica...
Transcribe →Dave Jacobs and David Greenberg | Homethrive
May 13, 202100:50:11Tap to summarizeDave Jacobs and David Greenberg join the podcast to discuss how Homethrive is providing their customers access to their own master’s level social worker and a digital platform to help provide care for their aging loved ones at home.Prior to Homethrive, Dave and David both served at Medline. Dave Jacobs as President of the Durable Medical Equipment division and Medline’s Post-Acute business that encompassed nursing homes, home health, assisted living and managed care insurance. David Greenberg served as Executive Vice President of Strategy and Group President, defining and supporting strategic priorities, leading business development initiatives to strengthen the Medline portfolio, and M&A. In this episode, you’ll hear why Dave and David decided to leave their high paying Senior-Executive roles at well-respected companies to create Homethrive. You’ll hear how Homethrive is helping people look after their aging parents while allowing them to stay in their own homes, instead of an aged care facility. Here’s a glance at what you’ll learn from Dave Jacobs and David Greenberg in this episode: The foundation story of Homethrive: Why the co-founders left their Senior-Executive roles to create their own company.How Homethrive is helping people look after their aging parents while allowing them to stay at home instead of an Aged Care Home.Why Traditional Benefit Offerings often aren’t enough for employees burdened with care-related responsibilities for their aging parents.How Homethrive is able to provide each customer with their own unique Care Guide and the types of services they offer.The positive impact this can have on employees knowing they have an advocate to address elder care issues for loved ones.Timestamps:0:22 – Welcoming David and Dave to the show1:00 – Who is Dave Jacobs?2:00 – Who is David Greenberg?3:42 – Why David and Dave left their Senior-Executive roles to create Homethrive8:20 – The state of traditional benefit offerings in the age of COVID-1910:50 – How organizati...
Transcribe →Nate Murray | Crossover Health
Apr 14, 202100:55:57Tap to summarizeIn this episode, Michael interviews Nate Murray, the Chief Business Development Officer at Crossover Health. Crossover Health is a national primary care medical group that connects employees with remarkable care options while helping employers take control of their healthcare spend. In this episode, you’ll hear about some of the deficiencies in primary care today and why many large employers have started to engage in direct contracts with providers to offer improved primary care to their employees. Tune in to hear about the evolution of the Crossover Health primary care model and how they are using a team based approach to deliver extraordinary care for their members.Here’s a glance at what you’ll learn from Nate in this episode: What the Health 2.0 movement is and where it’s going.Why rushed doctor visits equate to poor healthcare and how this impacts costsHow deals with Apple, Facebook and Amazon helped Crossover Health design a primary health model.How Crossover Health creates a relationship between patients and doctorsHow integrating behavioral health and physical therapy into the Crossover model impacts patient careHow effective primary care can help companies reduce their downstream costs.Timestamps:0:22 – Introducing Nate and Crossover Health2:55 – How Nate got into healthcare4:38 – Nate’s wife having rheumatoid arthritis exposed the inability between what insurance companies were capable of compared to doctors.7:16 – It’s less about the health insurance, and it’s more about the quality of healthcare that’s having an impact on costs.8:12 – The Primary Care Crisis: Primary Care is the speedbump to the expensive healthcare industry.11:20 – The system is lowering the quality of care. Doctors can’t provide quality if they’re seeing 30 patients a day.14:48 – Crossover Health: How they transitioned into focusing on primary care by securing a deal with Apple.18:00 – The F...
Transcribe →Christin Deacon | Amino
Mar 19, 202100:49:24Tap to summarizeIn this episode, Michael moderates a webinar that highlights an employer who took action to help their employees find higher quality, more cost-effective care. The episode highlights two panelists, one with Christin Deacon, the Assistant Director of the New Jersey State Health Plans, and the second with David Vivero, the Co-Founder and CEO of Amino. Christin is a healthcare leader and public sector entrepreneur. She is a former deputy attorney general and private sector restructuring attorney, and her unique background allows her to have a different perspective on the status quo in the realm of healthcare. She engaged with Amino to get ahold of out-of-network spend and make an impact on the trajectory of cost in New Jersey, which is $2B on pharmacy and $5B on medical and growing. When David Vivero spoke with Christin and learned the needs of the state and its members, he learned that staying within the network and better hospital selection were primary concerns. Employers and employees were having trouble finding cost-effective care, and he knew Amino’s platform could solve for that. The state was able to move fast and implement Amino in just eight months, and their first push was the digital experience and matching people with the right provider and tools. David explains that the goal was to solve the three fundamental problems of healthcare guidance: providing the data to inform a good decision, creating an experience that delivers results, and distributing it effectively. The Amino Smart Match label finds the high-performance network by stratifying the network by cost, quality, experience, and appropriateness, and their Integrated Benefits Tool connects the dots in the healthcare system so members cut through the noise and find exactly what they need. Amino is all about “Getting back to it.” They understand that people don’t want to be experts in healthcare and just want to be healthy with the support of quality, cost-effective care. And with an NPS score of over 80, it’s working. On the horizon, Christian sees more engagement in digital health, a spike in telemedicine, new models of delivery, and more opportunities for education. As for Amino, they have an exciting road ahead. They’re following trends in the market, working towards ER avoidance, and getting into retail clinics. Here’s a glance at what we discuss in this episode: 00:30 - Introducing the panelists and discussion.03:00 – Christin’s unique background, burnout, and draw to public service. 04:15 – The division of pensions and benefits and the health benefits climate in 2018.05:10 – Status quo, out-of-network spending, and getting ahold of cost and spend. 05:50 – The trajectory of cost: $2B of...
Transcribe →Omar Dawood | Calm
Mar 10, 202100:45:20Tap to summarizeIn this episode, Michael interviews Omar Dawood, the Chief Medical Officer and Head of Sales at Calm, the #1 app for sleep, meditation and relaxation. The app has over 100 million downloads and over 1.5M 5-star reviews.Omar is a clinician and stage IV cancer survivor with over 25 years of senior management, medical research and clinical experience, innovating medical devices and digital health products as a senior executive. At Calm, he leads B2B employer and health plan sales and is passionate about helping people around the globe lead healthier, happier lives by building resilience through better sleep and improved mindfulness.While 20% of Americans are dealing with a mental health illness of some sort, Omar believes that we shouldn’t forget about the other 80% of people who experience stress and anxiety without a mental health diagnosis. That’s where Calm comes in to act as a preventative measure to improve behavioral and mental health as well as resilience through mindfulness practices, meditation, and strategies for better sleep. Calm started as a B2C app but is making strides in the B2B sector to support employers, employees, and organizations. And it’s working. The sign-up rate on employer accounts is 30% with 80% engagement, and the experiences it offers – like the “Daily Calm” and “Sleep Story” – are helping employees reduce stress, sleep better, respond better to life, communicate more effectively, and boost immunity around the world. The benefits Calm offers to organizations and employees is clear. For organizations, they provide actionable insights and aggregate trends. For employees, they offer pathways to increased resilience and wellbeing and a “Calm Effect” that touches every area of their life.Calm’s NPS is just over 70 and they do qualitative ratings and satisfaction measurements in a number of ways. The team at Calm is excited for more innovation in behavioral and mental health and encourage collaboration in the field in order to spread health and happiness to billions. Here’s a glance at what we discuss in this episode: 00:50 - Introducing Omar and Calm. 02:30 – His cancer diagnosis changed his view on medicine and the industry’s lack of data; he didn’t appreciate the value of mental and behavioral health until 10 years ago. 04:45 – He saw a need to bring an engaging experience to behavioral health; this is how he came upon Calm and loves his role in bringing that to employers/employees. 06:30 – The 1 in 5 statistic: Omar believes we should consider the preventative health of the other 80% who also experience stress and anxiety but aren’t diagnosed.<...
Transcribe →