Voices of Self Funding

Podcast #12 Why and How to Educate Employees About Price Transparency

In this episode, Ramesh goes to a higher level with the author of Never Pay the First Bill, Marshall Allen, to talk about how employers can educate their members about healthcare prices and the upcoming price transparency. This conversation provides a unique perspective on actions employers can take to leverage price transparency.

This episode was sponsored by The Phia Group. For more information on price transparency or other topics related to the self-funding industry, please visit HCAA.org. 

Podcast #11 Finding the Cost Savings While Humanizing Care Navigation Programs

Care navigation programs are incredibly valuable in delivering a great experience for patients and significantly lower costs for employers. But why aren’t they the norm? Tune into this episode as our guest, Michelle Bounce, COO at J.P. Farley, a leading TPA, describes a life-changing personal encounter with our healthcare system, where she lost her child and faced the cold and impersonal healthcare system. And through this chilling experience, it has forever shaped and guided her desire to improve healthcare for all through an empathic care navigation model that treats the “human side of healthcare.” Michelle guides us through how TPAs can effectively turn care management on its head by simply “doing the right thing” and the cost savings follow suit.

This episode was sponsored by MedWatch. For more information on care navigation programs or other topics related to the self-funding industry, please visit HCAA.org. 

Episode #10 How to Win Leveraging TPA Offering

If you are trying to leverage innovation to deliver high impact to self-insured employers, this podcast is a must-listen for you! Ashok Subramaniam, CEO and co-founder of Centivo, a forward-thinking TPA, answers some of the important questions of major disruptions in the industry around price transparency, unbundling of provider networks, stronger relationships between brokers and TPAs, and the areas of focus to clarify your true value to employers. He frankly outlines where the puck is going to be in 3 years time – you don't want to be there.

This episode was sponsored by WLT Software. For more information on these or other topics related to the self-funding industry, please visit HCAA.org. 

Episode #9 Why Trust in Health Care Matters for Self-Insured Employers

Healthcare consumers don't trust our healthcare system. COVID-19 has brought this into sharp contrast. However, building trust is vital for effective care, reducing population risk, and driving down costs. Why should you care about building trust with employees and members on your self-insured employer plan? Listen to Kirti Mutakar, CEO of UnitedAg, a healthplan and TPA, on their approach to building trust with a difficult-to-reach employee population in the agri business, and the results this has delivered.

This episode was sponsored by AMPS. For more information on trust in healthcare or other topics related to the self-funding industry, please visit HCAA.org. 

Episode #8 Technologies to Improve Customer Service and Member Interactions

TPAs are increasingly facing a challenge around customer service, stuck doing tactical interactions with members, and seeing churn from their customer support team. Employers want more from their benefits and the support to their employees. Technology can help - but how? What is available? How are big health plans leveraging data and technology? Come and find out from Vijay Bhatt, Deputy CTO at Harvard Pilgrim, a health plan that has grown rapidly.

This episode was sponsored by Zipari. For more information on improving customer service or other topics related to the self-funding industry, please visit HCAA.org. 

Episode #7 What You Need to Do for Price Transparency Regulation

In this episode, Ramesh interviews Matthew Albright, Chief Legal Officer at Zelis, who has been involved in various healthcare regulatory issues, having worked at CMS. In this podcast episode, we will answer key questions such as what is the intent of price transparency regulation? What are the key requirements that TPAs and Employers need to worry about? What is the simplified version to worry about? And finally, what are the recommended steps to take?

This episode was sponsored by WEX. For more information on price transparency or other topics related to the self-funding industry, please visit HCAA.org.

 

 

Episode #6 Challenges TPAs Face

In this episode, Ramesh interviews Dallas Scrip, CEO of Benefit Management LLC from Wichita, KS, and Ashok Subramanian, CEO of Centivo, from Buffalo, NY. This episode dives into questions about the challenges TPAs face in competing against BUCA carriers, what investments TPAs need to make, and what the advantages TPAs have in their business model.

(Please Note: The episode was recorded before the Buffalo Bills game against Kansas Chiefs in the Superbowl.)

This episode was sponsored by Optum Rx. For more information on competing against the BUCAs or other topics related to the self-funding industry, please visit HCAA.org.

Episode #5 Surgery Networks & Their Cost Structure

In this episode, Ramesh interviews Dr. Keith Smith, founder of the Surgery Center of OK, one of the pioneering firms that have published their fixed prices down to the dollar for surgeries for more than 10 years. This podcast episode will touch on what a specialized surgery network means, what type of surgeries can be directly steered to specialized centers, what kind of savings to expect, and whether or not quality and cost are better at these specialized surgery centers.

This episode was sponsored by ECHO Health. For more information on surgery networks or other topics related to the self-funding industry, please visit HCAA.org.

Episode #4 Putting Together High Performance Networks & Programs

In this episode, Ramesh talks with Brian Klepper, an expert, and consultant on contracting to create high-performance provider contracts. The podcast will answer questions like: What are the issues with the way providers deliver care or programs, which category of services can employers put in outcome-based/high-performance contracts, what data is needed to contract and manage these outcome-based initiatives, how to go about seeking these contracts.

 

This episode was sponsored by ELAP. For more information on creating high performing networks or other topics related to the self-funding industry, please visit HCAA.org.

Episode #3 What Are Direct Provider Contracts

In this episode, Ramesh talks with Ernie Clevenger, someone who has dedicated his entire entrepreneurial career to bringing better care, managing risks and leveraging healthcare technology. He is founder of CareHere, a successful worksite clinic, now part of Premise Health. Ernie also runs and distributes MyHealthGuide, a newsletter bringing latest developments in the self-insured employer space. Today's podcast will answer questions pertaining to different models of operations like worksite clinics to direct on-site primary care models, what are the pricing models, what are the emerging trends, how is virtual primary care competing with direct primary care model, and what is the role of data to support these disparate models.

This episode was sponsored by Deerwalk. For more information on direct provider contracts or other topics related to the self-funding industry, please visit HCAA.org.