Self-Funded

"In what other industry could a purveyor put out 99% bad bills and stay in business?" - Linda Komisak “They're diagnosing things for things that you don't even have. And that’s scary.” - Kimberly Carleson Kimberly Carleson, CEO of US Beacon, and Linda Komisak, founder of Upturn Consulting LLC, joined me to talk about two critical ways of increasing healthcare transparency: claims reviews and quali...

"Quit tolerating mediocrity. Go get in action. Find the right broker consultant that will take you to a new place. Don't give up hope." - Scott Conard Dr. Scott Conard tragically lost 3 patients one summer to unexpected heart problems, and immediately changed how he thought of healthcare. This week on Self-Funded, we talk about “conscious capitalism”, and by extension “conscious healthcare”, what...

"It's progress we couldn't have envisioned decades ago." - Oscar “I felt interested in being part of something bigger than my practice and something that will impact even more people that I was able to in the hospital.” - Carolina Dr. Oscar Bronsther and Dr. Carolina Escobar from Interlink joined me this week to discuss the exciting and scary world of cell and gene therapy, CRISPR, and how we fund...

"If my child needs a gene therapy to live, they should get it and anyone's child should. So let's figure out how to pay for it." - Jake Frenz On the final of four podcasts filmed at a recent healthcare thinktank I hosted in Frisco, Texas, Jake Frenz, the founder and CEO of SmithRx, joined me to share his journey from the Marine Corps to Pharmacy Benefit Management, and what makes him so passionate...

 "I would say a lot of it is education, helping both the member and the provider realize that it's okay for them to get healthcare in home." - Dan Cochran On the third of four podcasts filmed at a recent healthcare thinktank I hosted in Frisco, Texas, Dan Cochran, CEO of Cochran Health Ventures, joined me to discuss infusions, in-home healthcare, why the future of healthcare will be personalized,...

"There can be a better path forward. We don't have to remain adherent to the system that is built against us. It's just going to take some rolling up of the sleeves and a commitment to it." - Shawn Sanford This week, another ParetoHealth colleague joins the show: Shawn Sanford, RVP of Sales and Pod Leader. Shawn and I discussed his transition from pro baseball to ancillary benefit sales to Pareto,...

“There's a reason why every insurance carrier likely owns or is owned by a pharmacy benefit management company, that’s one of the ways that they can drive revenue." - Kristen Rivers My guest this week, Kristen Rivers from ParetoHealth, is one of the strongest healthcare advocates I know.  This week on Self-Funded, Kristen and I discuss her upbringing, how that affects the work she does today, what...

Luke Aslesen, founder of INFRMD, joined me a few weeks ago for the podcast, and we also filmed this extended interview after, in which Luke asks me about my comedy background, upbringing, relationship with my wife, and more.  If you’re a long-time listener of the podcast and want to get to know me a bit better, or you just stumbled onto the podcast and want to know who I am, this is a great place...

“PBM is one of the most complicated concepts out there and it's incredibly difficult to understand. But it's not because the system itself is complicated. It's because pbms make it complicated.” - Justin Jasniewski Justin Jasniewski, CEO of Serve You Rx, joined me this week to discuss the state of the pharmacy benefit management (PBM) market in 2024.  We discussed the competitive landscape in the...

“You know, Africa has no peanut allergies.” - Dr. Marty Makary I was honored to be joined this week by Dr. Marty Makary to promote his new book “Blind Spots”, which published this week and is currently a national bestseller.  To purchase “Blind Spots”, use this link: https://geni.us/blindspots Dr. Marty Makary is a surgeon, researcher, and author, as well as an advocate for better approaches to pu...

“So many times these employers are like, ‘dude, I spend so much money on this, and my employees don't care at all.’ Or what's even worse is they go, ‘our employees love it, we have a great, great plan.’ Did they tell you that?” - Luke Aslesen This is one of my favorite podcasts of the year: Luke Aslesen, Founder of INFRMD, joined me to talk about entrepreneurship, creativity in insurance, comedy,...

“If we're facing a [mental health] crisis and we want radical change, we’ve got to think about radical solutions. If those radical solutions can show objectively with safety and efficacy data, that they're really helping people and really changing lives, then I think we ought to at least explore and get curious about offering those solutions to to people.” - Amil Patel We have a mental health cris...

“Utilization is key for virtual urgent care. Let us be your first line of defense, rather than like, ‘oh, I do have a telemedicine on the back of my insurance card, I’m not sure what it does.’” - Jon O’Toole Especially in the last few years (for obvious reasons), telehealth and virtual care have proved that they’re here to stay. But how do we best determine when a patient should use virtual or in-...

“Life is short. In the meantime, your health is, at the end of the day, your health is all you have." - Heather Bowers Differentiating yourself through customer service is a tricky thing: it’s talked about so frequently that it can almost feel outdated focusing so much on the customer experience.  But, as my guest Heather Bowers from Lone Star Benefits shared with me this week, it’s still the best...

“We're simplifying the complexities of healthcare. We gotta declutter it, we've gotta demystify it, we've gotta make it more transparent and understandable in bite sized ways where members know and understand what's happening for and to them." - Rob Gelb It sounds like a simple question, but as an industry, we’re still working towards figuring it out: how do we engage members?  Rob Gelb joined me...

“If you talk to almost anyone in this industry over a beer or something like that, I think they will all agree that we are operating in a pretty antiquated industry that needs some serious modernization, innovation, reimagination." - Brandon Weber This week’s episode of Self-Funded is coming to you from the (unfinished) San Francisco ParetoHealth office. Brandon Weber, founder of Nava Benefits, jo...

"I think, not just in terms of the type of AI Verikai does, but AI in healthcare in general, I'm so optimistic about it, just because we are in such early stages of this." - Justen Nestico Did you know that what type of car you drive determines how healthy you're likely to be? Justen Nestico, Director of Actuarial Solutions at Verikai, joined me this week to discuss a really important thing when i...

"The best way I can explain it is the concept is like your house is on fire, and now you go get homeowners insurance." - Kevin Chambers Kevin Chambers (Lucent Health) joined me this week to help me understand just what makes tribal healthcare plans so unique.  As Kevin shares in this episode, many companies are somewhat scared to insure tribes, as they have sovereignty and so any potential lawsuit...

"I think we need to do a better job of understanding each other and plugging each other in where we can help our clients to solve for issues that may not directly impact us, but make a world of difference for them." - Madison Baker Madison Baker, from Marsh McLennan, has expanded her business and online presence exponentially over the last year by creating engaging posts and content on LinkedIn. I...

“I realize there's this massive disconnect in the business model whereby you've got governments and health insurers paying billions and billions of dollars for what might be a not very effective therapy, and then there's all these potential cures, even, and much better treatments out there.” - Savva Kerdemelidis Savva Kerdemelidis and Zan Lowe, of Public Good Pharma, joined me this week to talk ab...

"The US healthcare system is simple, easy to navigate and affordable. Said no one ever." - Guy Benjamin Guy Benjamin returns to the show a year after his previous episode to share just how much Healthee has expanded in that time (spoilers: it’s 100x).  We talk about how Healthee’s role in the marketplace has shifted, what huge feature is on the horizon for them, and why Guy believes that the Healt...

"It's not always what you can do that makes you who you are. Sometimes the things that you don't do well create your style." - AG Ford We have a bit of a different episode in store for you this week: an interview with a local illustrator AG Ford, who’s worked on children’s book series like Construction Site and Magic Tree House. AG and I discussed just how hard it is to break into the world of ill...

“If you're going to be the fiduciary, you have to protect the members, you have to protect the plan, and you need to defend that allowable to make sure that you're covering all of your bases." - Amy Pellegrin We made it to episode 150! A huge thank you to every guest we’ve had on the show so far, and obviously to you, the listeners, for making the show what it is today. For this special episode, w...

"You're talking about the number one creator of wealth and security for people and one of their most important purchases. And like, how is this not in the employee benefits arena?" - Tommy Shumway For the first time ever, a father and son joined the podcast together. Dave and Tommy Shumway, from CityWorth, joined the show to discuss an innovative, yet somewhat obvious, benefit that they’ve rolled...

"Your fitness affects if you, even if you have a desk job. Your fitness is going to affect your performance over the long run, because it's your energy level."  - Chris Hamilton Chris Hamilton (Hotchkiss) needs no introduction on the show at this point; this is his fifth appearance!  This time, Chris introduced me to the world of Continuous Glucose Monitoring (CGM) by putting a CGM in my arm at th...