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Reconstructing Healthcare: Innovative Solutions For Employers To Lower Their Healthcare Costs

Reconstructing Healthcare: Innovative Solutions For Employers To Lower Their Healthcare Costs

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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 heal ...
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Colin 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, wit…
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Denise 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 clin…
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Veeneta 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…
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Wally 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 traditiona…
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Harris 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 th…
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Marshall 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 investig…
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Dave 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…
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In 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 pri…
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In 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…
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In 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…
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In this episode, Michael introduces Justin Leader, the CMO of Highlight Health and a self-funded benefits and risk advisor. Early in his career, Justin learned about the major shortcomings of the healthcare and health insurance industry and how it is built for profitability, not value. When he met Josh Spivak, the CEO of Highlight Health, they saw …
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In this episode, Michael introduces Doug Aldeen, a healthcare and ERISA attorney. He has represented reference-based pricing organizations, PPO networks, medium to small self-funded plans, TPA’s and provider sponsored HMO’s in various capacities. Doug started his career at an insurance defense firm, then worked at a local HMO for years. It was ther…
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In this episode, Michael introduces Mike Poelman, the founder and president of Apta Health. Although Mike started his career as an accountant and controller, he quickly realized that he was a salesman at heart so he shifted into the TPA world working on self-funded health plans. This is where he realized that things needed to be done differently. M…
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In this episode, Michael introduces Dr. Simon Mathews, a distinguished researcher, clinician, author, and Chief Medical Officer at Vivante Health. He is also a practicing gastroenterologist at the John Hopkins School of Medicine and the Head of Clinical Innovation at John Hopkin’s Armstrong Institute of Patient Safety and Quality. Simon’s research …
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In this episode, Michael introduces Dawn Cornelis, the co-founder and Chief Transparency Officer of ClaimInformatics. ClaimInformatics is a payment integrity solution that helps its clients identify improper healthcare claim payments and recoup the money for the employer. When Dawn entered the world of claim processing 30 years ago, it didn’t take …
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In this episode, Michael introduces Jim Wachtel, the Executive Vice President of Sales and Marketing for Renalogic. Renalogic is dedicated to helping employers manage kidney disease in their employee population and reducing dialysis costs with preventive programs and pricing solutions. Jim was inspired to enter the healthcare industry because he re…
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In this episode, Michael introduces Dr. Cristin Dickerson, a founding partner at Green Imaging, a full-service virtual medical imaging network owned and operated by board-certified radiologists. Dr. Dickerson founded Green Imaging to provide affordable, high-quality medical imaging for uninsured and high-deductible patients across the U.S. While sh…
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In this episode, Michael introduces A.J. Loiacono, the CEO at Capital Rx, a pharmacy benefit manager seeking to create the first efficient and transparent marketplace for prescription prices and ultimately reduce prescription costs for employer groups. A.J. has over 20 years of experience in pharmacy benefits, finance, and software development. Alt…
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In this episode, Michael introduces Jason Hellickson, the CEO of Regenexx, a global provider specializing in interventional orthopedics. Regenexx partners with self-funded employers to significantly reduce their orthopedic spending while providing employees a choice in care. Regenexx orthopedic procedures leverage the body's natural healing ability…
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Topics Revenue Cycle Management Rising healthcare costs Bundled Pricing Cost Savings Centers of Excellence Improving Employee Experience In this episode, Michael introduces you to Sachin ‘Sach’ Jain, CEO of Carrum Health. Join us as we discuss how Carrum Health has created an alternative marketplace for lower-cost surgical procedures with a focus o…
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In this episode, Michael introduces Marek Ciolko, the CEO of Gravie, a unique health plan that offers employers a shared savings model and employees the opportunity to personalize their insurance to meet their needs. Gravie does this by helping employers control costs while still providing employee-selected coverage and a better experience througho…
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In this episode, Michael introduces Steve Watson, a CFO/CHRO and founder of Trendbreakers, a community of finance, human resources, and benefit advisor professionals that are on a mission to break the trend of rising employee healthcare costs. Trendbreakers helps CFOs, CHRO’s and business owners make the best employee benefit decisions by offering …
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In this episode, Michael introduces two partners of ScoutRx, Robert LeCureaux, the VP of Client Development and Amy Bandy, the VP of Operations. ScoutRx helps employer groups and members maintain affordable prescription drug costs through the use of their three core cost containment strategies. When previously working in the pharmacy and PBM indust…
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In this episode, Michael introduces Matt McCambridge, the co-founder, and CEO of Eden Health, a virtual primary care and navigation platform centered around care teams. Eden Health helps employees navigate today’s complicated healthcare landscape across insurance, primary care, and mental healthcare so they can make smart, well-informed and cost-co…
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In this episode, Michael introduces Gabriel Mecklenburg, the co-founder and COO of Hinge Health, a musculoskeletal solution for employers and health plans. Hinge Health is pioneering the world's most patient-centered digital hospital, starting with musculoskeletal health. Gabriel brings a unique perspective to the company because of his background …
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In this episode, Michael introduces John Powers, the Executive Vice President of Sales and Marketing for Advanced Medical Pricing Solutions (AMPS). AMPS provides market-leading healthcare cost containment services for self-funded employers, public entities, municipalities, labor unions, brokers, consultants, TPAs, payers, reinsurers, and HMOs. John…
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In this episode, Michael introduces Shane Foss, the founder and CEO of Hooray Health. Hooray Health leverages an Urgent Care and Retail Clinic National Provider Network built for Individual and Group limited medical insurance plans. Shane has over twenty years of tenure as an executive in the medical industry and it was through this work that he be…
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In this episode, Michael introduces Dr. Neil Leibowitz, a psychiatrist, attorney, and the chief medical officer at Talkspace Online Therapy. Talkspace is a technology company whose aim is to expand access to mental healthcare. Dr. Leibowitz has an impressive educational and professional background and spent a good deal of time working with larger h…
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Topics: Specialty Drugs Specialty Pharmacy vs. Retail Pharmacy Pharmacy Benefits Misaligned Incentives Price Transparency Medication adherence versus compliance Quality of care Cost Savings In this episode, Michael introduces you to Andy Reeves, the Co-owner and CEO of OptiMed Specialty Pharmacy. Join us as we discuss how OptiMed Specialty Pharmacy…
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Topics: Misaligned incentives Fraud, Waste, and Abuse Health Insurance Consumer spend Medicare National Provider Identifier In this episode, Michael introduces you to Marshall Allen, an Investigative Journalist at ProPublica. Join us as we discuss how Marshall pierces the healthcare facade by investigating and reporting on stories that highlight th…
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Topics: Pharmacy Benefit Manager (PBM) Misaligned Incentives Price Transparency Efficacy versus Effectiveness Consumerism Specialty Drugs Drug Waste Drug Manufacturer Rebate Steerage In this episode, Michael introduces you to Mort Jorgensen, the Co-founder, and CEO of Rx’n Go, Paul Ford, the Founder of OrchestraRx and Pramod John, the CEO of VIVIO …
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Topics: Healthcare Financial Wellness Navigation Quality Transparency Steerage Narrow Network Smart Match Health Savings Account In this episode, Michael introduces you to David Vivero, the Co-founder and CEO of Amino Health. Join us as we learn about Amino Health, a health care financial wellness platform that integrates with an employer’s existin…
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Topics: Healthcare Literacy Wellness Gamification Content Tool Employee Engagement Behavior Change In this episode, Michael introduces you to Al Lewis, the CEO of Quizzify. Join us as we learn about Quizzify, a health literacy content tool that leverages gamification and comedy to educate individuals and drive savings and well being through increas…
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Topics: Healthcare Finance Healthcare Literacy Misaligned Incentives Corruption Supplier Induced Demand Forced Competition Consumer Education Change Management Steerage In this episode, Michael introduces you to Dr. Eric Bricker, an internal medicine physician, and former Co-Founder and Chief Medical Officer of Compass Professional Health Services.…
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Topics: Opioid Crisis Pain Killers Mental Health Addiction Chronic Pain Treatment Facilities In this episode, Michael introduces you to Tim Ryan, the Founder of a Man in Recovery Foundation. Join us as we learn more about how opioid addiction impacted Tim’s personal life and how he is striving to help others’ suffering from addiction and bring awar…
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Topics: Medical Captives Stop loss Risk Taking, Risk Sharing, Risk Shifting Data Analytics Transparency Cost Control Direct Provider Network Funding Strategies Cost Containment Strategies In this episode, Michael introduces you to Michael Schroeder, the President of Roundstone Insurance. Join us as we discuss how Roundstone Insurance provides emplo…
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Topics: Opioid Crisis Advocacy Pain Management Mental Health Addiction Chronic Pain Stress Management In this episode, Michael introduces you to Harry Nelson, a leading health law expert, and the author of The United States of Opioids: A Prescription for Liberating A Nation in Pain. Join us as we discuss the history of the opioid crisis, the implic…
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Topics: Telemedicine Virtual Clinic Primary Care Direct Primary Care On-Demand Primary Care Pediatric Care Subscription Impact Entrepreneur Pharmacy Utilization In this episode, Michael introduces you to Robbie Cape, CEO, and Co-Founder of 98point6. Join us as we discuss how 98point6 is seeking to tackle the primary care crisis by removing barriers…
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Topics: Onboarding Platform Comprehensive Digital Platform Benefits Administration Care Navigation Innovative Marketing Self-funded Plans Medical Loss Ratio Third Party Administrator Reference Based Pricing In this episode, Michael introduces you to Nancy Reardon, Chief Product and Strategy Officer of Maestro Health. Join us as we discuss Maestro H…
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Topics: Women’s Health Pediatric Health Digital Clinic Platform Family Planning Fertility Maternity Return To Work Telehealth Consumer Experience Point Solutions In this episode, Michael introduces you to Katherine Ryder, Founder and CEO of Maven Clinic. Join us as we discuss how Maven Clinic simplifies and modernizes the maternity and family plann…
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Topics: Sleep Health Management Outcomes Based Treatment Population Sleep Health Solutions Performance Improvement Neuroscience of Sleep Sleep Medicine Insomnia Sleep Apnea In this episode, Michael introduces you to Dr. Jeffrey Durmer, Co-Founder and Chief Medical Officer for FusionHealth. Join us as we discuss how FusionHealth’s practical sleep ap…
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Topics: Type 2 Diabetes Medication Reduction Diabetes Reversal Nutritional Ketosis Clinical Trials Performance-Based Reimbursement Increased access to care Cost Savings In this episode, Michael introduces you to Bill Snyder, Vice President for Enterprise Partnership Health Plans at Virta Health. Join us as we discuss Virta Health’s mission to rever…
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Topics: Chronic Conditions Consumerism Clinical and Financial Outcomes Data Science Behavior Enablement Smart Coaching Medication Affordability and Optimization In this episode, Michael introduces you to Glen Tullman, Executive Chairman of Livongo. Join us as we discuss how Livongo empowers people with chronic conditions to live better and healthie…
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Topics: On-Demand Health Insurance Consumerism Clinical Care Paths Aligned Incentives Cost Savings Dynamic Copays Price Transparency In this episode, Michael introduces you to Tony Miller, Co-founder and CEO of Bind On Demand Health Insurance. Join us as we discuss how Bind provides an innovative platform to address some of the deficiencies in trad…
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Topics: Concierge Support Cost Management Price Transparency Network Optimization Medical Bill Review Reference Based Pricing Level Funding Third Party Administrator (TPA) In this episode, Michael introduces you to Keith Lemer, CEO of WellNet Healthcare. Join us as we discuss how WellNet Healthcare provides employers with an entrepreneurial approac…
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Topics: Misaligned Incentives Engaged Healthcare Consumer Price Transparency Center of Excellence Local Healthcare Tourism Integrative Medicine Cost Savings In this episode, Michael introduces you to Dr. Josh Luke, a veteran hospital CEO and award-winning healthcare futurist, public speaker, and author. Join us as we discuss Dr. Luke’s newest book,…
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Topics: Hospital Billing Errors Medical Bill Review Reference-based pricing Price Transparency Network Discount Model Chargemaster Balance Billing Cost Savings In this episode, Michael introduces you to Dr. Merrit Quarum, Founder and CEO of WellRithms Inc. Join us as we discuss how WellRithms endeavors to transform healthcare through Hospital medic…
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Topics: Mental Health Behavioral Health Access to Care Quality of Care Evidence Based Care Consumer Experience In this episode, Michael introduces you to Sean McBride, Head of Partnerships at Lyra Health. Join us as we discuss how Lyra Health is transforming mental health care by creating a frictionless experience for patients, providers and employ…
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Topics: Specialty Drugs Data Analytics Net Acquisition Cost vs. Discount Pricing Improving Health Outcomes Specialty Drug Waste Prior Authorization Cost Savings Misaligned Incentives In this episode, Michael introduces you to Pramod John, CEO of VIVIO Health. Join us as we discuss how VIVIO Health, a specialty drug platform, utilizes data analytics…
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Topics: Pharmacy Benefit Manager Self-Funded Health Plan Misaligned Incentives Rebates Formulary Waste Formulary Design Specialty Drugs Clinical Programs Performance Guarantees In this episode, Michael introduces you to Mindi Fynke, President and CEO of Employee Health Insurance Management (EHiM). Join us as we discuss EHiM’s unique service-oriente…
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