In our knowledge segment, we talk a little bit about a big expense – pharmaceuticals. Many employers don’t know that prescription drugs make up 25-30% of their total healthcare spend. In fact, these numbers are projected to get more dramatic, reaching 50% in the next few years. 

Then we talk with Jake Frenz of SmithRx about the ways that we can continue creating value in the pharmaceutical space, his history of serving in the Marines, and a short digression into… classical music? In between Andrew Clayton’s prospects as a classical pianist, ski trips, and some shots taken at golf, we discussed the specific levers that can fix the problems of outsized pharmaceutical prices. 

Finally, in the “you know they’re a knucklehead when…” section, we discussed the role of people skills versus strategic vision in relationship-based businesses. It turns out – who knew? – that if you’re giving advice to someone, you need more than a good golf swing and a box of donuts.

In this episode, we go over the phenomenon of medical inflation and what parts of the COVID-19 pandemic have contributed to rising medical costs – as well as what self-insured employers can do about it.

Then we chat with Brian Olsen of Sterling Seacrest Pritchard (SSP) to talk about his deep, committed relationship with self-funding and why that means we need a dating site for SIIA members. He shares one great insight about the often-misunderstood relationship between high claims and self-funded plans that you won’t want to miss.

Finally, we discuss one knucklehead move that too many brokers use in a feeble attempt to contain costs. It’s the epitome of short-term thinking. Is your broker guilty of this particular howler?

How is anyone able to buy specialty pharmaceuticals without going broke? What are some of the economic pressures on doctors to prescribe expensive meds? Where is Andrew Clayton hiding, and will he be back next time?

Join us with special guest host Ashley Hull and guest Rashaun Reid of ParetoHealth as they team up with Andrew Cavenagh to tackle these questions in an updated format.

Along the way, they go into why taking the convenient route when you should be helping people is a classic knucklehead move, the strange phenomenon of giving up transparency for a few dollars off your PEPM costs, and how to educate physicians on best pharmaceutical practices.

How do you provide first-class healthcare benefits while also containing costs?

That’s the main question of this live episode, recorded with Suzanne Lutz, Laura Williams, and Santina Daily, three captive Members from very different industries and backgrounds. What they all have in common is a complete dedication to the well-being of their employees and a desire to change that relationship.

This is only a small part of the value that you can get from a ParetoHealth Members’ Meeting. If the advice here resonates with you, visit https://paretohealth.com to learn more.

Guest host: Jack Longstreth, SVP, ParetoHealth

In our second live episode from our San Diego Members’ Meetings Andrew Clayton and guest host Jack Longstreth chat with two VP’s of Human Resources: Kim Bauer of Altra Federal Credit Union and Lisa Levanger of Wasatch Property Management Inc. This episode delivers great conversation about how a high-quality self-insured solution can help develop better relationships with employees, drive an employee-centric culture, and improve retention.

Guest host: Jack Longstreth, SVP, ParetoHealth

We took the bold step of recording this episode before a “live audience” at our recent Paradigm and StructuRe Members’ Meetings. Andrew Clayton and guest host Jack Longstreth have a lively conversation with two great CFOs: Jill Kindell of Miami Valley Steel and Chris Bissinger of Essential Ingredients.

This episode is chock-full of advice from ParetoHealth Members who have seen phenomenal success in controlling their benefits, delivering tangible value to their employees, and forging a stronger company culture through their health plans.

The advice they share is specific, actionable, and a quick sampling of the value that our Members’ Meetings offer.

Why does stop-loss premium increase at a different rate than medical trend?

We broke down why on this episode. It turned out there was some math involved.

Hilarity ensued, but we got to the bottom of “leveraged trend” when it was all over. And with only a small number of… all the insurance terms you can possibly imagine.

Then we sat down with Seth Denson, our friend and partner to talk about staying focused on what’s really important in a world full of shiny distractions, the supply chain crisis in healthcare, and the differences in economics when you’re talking about care versus insurance.

After that, we launched into the… curious practice that some knucklehead brokers have of comparing a best-case scenario for fully-insured plans to a worst-case scenario for self-insured ones.

Hmm. I wonder what their motivation could possibly be. Really gets the old noggin joggin’.

We’re talking lasers, but not the “pew-pew” kind. This is our conversation on stop-loss lasers and how they’re calculated. Lasers are among the most pressing concerns for employers, so we break down the details.

Then we’re joined by Billy Potter, CEO of Snellings Walters, to talk about his journey into insurance, how business culture eats strategy for breakfast, and how to get the right people into the right roles. It also includes some psychological truths about your brave and beloved hosts, so listener discretion is advised.

In our “You know they’re a knucklehead when…” segment, we talk about a particular piece of knuckle-headedness that plagues the industry. Namely, the advice that someone should “always take the stop-loss laser.” It’s a little bit like telling someone that they should “always cross the street.” Depending on the street, you might end up facing a bigger problem than what you started with.

How does a stop-loss carrier calculate their rates? Why is it good to be big? Should people be shamed for not being able to do math in their heads?

We sit down to talk about these burning questions and much, much more. Helping us get to the heart of it all is Cara Kirsch, Area Vice President of Gallagher in Omaha, Nebraska. She walks us through her journey, telling us how her smart use of data, entrepreneurial spirit, and growing up in a small town have all combined to make her a leader, an inspiration, and a great person to have on your side. We also touch on industry diversity, why insurance isn’t boring (we swear!), and some big plans for a food truck.

In our recurring “You Know They’re a Knucklehead When…” segment, we examine a bizarre idea. Some brokers think that a stop-loss carrier can make people sick. Really. Seriously. It’s built into their numbers. Makes us all look bad.

We explain why the so-called “fully insured” model is neither full nor insured. We talk with Austin Madison of Hub International about baseball, his crazy high GPA, and how he realized that a self-insured model was better for his clients and his business. Then the gloves come off and we take on the knuckleheads, the spreadsheet addicts, the dinosaur insurance brokers who think they’re the smartest ones in the room – bless their hearts.