Impact Healthcare Podcast

Lester J. Morales
Impact Healthcare Podcast

Health benefits, one of the top 3 organizational expenses, become increasingly more costly each year with no end in sight. Health insurance disruptor Lester J. Morales interviews cutting-edge industry leaders implementing innovative strategies to lower healthcare costs by more than 20% while improving care quality for employees and their families. Need to see it to believe it? Subscribe to Impact Healthcare now!

  1. 4D AGO

    Unlocking Healthcare Savings with Reference-Based Pricing: Insights from Omar Arif

    In this episode of Impact Healthcare, host Lester Morales dives deep into the world of Reference-Based Pricing (RBP) with Omar Arif, Senior Vice President of Growth at Claim DOC. Together, they explore how RBP is disrupting the health benefits industry by replacing traditional PPO networks with a more transparent, cost-effective approach. Omar shares real-life examples of how organizations can save millions while improving access to care, debunking myths surrounding RBP and addressing common challenges. Whether you’re an employer, benefits consultant, or healthcare professional, this episode provides actionable insights to rethink your healthcare strategy. Key Takeaways:    What is RBP? A simplified breakdown of how RBP determines fair, transparent pricingfor healthcare services.       Overcoming Misconceptions: Tackling fears and addressing the perceived complexity of adopting RBP.         The Role of Advocacy: How proactive communication with providers ensures a seamless transition for employees and minimizes disruptions.       Audit and Fiduciary Responsibility: How Claim DOC’s rigorous auditing process safeguards plan assets andensures fair pricing.       Real-World Success: A case study highlighting a 41.4% reduction in healthcare costs for a 300-employee agricultural company.      Employee-Centric Focus: The importance of lowering employee contributions while improving healthcare access. This episode is a must-listen for anyone seeking innovative solutions to reduce healthcare costs without sacrificing quality. Connect with Claim DOC: Visit claimdoc.com, follow them on LinkedIn, or check out theirpodcast, Claim Talk, available on Spotify and YouTube. Listen now to discover how you can take control of your healthcare costs and create a lasting impact!

    50 min
  2. FEB 19

    The Power of Direct Primary Care: Redefining Employee Healthcare with Dr. Eric Crall

    On this episode of Impact Healthcare, Lester Morales dives deep into the revolutionary model of Direct Primary Care (DPC) with Dr. Eric Crall, a pioneer in transforming primary care. From the challenges of traditional healthcare to the incredible impact of DPC on employers, employees, and the healthcare system, this episode is packed with actionable insights. Key Takeaways:        What is DPC? A subscription-based healthcare model that eliminates insurance reimbursement and focuses on patient care.      The Employer Advantage: Learn how businesses like car dealerships and restaurants have reduced healthcare costs by up to 25% while improving employee satisfaction.      Why Employees Love It: No more waiting rooms, rushed visits, or financial barriers—DPC provides personalized care with unlimited access to doctors.      Lifestyle Medicine at the Core: Dr. Kroll explains how addressing root causes like stress, sleep, and nutrition prevents chronic diseases and improves overall well-being.    How DPC Scales: Whether your employees are spread across states or constantly on the go, discover how DPC ensures seamless, high-quality care. Real-Life Impact: Dr. Crall shares success stories, including a car dealership that saw substantial cost savings while offering better benefits. Employees gained access to care without out-of-pocket expenses, creating a healthier and more engaged workforce. Who Should Watch? This Episode?      Employers looking to cut healthcare costs and attract/retain top talent. Advisors seeking innovative ways to optimize health plans. Employees curious about how DPC can revolutionize their healthcare experience. What You’ll Learn:       The pitfalls of traditional fee-for-service models.      Why DPC is the future of primary care.         How employers can implement this model to benefit everyone involved. Take Action Now: If you're ready to explore DPC for your organization or want to connect with Dr. Aaron Kroll, visit Subscribe for More: Stay ahead of the curve with the latest strategies to disrupt the health benefits industry. Hit like, share, and subscribe to Impact Healthcare today!

    50 min
  3. FEB 5

    Tearing & Steering: The Future of Healthcare Cost Management with Josh Butler

    In this episode of Impact Healthcare, host Lester Morales welcomes Josh Butler, President of Butler Benefits and Consulting and High Plains Health Plan, to discuss the game-changing Texas House Bill 711—the "Tier and Steer Bill." This new legislation allows self-funded employers to customize health plans and incentivize employees to choose high-quality, lower-cost providers through financial benefits like $0 deductibles and co-pays. Josh shares how High Plains Health Plan has pioneered this approach, proving that transparent, direct contracting reduces costs while improving care quality. What is HB 711? Texas is leading the way by legally recognizing tiered healthcare models that reward smarter healthcare choices. How "Tier and Steer" Works: Employees pay less (or nothing) when they choose high-quality, cost-effective providers in Tier 1 networks. The Big Insurance Companies’ Role: Why traditional carriers don’t fully adopt these models—premium equals revenue. Direct Contracting Advantage: How negotiating with hospitals directly results in better deals, without hidden network fees. Employer Action Steps: Start with a risk assessment, analyze your claims data, and shift to cost-effective healthcare solutions. Bottom Line: If you’re still managing healthcare benefits the old way, you’re missing out on significant savings and better employee outcomes. Subscribe now for actionable strategies that lower costs and impact healthcare for the better!

    14 min
  4. JAN 22

    Captive Insurance Demystified: Control, Ownership, and Real Savings with Phillip Holowka

    In this episode of Impact Healthcare, host Lester Morales sits down with Phillip Holowka, COO of Complete Captive Management Services, to dive deep into the world of captive insurance. Together, they explore how captives empower employers to take control of their healthcare expenses, build equity, and improve employee benefits. Phillip shares his journey from EMS to the insurance industry, offering insights into why captives are a game-changer for businesses of all sizes. Whether you're a seasoned CFO or new to the concept, this episode provides a clear roadmap to understanding captives and their potential for revolutionizing your healthcare strategy. Key Takeaways:       Captive Insurance 101: Understand the difference between group captives, single-parent captives, and traditional insurance models. Control and Ownership: Learn why owning a captive puts you in charge of your healthcare dollars and policy language.        Risk Mitigation: Discover the importance of identifying and addressing high-cost claims to drive long-term savings.         Real-World Examples: Hear how employers, big and small, have leveraged captives to generate underwriting profits and reduce expenses.   Employee Impact: Learn how captives can align incentives, improve transparency, and enhance employee satisfaction. Actionable Insights: Captive insurance is more than a financial strateg it’s a commitment to proactive risk management and long-term savings. Connect with Phillip Holowka: Visit completecaptive.com or connect with him on LinkedIn to explore if a captive is the right solution for your organization. Subscribe now and join the movement to disrupt the health benefits industry with innovative strategies and actionable insights!

    51 min
  5. 09/18/2024

    Changing Healthcare from the Ground Up: How Direct Contracting and Data Transparency Are Revolutionizing Benefits | Featuring Daniel McCauley

    In this episode of Impact Healthcare, host Lester Morales sits down with Daniel McCauley, founder of Mac Consulting Group, to discuss how his personal experiences have shaped his passion for transforming healthcare benefits. 🚀 From aerospace engineering and tech to the healthcare benefits industry, Daniel’s journey is unique, but his insights into data transparency, direct contracting, and cash pay models are invaluable for employers and employees alike. Topics Covered in this Episode: Data Transparency & Direct Contracting 📊: Learn how direct contracting with medical providers can drastically reduce healthcare costs for both employers and employees, while improving access to high-quality care. Understanding Deductibles 💸: Why the traditional deductible model is broken and how it’s making healthcare unaffordable for many. Daniel breaks down the hidden issues behind deductibles and why they’re causing more harm than good. Personal Story Impacting Change ❤️: Daniel shares a personal story about his father’s healthcare journey, which ignited his mission to change the way employers and employees think about healthcare quality, cost, and access. Challenging the Status Quo 🏥: Lester and Daniel explore why employers, employees, and even medical providers are frustrated with the current system—and how innovative approaches like direct pay can solve these challenges for all parties involved. Guest Spotlight: Daniel McCauley 👨‍💼 Daniel McCauley is the founder of Mac Consulting Group, a firm dedicated to helping businesses take control of their healthcare costs 💼. With a background in aerospace engineering, tech, and insurance, Daniel brings a fresh perspective to the healthcare benefits industry, focusing on real solutions like cash pay options, direct contracting, and data-driven strategies that improve outcomes for everyone involved. Key Takeaways: 💡 Direct Contracting for Savings: Learn how direct contracts with healthcare providers can reduce employee out-of-pocket expenses and save employers money at the same time. 📊 Data-Driven Decisions: Using healthcare data to make smarter choices for your employees, leading to better care and lower costs. 🛑 Reevaluate Deductibles: Why the traditional deductible model doesn’t work, and how to structure a plan that benefits both the employer and the employee. ❤️ Personal Motivation for Change: How Daniel’s personal experience with his father’s medical journey has fueled his drive to improve healthcare for others. 📲 Don't Miss This Episode! If you’re an employer, HR professional, or someone navigating the complexities of healthcare benefits, this episode is packed with actionable insights that could save you thousands of dollars while offering better care for your employees. 📣 Subscribe to Impact Healthcare for more episodes on how to revolutionize your healthcare benefits 💼, and don’t forget to like 👍, share 📲, and leave a review to help more people find these game-changing strategies! Timestamps: 00:00 - Introduction to Daniel McCauley 04:15 - How Personal Experiences Shape Healthcare Reform 09:30 - Breaking Down the Deductible Problem 16:50 - Direct Contracting: A Win for Employers, Employees, and Medical Providers 23:20 - Why Healthcare Shouldn’t Be This Expensive 30:45 - Solutions to Reduce Costs and Improve Care Quality

    37 min
  6. 08/21/2024

    Rewriting the Rules of Private Equity with Patrick Staunton

    Welcome to the Impact Healthcare Podcast, where we're revolutionizing the health benefits industry with innovative ideas and game-changing strategies! In our latest episode, host Lester J. Morales has an inspiring conversation with Patrick Staunton, a partner in the Employee Benefits Group at Thompson Flanagan. Patrick's journey from starting his career at Cigna to becoming an influential figure at Thompson Flanagan is a testament to his passion for transforming the way private equity firms approach insurance!  During their conversation, Patrick takes us through the pivotal moments that shaped this transformation, including his personal experience of stepping into the world of private equity and the challenges he faced along the way.  Patrick shares the story of a company on the brink of a 60% insurance premium increase—an unsustainable burden for the business. Through innovative strategies, including the use of an independent third-party administrator and a transparent PBM, Patrick and his team were able to save the company nearly $1M. The story doesn't end there, as we explore the crucial role of communication and education in ensuring the success of these alternative plans, especially for blue-collar employees!  Join us as Patrick and Lester break down the complex world of private equity insurance, revealing how Thompson Flanagan’s hands-on approach not only provides value but also empowers employees to take control of their healthcare!   This episode is packed with insights, real-life examples, and a deep dive into the strategies that make a difference in the lives of employees and the bottom lines of businesses so whether you're in the healthcare industry or simply curious about the intersection of private equity and employee benefits, subscribe to the Impact Healthcare Podcast and don’t miss this transformative episode!

    39 min
5
out of 5
20 Ratings

About

Health benefits, one of the top 3 organizational expenses, become increasingly more costly each year with no end in sight. Health insurance disruptor Lester J. Morales interviews cutting-edge industry leaders implementing innovative strategies to lower healthcare costs by more than 20% while improving care quality for employees and their families. Need to see it to believe it? Subscribe to Impact Healthcare now!

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