82 episodes

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 health insurance marketplace but deliver lower costs and better value for your employees.



Who is this show for? It’s for employers, CEO’s, CFO’s, HR Directors and Benefit Managers and anyone else who is tired of the same poor results that we continue to get from our Health Insurance and Healthcare System. It’s for those who are suspect of the same old answers for why healthcare costs go up and want actionable strategies to get better results.



Join us! Get educated and get ready to take action!

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

    • Business
    • 5.0 • 65 Ratings

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 health insurance marketplace but deliver lower costs and better value for your employees.



Who is this show for? It’s for employers, CEO’s, CFO’s, HR Directors and Benefit Managers and anyone else who is tired of the same poor results that we continue to get from our Health Insurance and Healthcare System. It’s for those who are suspect of the same old answers for why healthcare costs go up and want actionable strategies to get better results.



Join us! Get educated and get ready to take action!

    Colin Quinn | Included Health Communities

    Colin Quinn | Included Health Communities

    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, with their first solution creating ways to help support the LGBTQ+ community. As President, Colin strives to raise the standard of healthcare for everyone, no matter what group you belong to or what industry you work in. 
    Colin Quinn received an MBA from Stanford University’s Graduate School of Business and went on to work in the finance and sales side of the pharmaceutical industry prior to launching Included Health. In 2021, Included Health was acquired by Grand Rounds and Doctor on Demand which has created a robust navigation and advocacy platform to support Employers in raising the bar in their recruitment and retention efforts. 
    Here’s a glance at what you’ll learn from Colin in this episode: 
    Why Included Health was launchedHow Included Health’s broad service offering can improve equity in healthcareHow Included Health reached an NPS score of 98%
    Timestamps:
    0:00 – Introduction and welcoming Colin to the show1:15 – Who is Colin Quinn and what is Included Health Communities?2:30 – How Colin pivoted from working in finance & sales in the pharmaceuticals industry to launching Included Health7:15 – How the acquisition of Included Health will allow the company to get to the next level and better serve employers and employees9:30 – What differentiates Included Health from the marketplace when it comes to healthcare navigations?12:20 – How will virtual care, digital solutions, and navigation increase the level of equity in healthcare & why is Included Health leading the way?20:30 – Why Included Health’s approach to equity can help multiple diverse groups22:15 – How does Included Health drive organizations forward in recruiting and retaining employees?27:10 – How do employers find out what their workforce wants/needs?29:10 – What does Included Health’s consumer satisfaction look like?30:35 – The research & development Included Health does to make iterative improvements to its offering32:45 – Who is Included in Health’s target market?34:00 – What exciting developments are coming for Colin?36:00 – How you can learn more about Included Health
    Resources:
    Learn more about Included Health Communities here: a...

    • 38 min
    Denise Shiffman | GroupWell

    Denise Shiffman | GroupWell

    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 clinical symptoms. GroupWell leverages technology to provide a platform where clinician-led group therapy can be accessed for specific groups of individuals dealing with similar issues and challenges. In addition, GroupWell provides wellness affinity groups led by certified behavioral coaches that can help people with sub-clinical levels of stress and anxiety as well as nutrition, weight loss, parenting, and other topics to support people’s emotional well-being. 
    Denise Shiffman held multiple executive roles at tech start-ups and at multi-billion-dollar tech and healthcare companies prior to starting GroupWell. This previous experience has helped her build a dynamic platform that can increase access to a mode of therapy that can help people learn the skills and behaviors to build connections and quality relationships and aid in the recovery from mental health conditions.
     Here’s a glance at what you’ll learn from Denise in this episode: 
    The personal experiences that led Denise to start GroupWellHow Group Therapy works and is proven to be as or even more effective than individual therapyHow GroupWell leverages technology to deliver evidence-based group therapy for Affinity GroupsWhy employers and care providers must pay more attention to mental health
    Timestamps:
    0:00 – Introducing and welcoming Denise to the show1:10 – Who is Denise Shiffman and what is GroupWell?2:35 – How Denise’s experience with chronic anxiety led her to create GroupWell5:45 – Making it through the pandemic, the state of mental health, and what lessons should employers be taking from the last two years? 11:00 – The issues that people with mental health issues face with current healthcare providers12:30 – Why is group therapy a relevant mode of treatment and why Denise decided to focus on it16:45 – How GroupWell works for those seeking mental health support23:40 – Why Denise works with certified coaches that lead affinity wellness groups and how mental health treatment is larger than just therapy27:10 – The timeline that GroupWell provides for their care29:10 – Exploring the data around how group therapy works for those seeking mental health care31:00 – How GroupWell attracts coaches and therapists to their network 35:20 – The method of tracking and sharing results with employers and how GroupWell keeps members engagedspan...

    • 46 min
    Veeneta Lakhani | Vida Health

    Veeneta Lakhani | Vida Health

    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 to prevent, manage and even reverse chronic conditions by bringing together mental and physical healthcare through a ground-breaking digital platform that connects patients to therapists and coaches. Vida Health’s clinical outcomes have led them to receive some of the highest customer satisfaction scores that we’ve seen on this podcast.

    • 42 min
    Wally Gomaa | SimplePay Health

    Wally Gomaa | SimplePay Health

    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 traditional health plans (deductible, coinsurance, confusing bills) a thing of the past while providing their members with the highest level of care. Based out of Dallas, Texas, SimplePay Health is taking on the status quo to reward employees for making choices that actually help lower overall costs.
    As a former President of a national insurance carrier, CFO of a healthcare provider and a benefits consultant, Wally has gained unique insight into the healthcare industry and leverages the SimplePay Health platform to address some of the problematic issues within our healthcare delivery and payment system.   
    Here’s a glance at what you’ll learn from Wally in this episode: 
    The payment system that SimplePay uses to make healthcare a breezeWhy Wally wants price transparency to become price CERTAINTYHow virtual care providers can provide higher quality careWhy simplifying complexities could bring the largest change to the healthcare industry
    Timestamps:
    0:00 – Introduction & welcoming Wally to the show1:05 – Who is Wally Gomaa and what is SimplePay Health?2:35 – The Bike Accident: How being hit by a car changed Wally’s perspective on the healthcare industry4:10 – Why haven’t price transparency tools & high-deductible health plans driven meaningful results? 7:10 – What is SimplePay Health doing to simplify health insurance?11:20 – How to show patients the disconnect between quality and price for commodity healthcare services13:35 – Using data to drive down costs whilst providing a higher quality service17:45 – SimplePay Health’s approach to using networks19:30 – Pharmacies & Aligning Incentives: How to reduce the formulary waste and price variations found at pharmacies & align incentives with employees22:50 – Digital Health Providers vs Brick & Mortar Providers: How virtual care providers can provide higher quality care25:20 – How SimplePay Health is implementing digital mental health services27:00 – Member Experience: How do employees navigate their healthcare service when using SimplePay Health?31:50 – Outcomes & Results: What results can employers expect when signing up to SimplePay Health?35:10 – How payments are managed by SimplePay Healthspan style="background-color:...

    • 50 min
    Harris Rosen + Ashley Bacot | Rosen Hotels & Resorts

    Harris Rosen + Ashley Bacot | Rosen Hotels & Resorts

    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 through their multiple hotels and resorts throughout Orlando, Florida. Harris and Ashley have created a healthcare model that not only saves the company in healthcare costs, but also provides healthier lifestyles for their employees, as they can choose their health over their wallet via the cost savings.
    Harris Rosen is the President and COO of Rosen Hotels & Resorts and has not only seen the growth of his hotel business, but through the success of his healthcare program, has created ProvInsure to implement their healthcare model into other companies.
    Ashley Bacot is the President of ProvInsure and Risk Manager for Rosen Hotels & Resorts. Ashley was integral in creating the self-insured healthcare model for Rosen that has helped save nearly half a billion dollars in healthcare costs since inception.
    Here’s a glance at what you’ll learn from Harris and Ashley in this episode:
    How Rosen Hotels & Resorts implemented their own self-insured healthcare model to save over $450 million since inception.The lessons taken from the Great Depression to survive COVID-19.How to remove the barriers within your healthcare plan to have healthier employees and reduce costs.The steps you can implement to allow your employees to choose their health over their wallet.
    Timestamps:
    0:00 – Introduction0:20 – Welcoming Harris and Ashley to the show1:12 – Who is Harris Rosen?1:50 – Who is Ashley Bacot?3:00 – The history of Rosen Hotels & Resorts and how they grew into a $361 million per year company.7:30 – How Rosen’s grandparents lessons on debt helped Rosen Hotels & Resorts survive through COVID-19.10:30 – Trying an alternate path: How an increase in healthcare costs led Harris to explore ways to provide primary care to his own employees.15:00 – “Rosen Care”: The initial success that led to over $450 million in healthcare savings.17:30 – Primary Care: Increasing access to quality primary care to employees via clinic access, benefit design & removing barriers.23:10 – How having an onsite clinic has impacted the health of employees and has lowered healthcare costs24:20 – Living by K.I.S.S and P.P.P.P.P.P – Keep It Simple Stupid and Prior Planning Prevents Piss Poor Performance25:50 – Encouraging Compliance: How to allow your employees to choose health over saving money29:10 – Why hospitals aren’t interested in competition and why the government and employers should get tough31:45 – Steering the employee towards high quality health care to create lower costs33:30 – Saving nearly half a billion dollars and Harris Rosen’s philanthropy39:00 – Managing a hospitality business and enticing people to work for Rosen Hotels and Resorts43:00 – If there was one question I should have asked: Fighting back against the insurance companies44:40 – How you can learn from Rosen’s model and implement it inside your business.
    Resources:
    Rosen Hotels & Resorts, Inc.: https://www.rosenhotels.com/ProvInsure: https://www.provinsure.com/
    Podcast Links:
    Website: http://www.reconstructinghealthcare.com/Apple Podcasts: a...

    • 47 min
    Marshall Allen

    Marshall Allen

    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 investigating the American healthcare system has led to writing his new book, titled “Never Pay the First Bill: and Other Ways to Fight the Health Care System and Win.”
    Marshall’s career has seen him honoured with multiple journalism awards, such as the Harvard Kennedy School’s 2011 Goldsmith Prize for Investigative Reporting and coming in as a finalist for the Pulitzer for his work at the Las Vegas Sun, where he worked before writing at ProPublica in 2011.
    In this episode, you’ll hear about real-life victories as employers and employees fight the healthcare industry. From dealing with price gouging, errors in billing, fraud and unnecessary treatments, Marshall has seen it all. Tune in to hear how employers and employees can fight back and protect themselves from being taken advantage of by the healthcare delivery and payment system.
    Here’s a glance at what you’ll hear from Marshall in this episode:
    Why Americans pay so much for healthcare whilst getting so little in returnHow Marshall’s career in investigative journalism led to him writing ‘Never Pay the First Bill’Why the business side of healthcare was designed to exploit both clinicians and patientsHow hospitals and insurance companies look after each other rather than the employee/employer.The inefficiencies and errors presented in the majority of medical bills and how to fight back
    Timestamps:
    0:20 – Introduction to Marshall Allen2:20 – Why did Marshall write: ‘Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win’7:08 – “The business side of healthcare was designed to exploit both clinicians and patients” – How the healthcare system takes advantage of Americans9:00 – The price variation patients deal with when going to hospital11:35 – Why aren’t hospitals showing transparent pricing and why aren’t insurance companies loyal to the employer/employee?15:15 – Employers are passing costs onto their employees16:30 – Increasing health literacy for employees and employers17:20 – How common are errors in medical bills?19:20 – The medical debt collecting industry21:30 – How to deal with medical debt22:18 – Why would you sue a medical provider for an unfair bill24:20 – The open price contract rule: Don’t pay more than Medicare would26:04 – How a hospital would react to a lawsuit in Small Claims Court28:00 – Using a referenced based pricing plan and why hospitals don’t like it30:20 – Share your medical finance victories with Marshall31:10 – Everybody’s Guide to Small Claims Court31:58 – Being aware of medical finance risks and how to avoid them33:45 – Avoiding unnecessary care34:10 – Avoiding immediate care35:20 – Mammograms: An unnecessary care example?38:05 – Stories of fraud in medical care and finance40:40 – The David Williams case44:00 – Who investigates fraud?46:30 – Standing up to a bully: How to push back49:45 – How to connect with Marshall Allen
    Resources:
    Follow Marshall Allen on ProPublica: https://www.propublica.org/people/marshall-allenFollow Marshall Allen on Twitter: https://twitter.com/marshall_allen?lang=enConnect with Marshall Allen via LinkedIn: a...

    • 52 min

Customer Reviews

5.0 out of 5
65 Ratings

65 Ratings

w* ,

Unlimited challenges meet solid solutions

Just when I think I’ve heard most of the wrongs within US healthcare I learn a whole new wrinkle. Yet, these well vetted guests are carving out paths to a new landscape of healthcare. You’ll be educated and more confident in our collective future.

malfoxley ,

Great show!

Michael, host of the Reconstructing Healthcare podcast, highlights all aspects of health care and more in this can’t miss podcast! The host and expert guests offer insightful advice and information that is helpful to anyone that listens!

JC JC JC JC ,

Excellent Healthcare Investigation Podcast

Michael’s pursuit and passion of investigating and uncovering healthcare’s deepest challenges is only matched by his desire to unveil healthcare’s greatest opportunities.

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