Self-Funded

Spencer Smith

Self-Funded, hosted by Spencer Smith, is the definitive resource for benefits consultants and employers who are ready to challenge the broken healthcare status quo. Each week, you'll get an insider's playbook of actionable strategies from industry leaders that help make healthcare better, together.

  1. 7 hr ago ·  Bonus

    2027 Renewal Season Prep with Imagine360 - LIVE!

    This episode was recorded live on LinkedIn with Bill Dembereckyj, CFO of Imagine360, and it's a look at renewal season from the seat that ultimately signs off on it.  Bill walks through three real cases: a 250-life senior living facility staring at a 50% increase, an 85-life restaurant group facing a $450,000 jump, and a 140-life private school looking at 60%. We get into why CFOs are being brought in far too late, why Bill started his own plan renewal in Q1, and what happens when finance only gets handed the result and asked to bless it. Audience questions from the live cover captives with RBP, whether stripping the network hurts steerage, and what happens when a member needs care somewhere you're not contracted. If you want to be more useful to the CFO in the room this renewal season, this is the episode. Tune in. "You've taken away all my other strategic choices. Now the only lever I have left is how much employees pay versus how much the company pays." — Bill Dembereckyj, CPA Thank you to our 2026 sponsors! ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more. Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more. Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more. Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com. Chapters: (00:00:00) Intro: What Is Imagine360 and What Is RBP? (00:02:56) The CFO's Role in the Renewal (00:04:35) The Bias Toward Procrastination (00:08:13) Balancing HR, Finance, and the CEO (00:09:36) Audience Question: Captives, RBP, and Cash Pay (00:13:40) Case One: Senior Living, 250 Lives, 50% Renewal (00:18:30) Fixed Budgets and the Fear of Maximum Exposure (00:21:09) Case Two: Restaurant Group, 85 Lives, 60% Renewal (00:24:19) What Healthcare Inefficiency Does to Company Value (00:28:31) Don't Pull Every Lever at Once (00:29:50) Audience Question: Does RBP Hurt Steerage? (00:33:08) Pharmacy: The $400,000 Rebate Nobody Saw (00:38:13) Case Three: Private School, 140 Lives, 60% Renewal (00:43:24) What Bill Wants From Consultants (00:49:09) Give Your Broker Some Grace (00:52:16) Closing Thoughts Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

    2027 Renewal Season Prep with Imagine360 - LIVE!

  2. 3 days ago

    Why Employers Should Cover Whole Genome Sequencing | with Joshua Resnikoff

    Whole genome sequencing costs about $1,000 today. Ten years ago it was fifteen. Clinical guidelines already say kids with epilepsy or developmental delay should be escalated to it, and more than half of them never are. My guest this week is Joshua Resnikoff, founder of Sunstone Health and a former bench scientist at Harvard.  He came to this the hard way. His middle son started spiking 105-degree fevers at 18 months old, and it took three years and several pediatricians to name the condition. When they finally did, the answer was that there's no treatment. Josh knew the tests existed. He just couldn't reach them. So he built a business that runs employer claims data, finds kids with a likely genetic basis for their disease, and gets them trio whole genome sequencing in twelve weeks instead of seven years. The part that matters for a plan sponsor: this runs as a voluntary benefit. No new plan language, no TPA codes, no prior auth, no insurance in the equation at all. Four documents and a claims feed. Josh takes the testing cost at risk, and getting a family to a diagnosis meaningfully cuts their utilization from there. We also cover why single-gene and exome testing miss 97% of the genome, what it costs, and why these families are already expensive whether you find them or not. If you're looking for cost containment that actually helps the member, this is the episode. Tune in. "We can help you deal with that before it ever actually becomes a claim." - Joshua Resnikoff, Sunstone Health Thank you to our 2026 sponsors! ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more. Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more. Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more. Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com. Chapters: (00:00:00) Intro: The Black Box of Healthcare Pricing (00:04:24) 98.6 to 105 in the Time It Takes to Get Milk (00:11:01) Everything on the Shelf, Nothing Within Reach (00:16:40) One in Ten Americans (00:22:45) What Genetic Testing Actually Means (00:29:33) Who Pays, and Why the Families Already Know (00:34:56) The Case for Sequencing Everyone (00:40:00) The Guidelines Say Do It. Half Don't. (00:45:17) Direct Primary Care and the Voluntary Benefit Model (00:50:57) The Mechanics: Four Documents and a Claims Feed (00:55:40) Vendor Fragmentation and the Netflix Problem (01:00:48) The Moonshot and the $2 Trillion in Waste Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

    Why Employers Should Cover Whole Genome Sequencing | with Joshua Resnikoff

  3. 21 Aug ·  Bonus

    The "Wild West" of Peptides | with Rick Manuel

    Half of what this pharmacy compounds is GLP-1s. The other half is a category most benefits professionals have never had to think about, and probably will within a few years. I got a tour of Optimal Balance Pharmacy's facility and sat down with co-owner Rick Manuel to talk through what peptides actually are, how the FDA's category two list works, and what happens if those compounds move to category one. We get into why BPC-157 has a better safety profile than ibuprofen and the mechanism behind that, how lyophilization quietly strips 30 to 40% of protein concentration out of the product people buy online, and what to look for in a compounding pharmacy's sterility and endotoxin testing. Rick also explains why compounded GLP-1s can be dosed twice weekly instead of once, why physicians are having to self-educate on a category medical school never covered, and why he thinks insurance coverage for peptides is roughly a decade away. If you've been seeing this stuff on Instagram and wondering what's real, this is a look behind the curtain. Tune in. This episode is a discussion of an emerging category and is not medical advice. "It's not the drug that's making you lose muscle. It's the reduction of appetite." — Rick Manuel Chapters: (00:00:00) What Peptides Actually Are (00:00:46) The FDA Category Two List (00:01:44) Why BPC-157 Beats Ibuprofen (00:04:15) How Peptides Signal the Body (00:07:20) The Instagram Problem and Lyophilization (00:09:24) Inside Optimal Balance's Testing and Compliance (00:12:33) Educating Physicians on a New Category (00:14:27) Compounded vs. Brand GLP-1s (00:15:54) The Rules for Compounding Right Now (00:16:38) Why Twice a Week Beats Once (00:20:36) The Recovery Blend (00:24:23) Protein, Resistance Training, and Muscle Loss (00:26:50) Where This Goes Next (00:28:18) Why Peptides May Never Be FDA Approved Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

    The "Wild West" of Peptides | with Rick Manuel

  4. 18 Aug

    The Right Way to Cover GLP-1s in Your Health Plan | with Embla

    Everyone in this market is optimizing for the wrong thing. Consumers want the most weight loss for the cheapest price, and up to 40% of what they're losing is muscle. My guests this week are Nicholas Syhler, a former cardiologist who left his residency to work upstream of the heart attacks he was treating, and Paul Elsass, an exercise physiologist who spent years in startup land before landing on the one root cause nobody had solved.  Their company, Embla, runs a coach-first GLP-1 program out of Copenhagen with peer-reviewed data on almost 5,000 patients showing 55% less medication and the same weight loss outcomes seen in clinical trials. We get into why the drug was never designed to shut off hunger, why members can sit on a quarter milligram of semaglutide for months instead of escalating every 30 days, and the claims data suggesting aggressive dosing is quietly driving up MSK spend. We also cover why they built the model around self-funded employers rather than direct-to-consumer, what one bundled price under $500 a month actually includes, and their plan to move from weight loss into full cardiometabolic care with deprescribing as the goal. If you're evaluating a GLP-1 strategy for 2027, this one reframes the question. Tune in. "We were seeing four to six pounds per week. That's way too much. It should be one to two." — Nicholas Syhler Thank you to our 2026 sponsors! ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more. Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more. Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more. Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com. Chapters: (00:00:00) Intro: Meet Embla(00:01:30) From Cardiology Residency to Quitting Medicine(00:05:56) Reading the First Line on the Label(00:07:07) Losing Weight Too Fast: The Muscle Problem(00:08:34) Why "Eat Less, Move More" Fails(00:12:43) Coach First, Clinician Second(00:14:19) A Quarter Milligram for Four Months(00:16:52) Semaglutide vs. Tirzepatide(00:19:29) The MSK Claims Nobody Saw Coming(00:22:17) Why Self-Funded Employers, Not Consumers(00:25:09) Where the Name Embla Comes From(00:27:28) One Price, Everything Included(00:30:42) Learning About PBMs the Hard Way(00:34:43) Deprescribing and Cardiometabolic Care(00:42:30) Why America Makes This Harder(00:46:30) The Three Behavioral Levers(00:49:27) How the Program Actually Rolls Out(00:54:14) Diet, Fasting, and Food Quality(00:57:10) The Moonshot(01:00:59) Closing Thoughts Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

    The Right Way to Cover GLP-1s in Your Health Plan | with Embla

  5. 11 Aug

    Nobody In Washington Understands Employer Healthcare | with Katy Talento

    Katy Talento ran healthcare at the White House Domestic Policy Council and helped push through the price transparency executive order. Now she runs health plans for a living, including for the convent where she once lived as a nun. She spends this episode on why a post-network world keeps hitting the same wall: the three-way contracts between carrier, TPA, and provider that make the network Plan A by force. She explains why she thinks those provisions violate the Sherman Act, what DOJ has started doing about it, and why the workarounds employers use today amount to an underground railroad rather than a functioning market. We also cover the 2026 CAA and the DOL rule that together make PBMs fiduciaries and may do the same to TPAs, her four-part "school choice for healthcare" plan to scale cash pay nationally, and the AI upcoding wave she thinks is breaking stop-loss actuarial models right now. If you've ever wondered why the obvious fix isn't available to you, this is the episode. Tune in. "Nobody in the entire town understands employer-sponsored care. All the oxygen is on 20 million people on the ACA. But 180 million people over here, we're not doing any policy for." - Katy Talento Thank you to our 2026 sponsors! ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more. Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more. Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more. Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com. Chapters: (00:00:00) Intro(00:01:05) From Epidemiologist to Capitol Hill(00:05:37) The Nun Years and Her First Client(00:10:50) Inside the Price Transparency Executive Order(00:16:58) Why Washington Ignores 180 Million People(00:20:33) What Transparency Data Can Actually Do Now(00:25:55) The Plantation Contracts(00:29:01) DOJ, the Sherman Act, and Anti-Competitive Provisions(00:33:04) The CAA and the DOL Rule That Reset Fiduciary Duty(00:39:16) Why the Big Three PBM Model Is Now Illegal(00:46:53) RBP's Access Problem: The Nuns at NYU Langone(00:54:54) The Holy Grail: One Cash Price(00:57:46) School Choice for Healthcare(01:13:43) AI Upcoding and Why Stop-Loss Models Broke(01:21:15) Closing Thoughts: Tell Your Story Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

    Nobody In Washington Understands Employer Healthcare | with Katy Talento

  6. 4 Aug

    The Switch: Why Employers Want To Be Led, Not Sold | with Billy Potter

    My guest this week is Billy Potter, now CEO of Snellings Walters, and we spend this episode on "the Switch," his firm's process for moving employers from fully insured to self-funded. Billy explains why he thinks it has almost nothing to do with insurance and everything to do with changing who a business trusts to lead them. We get into why "does that make sense?" is the worst question in sales, why he asks prospects "where did I lose you?" instead, and why he believes most deals aren't lost on product, they're lost on communication.  Billy breaks down how Culture Index reshaped how his firm hires, trains, and sells, why he tells skeptical prospects out loud that they shouldn't believe a word of his pitch, and why price-driven clients are usually being trained that way by their own consultant. If your presentation is technically correct but you keep losing deals anyway, this is the episode. Tune in. "People don't buy what's best for them. They buy what they understand the fastest." - Billy Potter Thank you to our 2026 sponsors! ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more. Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more. Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more. Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com. Chapters: (00:00:00) Intro: Grace, Truth, and Growth(00:03:19) Culture Index and Why It Blew Spencer's Mind(00:04:33) Billy's Background: Rugby, Sun Life, and a Borrowed ID(00:08:13) Partner vs. Vendor: Why "Supplier" Is a Dirty Word(00:12:52) What Drew Him to the Consulting Side(00:14:34) The Peanut Butter Fight and the Valley of Despair(00:16:19) Advice for Young Producers: Dream Big, Get Rejected(00:19:44) Spencer's Story: The Nursery Floor and Three Cases in a Morning(00:24:49) Becoming CEO and Learning to Manage His Emotions(00:29:08) Why He Loves Building Other People Up(00:30:44) EOS and Smoking Out the Real Issue(00:32:20) How Culture Index Runs Through the Whole Business(00:35:06) The Switch: Changing Who Gets to Lead(00:39:44) His First Big Sale: Telling a Client to Go Talk to Their Agent(00:43:02) "Billy Potter Is Gonna Mess Up, and I'll Be There"(00:45:44) Win and Lose the Same Way: The Anthony Russo Lesson(00:50:20) Why 83% of Employees Don't Understand Their Own Plan(00:53:17) The Fifth-Grade-Level Rule and Why Insurance Loves Jargon(00:56:31) "Where Did I Lose You?" and Other Pivot Questions(00:58:12) The Last Slide: "You Don't Believe Anything We Just Told You"(01:01:14) The "Oh, Damn It" Moment and Who's Really at Fault(01:03:37) Where Self-Funding Is Headed(01:05:11) AI, Robot Surgeons, and the Future of White-Collar Jobs(01:12:27) The Chick-fil-A Standard: Hospitality as a Differentiator(01:14:49) Retaining Our Humanity in an AI World(01:17:07) Closing Thoughts Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

    The Switch: Why Employers Want To Be Led, Not Sold | with Billy Potter

  7. 31 Jul ·  Bonus

    Trump's Generic Drug Tariffs & The 14% ACA Hike | Last Month in Healthcare

    "Generic drugs are not the costly drugs. A 100% increase on a relatively inexpensive generic may not even be noticeable." In this episode of Last Month in Healthcare, Producer Nathaniel and I sat down with Sean McGowan of Centivo to break down the biggest healthcare news stories of July 2026. We started with the proposed tariffs on generic drugs - 100% in 2028, 200% in 2029 - and what that actually means when India supplies roughly half of U.S. generic volume and China supplies most of the active ingredients. We also dug into ACA marketplace insurers proposing a 14% median premium increase for 2027 and whether ICHRA adoption is quietly loading that risk pool, the Patients Deserve Price Act clearing Senate HELP 21-1 and whether posted prices change any real behavior, specialty drugs on track for a 32% jump by 2028 driven by utilization rather than unit price, and a misleading headline about $6.6 trillion in "tax help" for employer plans that's actually been on the books since the 1950s. To cap it off, we ran a point solution trade deadline in honor of the MLB deadline - six solutions on the roster, a $100 cap, and some tough calls on who's overpaid. Plus I answered a listener question on whether covering GLP-1s for weight loss locks an employer in for good. Tune in for a great conversation! Thank you to Walk-On Clinic for sponsoring this episode. Visit walkonclinic.com to learn more. Chapters: (00:00:00) Intro: Sean McGowan and Walk-On Clinic (00:01:39) 200% Tariffs on Generic Drugs by 2029 (00:04:41) ACA Insurers Want a 14% Premium Hike for 2027 (00:07:28) The Patients Deserve Price Act Clears Committee (00:10:44) Specialty Drug Costs to Jump 32% by 2028 (00:13:10) The $6.6 Trillion Tax Break Nobody Noticed (00:14:37) Game: The Point Solution Trade Deadline (00:19:52) Ask Spencer Anything: Can You Un-Cover GLP-1s?

    Trump's Generic Drug Tariffs & The 14% ACA Hike | Last Month in Healthcare

  8. 28 Jul

    Outlier Clauses: Healthcare's Best Kept Secret | with Ryan Bojrab

    "If you're expecting to pay $50k, but it hits an outlier clause, you could be paying upwards of three, four, five, six hundred thousand dollars." What if the single biggest driver of your high-cost claims isn't your discount, your network, or your utilization, but a contract provision almost nobody in this industry has ever read? My guest this week is Ryan Bojrab, who leads new solution development at Aon and came into this business through a channel almost nobody uses: he started his career as a clinician with a doctorate in physical therapy, treating patients inside a federally qualified health center.  When carriers started dictating how many visits he could give a patient, he began pulling the thread, and hasn't stopped since. Ryan and I spend this episode discussing the outlier clause: the provision buried in hospital-carrier contracts that flips your negotiated discount once billed charges cross a threshold. Expecting a 50% discount on an open heart surgery? Once the trigger hits, you may be paying 70% of billed charges on the entire episode of care, and watching a $50,000 claim become a $500,000 one.  Ryan calls it the casino's high roller table, and it's where hospitals make their money. It also produces one of the most perverse incentives in American healthcare: the longer you're in the bed, the worse your discount gets. If you've ever put two networks side by side, seen a massive pricing delta, and couldn't explain why - tune in. Thank you to our 2026 sponsors! ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more. Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more. Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more. Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com. Chapters: (00:00:00) Intro: The Best Kept Secret in Network Contracts (00:05:59) From Clinician to Consultant: On the Receiving End of Every Vendor Pitch (00:10:46) Why Indiana Became a Self-Funding Powerhouse (00:16:00) What Is an Outlier Clause? The Casino's High Roller Table (00:21:00) The Hospital's Defense and the Inverted Discount (00:27:43) What You Can Actually Do: RFP Language and Direct Contracting (00:35:12) Prompt Pay Providers and the Death of Spec Advance (00:41:17) A Quarter-Million-Dollar Claim With No Checks and Balances (00:47:39) Decoupling Primary Care From Insurance (00:53:36) The Four Buckets of Quality (00:58:53) Tiering and Steering at National Scale (01:05:36) Closing Thoughts: Contract Terms Are the Next Frontier Key Links for Social: @SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02 Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286 Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/ Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

    Outlier Clauses: Healthcare's Best Kept Secret | with Ryan Bojrab
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Trailer

About

Self-Funded, hosted by Spencer Smith, is the definitive resource for benefits consultants and employers who are ready to challenge the broken healthcare status quo. Each week, you'll get an insider's playbook of actionable strategies from industry leaders that help make healthcare better, together.

Information

  • Creator
    Spencer Smith
  • Years Active
    2021 - 2026
  • Episodes
    299
  • Rating
    Clean
  • Copyright
    © Spencer Smith
  • Show Website
    Self-Funded

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