The ShiftShapers Podcast

David Saltzman
  • 4.4 (20)
  • MANAGEMENT
  • UPDATED WEEKLY

Change either paralyzes or energizes - the choice is yours. Hear from businesses and entrepreneurs who have become energized and who have profited by shaping the shifts in their markets and practices. Become a SHIFTSHAPERS INSIDER and get our latest download, advance notice of all podcasts, podcast summaries, and special INSIDER-ONLY content. INSIDER SIGN UP

  1. 4D AGO

    EP 542 What If Chronic Disease Was Optional? - with Brett Smith

    Employers keep paying for the symptoms of obesity, diabetes, and metabolic syndrome while the root causes go untouched. We unpack why many wellness models fail, how insulin resistance hides for years, and what chronic disease reversal can look like when a physician-led metabolic health team measures the right signals and tapers meds safely.  • metabolic syndrome as a dominant driver of employer healthcare costs  • why low-fat guidance and ultra-processed food worsen hunger and outcomes  • fasting insulin and CGMs as earlier and more actionable markers than glucose alone  • nutritional ketosis versus diabetic ketoacidosis and why the terms get conflated  • GLP-1 medication costs plus the idea of a structured GLP-1 off-ramp  • reported outcomes including weight loss and guaranteed improvements in A1C and blood pressure  • deprescribing as a safety requirement when health improves quickly  • ROI logic for self-funded plans including claims reduction and lower pharmacy spend  Call my cell phone, 262-255-9545. brett@toward.health

    36 min

  2. MAR 24

    EP 541 When CFOs Treat Healthcare As Any Other Cost - with Carl Schuessler, Jr.

    We explore how employers can manage healthcare like any other cost by shifting from insurer-built, passive plans to employer-built, actively managed designs. Carl Schuessler, Jr. shares candid tactics on data, precision testing, and honest change management that help advisors become true risk partners. • defining a health plan mission that aligns to EBITDA and predictability • focusing on data hot spots such as MSK, imaging, pharmacy, and facilities • using billing audits and cost containment partners to reduce leakage • when and how to apply precision tests as costs drop • overcoming fear of self-funding with worst-case clarity and reserves • building crawl-walk-run-fly ramps with navigation, pharmacy, and bundles • unbundling components to align incentives and improve outcomes • elevating advisors to CFO-level strategic partners As a benefits advisor, you need more than a platform. You need a partner that makes you indispensable and impossible to replace. That’s BenePower. For more information or to schedule a demo of Benepower, go to BenePower.com

    27 min

  3. MAR 17

    EP 540 Ethics As The Competitive Edge - With Adam Russo, JD

    We dig into who truly makes claim decisions in self-funded plans and why that matters when ethics and compliance collide. Adam Russo shares how fiduciary prudence, transparent compensation, and NSA arbitration are reshaping risk, trust, and costs. • plan sponsors as final decision makers on claims • plan documents lagging laws and mandates • compliance versus ethics as distinct obligations • transparent compensation, performance fees, and caps • fiduciary prudence in subrogation and settlements • NSA and IDR process failures driving higher spend • negotiation strategy, data, and calibrated offers • governance, documentation, and audit-ready processes For more information or to schedule a demo of Benepower, go to BenePower.com

    33 min

  4. MAR 10

    EP 539 From Founder Hustle To Scalable Structure - With Forrest Derr

    We dig into why growth stalls when roles blur and the founder stays the bottleneck. Forrest Durer shows how clear seats, weekly scorecards, and steady leadership cadence create accountability and make scaling calm and repeatable. • common founder-led bottlenecks and warning signs • seats defined by 5–7 responsibilities not titles • building a simple pyramid with an integrator or COO • activity-based KPIs and weekly scorecards • busy work versus productive work • weekly one-to-ones and leadership cadence • documenting processes for onboarding and quality • writing and using vision and core values daily • letting go at the 80% standard to free the founder • when and how to use fractional leaders

    20 min

  5. 12/30/2025

    EP 534 ENCORE: Choice Without Chaos - with Chad Schneider

    We revisit how employers can control healthcare spend while expanding employee choice through ICRAs, with Chad Schneider of Thatch sharing what works, what breaks, and what’s next. We dig into change management, decision tools, dynamic contributions, and the broker’s evolving role. • Why ICRAs surged after 2020 and boomed in 2024 • Carrier expansion and a stronger individual market • The real barrier being change management and fintech • Decision support that mirrors travel-style shopping • Dynamic contributions that create equity across markets • Carve-out classes to manage renewals and strategy • Common misconceptions among brokers and employers • Data, APIs, and real-time enrollment tracking • Emerging perks, localized networks, and future trends Please feel free to go to our website, which is thatch.com, reach out to me on LinkedIn. I’d love to chat with you, and we can happily go through our process, quoting, show you all the cool bells and whistles, and we’d love to be able to engage further.

    25 min

  6. 12/23/2025

    EP 516 ENCORE: Rethinking Provider Networks - with Scott Smith

    We revisit how PPOs got built on discounts and show why total value beats sticker price. Scott Smith joins us to explain nationally curated high-performance networks that rank providers on effectiveness, appropriateness, and cost, and how that changes renewals, member experience, and fiduciary risk. • why traditional PPO discounts miss total cost of care • how consolidation and narrow networks increase abrasion • claims-based scoring at the provider NPI level • quality metrics that matter: effectiveness, appropriateness, cost • member tools: stars, plain-language summaries, mobile access • plan design that waives cost sharing for high-quality choices • PEPM pricing without shared savings games • national footprint for TPAs and large employers • faster ROI and improved MLR through reduced waste • roadmap to a true BUCA alternative

    26 min

  7. 12/16/2025

    EP 518 ENCORE: Quality Without Guesswork - with Kate Grohall

    We explore how reducing variation in cost, outcomes, and experience creates real value, and why deep provider metrics and real-time member support outperform box-checking credentialing. Kate Grohal shares a playbook for aligning incentives without repeating the mistakes that soured HMOs. • defining quality as reducing variation across cost, outcomes, experience • Kate’s path from patient escort to quality leader • why NCQA alone falls short for measuring provider performance • additional metrics: infection rates, readmissions, team engagement, co-management • building value-based networks that screen out low-performing providers • real-time care navigation via nurses, MAs, and app-based prompts • behavior change through waived cost-sharing and premium reductions • the downside of PEPM fees and paying for non-performance • differentiating value-based care from old-school HMO denial tactics • employers moving from back seat to driver’s seat • tech adoption gaps and the next five-year horizon Visit BenaPower.ai or email info@BenaPower.com to schedule a demo For more information, visit HatcherMedia.net — that’s H A T C H E R Media.net

    27 min

  8. 12/09/2025

    EP 531 ENCORE: Solving The Health Payment Puzzle - with Tom Policelli

    We revisit the rising problem of the “functionally uninsured” and ask how to restore real access for employees who delay care because of confusion and cost. Paymedix CEO Tom Policelli shares how a super EOB, upfront provider payment, and 0% financing change behavior and bend trend. • confusion outranking cost as the top barrier to care • hospitals pushing prepayment and the access wall it creates • income-tier patterns driving ER and inpatient overuse • super EOB mechanics and single monthly reconciliation • provider payment upfront and revenue-cycle relief • employer savings of two to three trend points annually • advisor positioning and retention benefits • partnerships with EXO Health to improve network economics • TempoPay for pharmacy access and first-dollar fills • risk management via broad pooling and automatic eligibility • national expansion through aligned partners and TPAs • a third path beyond prepay or bill-and-pray collections “Go to PayMedix.com.”

    24 min
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4.4
out of 5
20 Ratings

About

Change either paralyzes or energizes - the choice is yours. Hear from businesses and entrepreneurs who have become energized and who have profited by shaping the shifts in their markets and practices. Become a SHIFTSHAPERS INSIDER and get our latest download, advance notice of all podcasts, podcast summaries, and special INSIDER-ONLY content. INSIDER SIGN UP

Information

  • Creator
    David Saltzman
  • Years Active
    2014 - 2026
  • Episodes
    547
  • Rating
    Clean
  • Copyright
    © 2026 The ShiftShapers Podcast
  • Show Website
    The ShiftShapers Podcast

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