HealthCare Consumerism Radio

The featured guest on this week's program is Dr. Christopher Whaley, an adjunct professor of health policy at UC Berkley and RAND Corporaton researcher, who also works with Castlight Health on research studies. In today's interview, Dr. Whaley will discuss how reference-based pricing helps employers and patients lower costs of care.   Reference-based pricing is a type of benefit design that enables an employer to establish the maximum amount it will cover for a specific service. This maximum amount is the reference price. If their employee should choose to receive care for that service at a location that charges more than the reference price, the employee will be responsible for paying the amount above the reference price.  

The featured guest on this week's program is Dr. Christopher Whaley, an adjunct professor of health policy at UC Berkley and RAND Corporaton researcher, who also works with Castlight Health on research studies. In today's interview, Dr. Whaley will discuss how reference-based pricing helps employers and patients lower costs of care.   Reference-based pricing is a type of benefit design that enables an employer to establish the maximum amount it will cover for a specific service. This maximum amount is the reference price. If their employee should choose to receive care for that service at a location that charges more than the reference price, the employee will be responsible for paying the amount above the reference price.  

The first guest today will be Linda Heuer, founder of 121 Benefits. Earlier this year, Linda purchased Eide Bailly Employee Benefits Services from the well-known CPA firm and introduced a new TPA to the Midwest. The company is called 121 Benefits. Heuer, a former Eide Bailly principal, had noticed that the benefits industry was becoming increasingly self-service, which runs counter to the increasing complexity that employers and individuals face when dealing with health benefits. As a result, her focus with 121 Benefits is to provide a more responsive, personal, face-to-face service experience and a high level of benefits expertise. Using her team’s first-hand knowledge of employer preferences for one-to-one service and their proven compliance leadership, the 121 Benefits team offers a fresh approach for private and public employers. The second guest on this week's show will be Bill Haber, senior director, business development for PokitDok, an API platform built to power the business of health. In this segment, Bill will discuss how PokitDok’s APIs power interoperable transactions and how that relates to health care consumerism. He will also talk about how hospital systems, digital health companies and systems integrators, to name a few, can utilize PokitDok’s platform to improve workflows, cut costs and put power in the hands of the patient.

The first guest today will be Linda Heuer, founder of 121 Benefits. Earlier this year, Linda purchased Eide Bailly Employee Benefits Services from the well-known CPA firm and introduced a new TPA to the Midwest. The company is called 121 Benefits. Heuer, a former Eide Bailly principal, had noticed that the benefits industry was becoming increasingly self-service, which runs counter to the increasing complexity that employers and individuals face when dealing with health benefits. As a result, her focus with 121 Benefits is to provide a more responsive, personal, face-to-face service experience and a high level of benefits expertise. Using her team’s first-hand knowledge of employer preferences for one-to-one service and their proven compliance leadership, the 121 Benefits team offers a fresh approach for private and public employers. The second guest on this week's show will be Bill Haber, senior director, business development for PokitDok, an API platform built to power the business of health. In this segment, Bill will discuss how PokitDok’s APIs power interoperable transactions and how that relates to health care consumerism. He will also talk about how hospital systems, digital health companies and systems integrators, to name a few, can utilize PokitDok’s platform to improve workflows, cut costs and put power in the hands of the patient.

On the first segment of today's show, Dr. Dee Edington and Jack Bastable, co-founders of the Edington CBIZ Next Practice Awards, tell us how the award program came to be, how companies earn the award and what the value of this special achievement is. Doug and the guests will also talk about some highlights from the well-being track at 2016 IHC FORUM West in Las Vegas. Collaborating with expert consultants at CBIZ, we have designed five workshop sessions that cover the range of wellness in today's workplace. Tune in at 11:10 a.m. (ET) to learn more about the Edington CBIZ Next Practice Awards and what we have planned for November's conference. For the second segment, Doug will talk with Jen Arnold, owner of Redesigning Wellness, a consulting and training company that creates engaging and effective health and wellness strategies for forward thinking organizations. Worksite wellness should be treated just like any other business initiative in your company. Unfortunately, it rarely gets the attention it deserves. Often the responsibilities are thrown on an overworked HR person who already has too much on their plate. And these activities usually stay in HR with little exposure to the CEO. Wellness turns into haphazard activities, the same people participating and maybe the occasional Biggest Loser contest. Then you pray you’ll find something in your annual health care claims that shows a positive ROI. That’s not the way results happen! In this interview, Jen will talk about ways to redesign the common worksite wellness program in order to gain better traction and results.

On the first segment of today's show, Dr. Dee Edington and Jack Bastable, co-founders of the Edington CBIZ Next Practice Awards, tell us how the award program came to be, how companies earn the award and what the value of this special achievement is. Doug and the guests will also talk about some highlights from the well-being track at 2016 IHC FORUM West in Las Vegas. Collaborating with expert consultants at CBIZ, we have designed five workshop sessions that cover the range of wellness in today's workplace. Tune in at 11:10 a.m. (ET) to learn more about the Edington CBIZ Next Practice Awards and what we have planned for November's conference. For the second segment, Doug will talk with Jen Arnold, owner of Redesigning Wellness, a consulting and training company that creates engaging and effective health and wellness strategies for forward thinking organizations. Worksite wellness should be treated just like any other business initiative in your company. Unfortunately, it rarely gets the attention it deserves. Often the responsibilities are thrown on an overworked HR person who already has too much on their plate. And these activities usually stay in HR with little exposure to the CEO. Wellness turns into haphazard activities, the same people participating and maybe the occasional Biggest Loser contest. Then you pray you’ll find something in your annual health care claims that shows a positive ROI. That’s not the way results happen! In this interview, Jen will talk about ways to redesign the common worksite wellness program in order to gain better traction and results.

The first guest on this week's program will be Jessica Grossmeier, vice president of research, HERO. The concept that good health is good business has been validated over the years by research linking health risk factors to higher employee health care costs, reduced on-the-job productivity and higher absenteeism. More recently, research has expanded its focus to overall well-being, with some studies showing a correlation between low employee well-being, higher turnover, lower employee engagement and lower employee performance. Now, the latest emerging body of research, including a new study from HERO, demonstrates that improved stock performance may be yet another reason to invest in a healthy workforce. In this interview, Jessica will share the findings and discuss the applications of this new research.  For the second segment, we'll continue the wellness theme as we welcome Jeff Brizzolara, PhD, MPH, chief clinical officer, Viverae, to the show. Analyzing the true impact of a corporate wellness program can be tricky, as companies have learned that compiling individual health improvements across an entire population to form one standard of measurement is difficult. To formulate program effectiveness, more employers are embracing value of investment or return on investment, but oftentimes they can’t make the direct connection from seeing a significant difference in their health care costs. The traditional framework for health care ROI needs to change in order to portray a more accurate figure, which includes critical factors that sustain a healthy lifestyle or contribute to improvements in productivity.

The first guest on this week's program will be Jessica Grossmeier, vice president of research, HERO. The concept that good health is good business has been validated over the years by research linking health risk factors to higher employee health care costs, reduced on-the-job productivity and higher absenteeism. More recently, research has expanded its focus to overall well-being, with some studies showing a correlation between low employee well-being, higher turnover, lower employee engagement and lower employee performance. Now, the latest emerging body of research, including a new study from HERO, demonstrates that improved stock performance may be yet another reason to invest in a healthy workforce. In this interview, Jessica will share the findings and discuss the applications of this new research.  For the second segment, we'll continue the wellness theme as we welcome Jeff Brizzolara, PhD, MPH, chief clinical officer, Viverae, to the show. Analyzing the true impact of a corporate wellness program can be tricky, as companies have learned that compiling individual health improvements across an entire population to form one standard of measurement is difficult. To formulate program effectiveness, more employers are embracing value of investment or return on investment, but oftentimes they can’t make the direct connection from seeing a significant difference in their health care costs. The traditional framework for health care ROI needs to change in order to portray a more accurate figure, which includes critical factors that sustain a healthy lifestyle or contribute to improvements in productivity.

The first guest is Sean McManamy, SVP, strategy and product, HealthFitness, who discusses elusive drivers of wellness program participation. Sean will share new research that shows that to drive participation in wellness programs employers must address both the emotional and functional needs of employees and include personalized, customized communications. The research survey – conducted by HealthFitness in 2015 and 2016 – shows that wellness program participants have greater satisfaction with programs offered, perceived themselves as healthier and have a more positive attitude toward their employer. Yet, despite the myriad of available tools, tech and programs that are attractive to employees, a significant number – nearly 60 percent – remain outside of the program.: They are those who indicate they are likely to start participating, but for some reason do not. Fortunately, research findings point to ways employers can maximize the significant potential of their wellness programs by focusing on some of the elusive drivers that move employees to take action. For the second segment, Dr. Adrian Rawlinson, chief medical officer and co-founder at Obeo Health, joins the show to discuss how to use health care data for the benefit of both employees and employers. Obeo Health is a health care technology leader changing how employees engage with their health care decisions. Their platform combines advanced prescriptive analytics and personal health data to give more transparency and control. By helping employees objectively evaluate, manage and understand their health care needs, Obeo Health's solutions drive down costs and increase satisfaction for everyone.

The first guest is Sean McManamy, SVP, strategy and product, HealthFitness, who discusses elusive drivers of wellness program participation. Sean will share new research that shows that to drive participation in wellness programs employers must address both the emotional and functional needs of employees and include personalized, customized communications. The research survey – conducted by HealthFitness in 2015 and 2016 – shows that wellness program participants have greater satisfaction with programs offered, perceived themselves as healthier and have a more positive attitude toward their employer. Yet, despite the myriad of available tools, tech and programs that are attractive to employees, a significant number – nearly 60 percent – remain outside of the program.: They are those who indicate they are likely to start participating, but for some reason do not. Fortunately, research findings point to ways employers can maximize the significant potential of their wellness programs by focusing on some of the elusive drivers that move employees to take action. For the second segment, Dr. Adrian Rawlinson, chief medical officer and co-founder at Obeo Health, joins the show to discuss how to use health care data for the benefit of both employees and employers. Obeo Health is a health care technology leader changing how employees engage with their health care decisions. Their platform combines advanced prescriptive analytics and personal health data to give more transparency and control. By helping employees objectively evaluate, manage and understand their health care needs, Obeo Health's solutions drive down costs and increase satisfaction for everyone.

The first guest is Robin Gelburd, president of FAIR Health. The U.S. is in the midst of an epidemic of abuse of opioids, including both prescription painkillers and heroin. Unlike previous opioid abuse epidemics, this one is disproportionately affecting white, middle-class people in non-urban settings, including those with private health insurance. Drawing on its database of over 21 billion privately billed health care claims, FAIR Health has recently released two white papers on the crisis. The first examines the scope of the epidemic among the privately insured; the second reveals the specifics of services and costs associated with opioid abuse and dependence diagnoses, including both professional charges and allowed amounts. FAIR Health’s investigation demonstrates the growing impact of the opioid crisis not only on patients but on insurers, employers, providers and all other health care stakeholders. The second guest on the program is Denise Winston, financial wellness specialist and founder of Money Starts Here, who will be discussing why financial wellness is the next big focus for employers. Most of us are no strangers to financial worries, especially in today's economy. In the workplace, however, there's a growing concern that needs addressing: the impact of financially stressed employees on the workplace. The harsh reality is that the majority of working Americans are already living paycheck to paycheck, and it's getting worse. Unfortunately, due to the ACA, many employers have seen huge increases in their health care premiums and have no other option except to shift more of those health care costs onto their already financially stressed employees. In this interview, Denise and Doug will take a look what monetary worries will do to an employee's quality of life and how it impacts a company's bottom line.

The first guest on this week's show will be Michelle Snyder, chief marketing officer for Welltok, who will reveal insights into what employees really think about wellness. Welltok and the National Business Group on Health issued a survey of over 1,000 full-time employees of large employers on their thoughts on employee wellness programs. The survey reveals how employers can drive greater program participation. Key factors uncovered include the importance of personalization, impact of rewards and need for multi-channel communication. A one-size-fits-all approach will not work for employers that want to maximize their program investments. This deep dive exposes where opinions differ by gender, income and age. The second guest on the program will be George Bennett, co-founder, chairman and CEO for Good Measures. Good Measures has developed a breakthrough approach related to measuring and improving health by helping people change their eating habits that combines the human touch and caring of a Registered Dietitian with the computational power of an extraordinarily powerful digital app. The digital app (and the extensive cloud based analytical tools that underpin it) simplifies the complex task of helping an individual meet his/her multiple nutritional needs simultaneously (right number of calories; enough fiber; right amounts of protein, carbs, and fat; enough calcium; enough Vitamin D; not too much sodium, etc.) using a food/meal library that only contains foods that the individual likes and will eat. The implications of the new, patented approach are extensive and powerful.

On this week's show, host Doug Field talks with guests from Fifth Third Bank and Fidelity Health Marketplace. The first guest is Mark Robich, vice president and consumer-directed health care lead at Fifth Third Bank. In this interview, Mark will talk about Fifth Third Bank's recently introduced Consumer-Directed Health Care Solution and how this new solution makes it easier for business customers to administer high deductible health plans paired with tax-advantaged financial accounts, such as HSAs, FSAs and HRAs. Fifth Third joined Chard Snyder along with technology platform provider WEX Health to deliver a seamless experience and create one-stop shopping for employers. The second guest on the program is Joe Laurin, president of Fidelity Health Marketplace. In today's interview, starting at 30 minutes, Joe will talk about trends around private health exchanges and give his thoughts on the funding models used by some of these exchanges. He will also touch on the news about some national insurance companies pulling out of the public exchanges and on how that impacts people’s perception of private health exchanges.

The first guest on this week's program is Tibi Zohar, CEO of DoctorGlobe, the first and only U.S. domestic online hospital-shopping platform utilizing big data and crowd wisdom to exploit price inefficiency and identify quality of inpatient care. Everyone agrees that inpatient care is expensive in America. Transparency has become a common buzzword in every health care-related conversation, especially since the implementation of the ACA. The two common methods to overcome rising non-transparent costs have been either to negotiate prices (carriers) or to invent prices (RBP). But maybe there’s a better, more modern way to solve this puzzle? Catch this interview to find out how DoctorGlobe can help employers overcome non-transparency and identify quality in health care. The second guest on this week's program is Laurie Brednich, CEO and founder of HR Company Store, the premier website to help HR professionals find, rate and review vendor partners. Laurie began her career in the insurance industry working for Horizon Blue Cross and Blue Shield, MetLife and Hartford Steam Boiler. She then decided to take her unique skill set and apply it to the HR sector where she had a lengthy career helping employers maximize their benefit plan offerings. She has held employee benefit leadership positions at American Standard, the NBA, Pinnacle Foods Group, GoDaddy and most recently Sprouts Farmers Market. In this interview, Laurie will discuss why it's important for HR professionals to have an objective resource when selecting vendors and why mastering the art of the RFP is an essential skill for almost all HR professionals.

The first guest on this week's show will be Marcia Otto, vice president of pricing and transparency applications, Health Advocate. As consumer-driven health care continues to grow, more employees are taking an increasing role in managing the costs of their health care. To address this, a plethora of pricing transparency tools and similar resources have emerged to help them identify cost-effective, high-quality care that can lower health care spending. Despite the availability and value of these tools, utilization is still lacking. However, there are a number of strategies organizations can implement to motivate engagement and utilization of pricing transparency tools and realize their many benefits. In this interview, Marcia will talk about strategies for improving engagement in pricing transparency tools. For the second segment, starting at 11:30 a.m. (ET), Pam Mortenson, executive vice president, wellness solutions, Health Advocate, will join the program. Workplace wellness programs are now widespread at companies across the U.S.; yet, while these programs are intended to improve employee health and reduce overall health care costs, many employers still struggle to engage their workforce. In order to motivate employees to take action, organizations are beginning to adopt a holistic approach and shift from wellness to well-being. By creating a flexible, diverse program that goes beyond physical wellness to consider employees’ emotional, financial and social health, well-being programs more effectively address employees’ unique needs and drive engagement. 

The first guest on today's program is Tim O'Shea, CEO of Clearview Logix. Our experience tells us and studies confirm that many individuals pick the “wrong” health plan, i.e. the plan that does not cover the services they will likely need for the lowest total cost, often costing them hundreds or even thousands of dollars annually. People need help, because health plans are complex. Consumers increasingly expect decision support for major purchases. Our goal is to give them that guidance for health insurance – quickly and effectively. One of the critical elements in consumerism is health plan selection decision-support, which can be implemented easily, quickly and inexpensively without disrupting current platforms or administrative processes – a potentially valuable capability for midsized employers looking to push down the consumer-driven path. The second guest on today's show is Bill Hennessey, M.D., CEO of Pratter, America's medical cost savings company. By being independent of all health insurance companies, Pratter is able to use de-identified self-insured cost data to help deliver affordable care options to employees. Pratter’s cost savings analysis is used to determine which self-insured companies can benefit the most from its service and quantifies an ROI that can even be used to generate a money back guarantee proposal. All cost data gathered becomes instantly searchable on pratter.us by zip code – hospital charges and insurance company payments – for the first time ever. Catch this interview at 11:30 a.m. (ET) to learn more about Pratter's unique, grassroots solution.

The featured guest on this week's program will be Mike Sullivan, co-founder and chief growth officer for OneDigital, formerly known as Digital Insurance and Digital Benefit Advisors. In today's interview, Mike and Doug will talk about the convergence of technology and advisory solutions in the mid-sized and small employer benefits marketplace. Agencies are being asked regularly to deliver an expanded set of solutions to employers that involve software and advisory. It generally encompasses either process efficiency or analysis. The elegance and sophistication of these tools is rapidly evolving and moving down market. New investments in talent and solutions to keep pace with this change are challenging agencies to their very core.

On this week's edition of HealthCare Consumerism Radio, host Doug Field will talk with a new member of the team at ECFC, the leading non-profit organization dedicated to maintaining and expanding employee benefit programs on a tax-advantaged basis. Donna Crisalli has recently joined ECFC as technical advisor. Donna brings 20 years of experience working in senior positions at the Internal Revenue Service. As technical advisor, she provides counsel on matters pertaining to the eligibility of expenses for medical claims subject to the Internal Revenue Code section 213(d), which defines qualified medical expenses that can be reimbursed to an individual, on a tax-preferred basis, through account-based health plans, such as FSAs, HRAs and HSAs. Following the discussion with Donna, Doug will discuss this week's announcement regarding the co-location of Private Exchange FORUM, previously planned for September in Baltimore, with this year's IHC FORUM West at the Red Rock Resort in Las Vegas.

The first guest will be Robin Gelburd, president of FAIR Health. Consumers are frequently exposed to surprise balance bills when they unwittingly receive out-of-network services at in-network facilities. Consumers also receive sizable bills in the wake of receiving emergency care at a facility outside of their plan’s network. In order to address this growing concern—sometimes causing consumers to go into medical bankruptcy—state legislatures are designing legislation that holds a consumer harmless to in-network payment amounts and offers various approaches to how providers should be paid for such services. New York and Connecticut are examples of two such states that have moved in this direction. Other states are contemplating their own creative solutions to this pressing problem and are being watched with keen interest by stakeholders and policymakers. The second guest will be Kevin Robertson, senior vice president, director of sales, HSA Bank. After months of anticipation about the Department of Labor’s proposed regulatory fiduciary standards guidance, the final DOL regulations were issued on April 6, 2016. More than five years in the making, this guidance impacts many different aspects of retirement plans and some aspects of health benefits, including health savings accounts. These changes entail wide-sweeping impacts to a number of different plans and products that an employer may utilize within their retirement and benefit offerings. While the 600 pages of new regulations were not specifically targeting HSAs, these health accounts were explicitly identified as subject to the new rules. This interview tries to provide a simplified explanation of the regulations and their impact on HSA administrators, advisors and employers/plan sponsors.

The first guest is Rick Bates, the co-founder and CEO, SingleCare. As a result of the ACA, employers and benefit managers are experiencing a changing health care landscape that’s difficult to navigate. They are confronting a slew of new rules and regulations that are time consuming and increasingly expensive. In this interview, Rick will explain how technology is influencing the industry today and how employers and benefit managers need to incorporate these digital platforms into their benefits program. Specifically, he’ll discuss how health-tech companies like SingleCare are building a forward-thinking, technology-driven solution that not only streamlines the benefits process and reduces costs for employers, but also helps millions of Americans get the care they need without breaking the bank.   The second guest on this week's show is John H. Capobianco, president and chief marketing officer, HCIactive, who will be talking about the real cost benefits of workplace wellness programs. It’s no secret that wellness programs have gone mainstream. Many companies signed on with the wellness movement based on the promise that these programs would save them money on health expenses. However, for a number reasons, not everyone is seeing the savings they expected and there is growing doubt over the effectiveness of wellness programs. Understanding the real benefits that wellness programs provide – beyond health-related cost savings – can offer a shift in perspective.