78 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
    • 4.9 • 62 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!

    Harris Rosen + Ashley Bacot | Rosen Hotels & Resorts

    Harris Rosen + Ashley Bacot | Rosen Hotels & Resorts

    Harris Rosen and Ashley Bacot of Rosen Hotels and 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 and 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 and 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 and 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 – Introduction
    0:20 – Welcoming Harris and Ashley to the show
    1:12 – Who is Harris Rosen?
    1:50 – Who is Ashley Bacot?
    3:00 – The history of Rosen Hotels and Resorts and how they grew into a $361 million per year company.
    7:30 – How Rosen’s grandparents lessons on debt helped Rosen Hotels and 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 and removing barriers.
    23:10 – How having an onsite clinic has impacted the health of employees and has lowered healthcare costs
    24:20 – Living by K.I.S.S and P.P.P.P.P.P – Keep It Simple Stupid and Prior Planning Prevents Piss Poor Performance
    25:50 – Encouraging Compliance: How to allow your employees to choose health over saving money
    29:10 – Why hospitals aren’t interested in competition and why the government and employers should get tough
    31:45 – Steering the employee towards high quality health care to create lower costs
    33:30 – Saving nearly half a billion dollars and Harris Rosen’s philanthropy
    39:00 – Managing a hospitality business and enticing people to work for Rosen Hotels and Resorts
    43:00 – If there was one question I should have asked: Fighting back against the insurance companies
    44:40 – How you can learn from Rosen’s model and implement it inside your business.
    Resources:
    Rosen Hotels and Resorts, Inc.: https://www.rosenhotels.com/ (https://www.rosenhotels.com/)
    ProvInsure: https://www.provinsure.com/ (https://www.provinsure.com/)
    Podcast Links:
    Website: http://www.reconstructinghealthcare.com/ (http://www.reconstructinghealthcare.com/)
    Apple Podcasts: https://podcasts.apple.com/us/podcast/reconstructing-healthcare-innovative-solutions-for/id1240066325 (https://podcasts.apple.com/us/podcast/reconstructing-healthcare-innovative-solutions-for/id1240066325)
    Instagram: https://www.instagram.com/reconstructinghealthcare/ (https://www.instagram.com/reconstructinghealthcare/)
    Facebook: https://www.facebook.com/ReconstructingHealthcare/ (https://www.facebook.com/ReconstructingHealthca

    • 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 return
    How 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 patients
    How 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 Allen
    2:20 – 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 Americans
    9:00 – The price variation patients deal with when going to hospital
    11:35 – 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 employees
    16:30 – Increasing health literacy for employees and employers
    17:20 – How common are errors in medical bills?
    19:20 – The medical debt collecting industry
    21:30 – How to deal with medical debt
    22:18 – Why would you sue a medical provider for an unfair bill
    24:20 – The open price contract rule: Don’t pay more than Medicare would
    26:04 – How a hospital would react to a lawsuit in Small Claims Court
    28:00 – Using a referenced based pricing plan and why hospitals don’t like it
    30:20 – Share your medical finance victories with Marshall
    31:10 – Everybody’s Guide to Small Claims Court
    31:58 – Being aware of medical finance risks and how to avoid them
    33:45 – Avoiding unnecessary care
    34:10 – Avoiding immediate care
    35:20 – Mammograms: An unnecessary care example?
    38:05 – Stories of fraud in medical care and finance
    40:40 – The David Williams case
    44:00 – Who investigates fraud?
    46:30 – Standing up to a bully: How to push back
    49:45 – How to connect with Marshall Allen
    Resources:
    Follow Marshall Allen on ProPublica: https://www.propublica.org/people/marshall-allen (https://www.propublica.org/people/marshall-allen)
    Follow Marshall Allen on Twitter: https://twitter.com/marshall_allen?lang=en (https://twitter.com/marshall_allen?lang=en)
    Connect with Marshall Allen via LinkedIn: https://www.linkedin.com/in/marshallallen/ (https://www.linkedin.com/in/marshallallen/)
    Never Pay the First Bill on Amazon: https://amzn.to/3tS01ZQ (https://amzn.to/3tS01ZQ)
    Marshall Allen’s website: https://www.marshallallen.com/about-marshall (https://www.marshallallen.com/about-marshall)
    Fair Health Consumer: https://www.fairhealthconsumer.

    • 52 min
    Dave Jacobs and David Greenberg | Homethrive

    Dave Jacobs and David Greenberg | Homethrive

    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 division and Medline’s Post-Acute business that encompassed nursing homes, home health, assisted living and managed care insurance. David Greenberg served as Executive Vice President of Strategy and Group President, defining and supporting strategic priorities, leading business development initiatives to strengthen the Medline portfolio, and MandA.
    In this episode, you’ll hear why Dave and David decided to leave their high paying Senior-Executive roles at well-respected companies to create Homethrive. You’ll hear how Homethrive is helping people look after their aging parents while allowing them to stay in their own homes, instead of an aged care facility.
    Here’s a glance at what you’ll learn from Dave Jacobs and David Greenberg in this episode:
    The foundation story of Homethrive: Why the co-founders left their Senior-Executive roles to create their own company.
    How Homethrive is helping people look after their aging parents while allowing them to stay at home instead of an Aged Care Home.
    Why Traditional Benefit Offerings often aren’t enough for employees burdened with care-related responsibilities for their aging parents.
    How Homethrive is able to provide each customer with their own unique Care Guide and the types of services they offer.
    The positive impact this can have on employees knowing they have an advocate to address elder care issues for loved ones.
    Timestamps:
    0:22 – Welcoming David and Dave to the show
    1:00 – Who is Dave Jacobs?
    2:00 – Who is David Greenberg?
    3:42 – Why David and Dave left their Senior-Executive roles to create Homethrive
    8:20 – The state of traditional benefit offerings in the age of COVID-19
    10:50 – How organizations can transition their benefit offerings as employees and their parent's age
    12:20 – Diversity, Equity, and Inclusion: Is their inequity in benefits and healthcare?
    14:15 – The Homethrive Product: What problems are Homethrive trying to solve?
    16:40 – Homethrive’s Unique Product Offering: Your own Care Guide and access to technology
    20:55 – A concierge resource for eldercare issues and unique needs
    24:20 – The Employee Experience: How do the children of aging parents use Homethrive?
    27:00 – The Scope of the Problem: Do companies know that their employees need to have access to aged care?
    28:10 – Suffering in Silence: Why aren’t employees bringing aged care up with CHRO’s?
    30:10 – How does Homethrive recruit their Care Guides?
    33:50 – The outcomes of Homethrive so far: Increasing productivity, reducing stress, increasing quality time
    36:30 – How COVID-19 has impacted the Homethrive service
    37:10 – Targeted Segments: The fee structure for the employer segment
    39:50 – How many employees are managed under Homethrive and the incentives being offered
    42:08 – Why Geography isn’t an issue
    43:35 – If there was one question that I didn’t ask: How much of a need aged care is in the US?
    45:55 – Being a high touch service company whilst utilizing technology
    48:00 – How you can find more about Homethrive
    Resources:
    Homethrive: https://homethrive.com/ (https://homethrive.com/)
    Dave Jacobs LinkedIn: https://www.linkedin.com/in/dave-jacobs-215b702/ (https://www.linkedin.com/in/dave-jacobs-215b702/)
    David Greenberg LinkedIn: https://www.linkedin.com/in/david-c-greenberg/ (https://www.linkedin.com/in/david-c-greenberg/)
    Podcast Links:
    Website: http://www.reconstructinghealthcare.com/ (http://www.reconstructinghealthcare.com/)
    Apple Podcasts: https://podcasts.apple.com/us/podcast/reconstructing-healthcare-innovative-solutions-for/id1240066325...

    • 50 min
    Nate Murray | Crossover Health

    Nate Murray | Crossover Health

    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.

    • 55 min
    Christin Deacon | Amino

    Christin Deacon | Amino

    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.

    • 49 min
    Omar Dawood | Calm

    Omar Dawood | Calm

    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, innovating medical devices and digital health products as a senior executive. At Calm, he leads B2B employer and health plan sales and is passionate about helping people around the globe lead healthier, happier lives by building resilience through better sleep and improved mindfulness.
    While 20% of Americans are dealing with a mental health illness of some sort, Omar believes that we shouldn’t forget about the other 80% of people who experience stress and anxiety without a mental health diagnosis. That’s where Calm comes in to act as a preventative measure to improve behavioral and mental health as well as resilience through mindfulness practices, meditation, and strategies for better sleep.
    Calm started as a B2C app but is making strides in the B2B sector to support employers, employees, and organizations. And it’s working. The sign-up rate on employer accounts is 30% with 80% engagement, and the experiences it offers – like the “Daily Calm” and “Sleep Story” – are helping employees reduce stress, sleep better, respond better to life, communicate more effectively, and boost immunity around the world.
    The benefits Calm offers to organizations and employees is clear. For organizations, they provide actionable insights and aggregate trends. For employees, they offer pathways to increased resilience and wellbeing and a “Calm Effect” that touches every area of their life.
    Calm’s NPS is just over 70 and they do qualitative ratings and satisfaction measurements in a number of ways. The team at Calm is excited for more innovation in behavioral and mental health and encourage collaboration in the field in order to spread health and happiness to billions.
    Here’s a glance at what we discuss in this episode:
    00:50 - Introducing Omar and Calm.
    02:30 – His cancer diagnosis changed his view on medicine and the industry’s lack of data; he didn’t appreciate the value of mental and behavioral health until 10 years ago.
    04:45 – He saw a need to bring an engaging experience to behavioral health; this is how he came upon Calm and loves his role in bringing that to employers/employees.
    06:30 – The 1 in 5 statistic: Omar believes we should consider the preventative health of the other 80% who also experience stress and anxiety but aren’t diagnosed.
    08:50 – The pandemic opened up the dialogue that we’re all coping and should do something about it because we’re human, not because we’ve been diagnosed.
    10:00 – Most employees experience stress and anxiety; digital health made help easier and more accessible, but still sat downstream in terms of treatment.
    12:50 – What was missing was something more upstream and preventative.
    13:00 – EAP services 0-3% engagement, Calm’s sign-up rate is 30% on employer accounts and average engagement of 80%; it’s not seen as behavioral health at all.
    14:40 – Calm is an experience, not a product, and becomes a part of the user’s life to support better resilience through meditation, mindfulness, and better sleep.
    16:30 – They started with B2C and are now working with employers and organizations to broaden their impact.
    18:15 – The benefits of meditation: The “Daily Calm” content through the app helps people respond (not react) to life and communicate better.
    21:30 – It impacts your immune system, your ability to support yourself through challenges, and shift your perspective.
    23:20 – Narrated mindfulness topics: Gratitude, visualization, positive frameworks, communication.
    27:00 – Using Calm for better sleep: The “Sleep Story” is a bedtime story told by a narrator of your selection, t

    • 45 min

Customer Reviews

4.9 out of 5
62 Ratings

62 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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