"In what other industry could a purveyor put out 99% bad bills and stay in business?" - Linda Komisak

“They're diagnosing things for things that you don't even have. And that’s scary.” - Kimberly Carleson

Kimberly Carleson, CEO of US Beacon, and Linda Komisak, founder of Upturn Consulting LLC, joined me to talk about two critical ways of increasing healthcare transparency: claims reviews and quality metrics.

These two topics are key to understanding why the healthcare system is so broken. If you buy any other service, you can (a) expect to only be billed for the services that were performed and (b) have the ability to research the quality of vendors and pick the best one.

Why can’t we do that in healthcare?

This is an incredibly informative episode, and we cover more than just those two topics including nurse staffing shortages, how to identify the best hospital systems, and why it’s so important to gather feedback from nurses.

Chapters:

00:00:00 Meet Kimberly Carleson and Linda Komisak
00:01:11 Taking Feedback from Nurses
00:06:30 Nurses' Impact on Hospital Quality
00:11:31 Why Are There Nursing Shortages?
00:18:18 Nurse Advocacy for Enhanced Patient Experience
00:25:18 Quality Metrics and Patient Billing Integrity
00:39:11 The Importance of Nurse Feedback
00:49:17 Surgeon Incentives in Billing
00:58:12 Healthcare Cost Savings Through Billing Review

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words:

Healthcare Quality, Nurse Insights, Patient Experience, Claims Integrity, Quality Metrics, Upcoding Practices, Nursing Shortage, Billing Transparency, Nurse Anonymity, Healthcare Billing, Hospital Quality, Nurse Feedback, insurance, nursing, healthcare, health insurance, podcast, self funded, self funding

#HealthcareQuality #NurseInsights #PatientExperience #ClaimsIntegrity #QualityMetrics #UpcodingPractices #NursingShortage #BillingTransparency #NurseAnonymity #HealthcareBilling #HospitalQuality #NurseFeedback #insurance #nursing #healthcare #healthinsurance #podcast #selffunded #selffunding

"Quit tolerating mediocrity. Go get in action. Find the right broker consultant that will take you to a new place. Don't give up hope." - Scott Conard

Dr. Scott Conard tragically lost 3 patients one summer to unexpected heart problems, and immediately changed how he thought of healthcare.

This week on Self-Funded, we talk about “conscious capitalism”, and by extension “conscious healthcare”, what the 7 numbers that everybody needs to know are, and how we need to change the way we approach health risk.

Chapters:

00:00:00 Meet Scott Conard
00:02:08 Crony Capitalism In Healthcare
00:06:34 Focus On Aligning Incentives
00:15:38 Holistic Well-being Approach To Healthcare
00:27:12 Revolutionizing Self-Insurance
00:37:54 Healthcare Advocacy And Engagement
00:42:22 How Do We Get People To Care About Their Health?
00:49:08 Primary Care's Role in Healthcare

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words:

Conscious Capitalism, Employer Driven Healthcare, insurance, healthcare, health insurance, Empowering Employers, Incentive Programs, Risk Management, Alternative Risk, health risk, fixing healthcare, selffunded, podcast

#ConsciousCapitalism #EmployerDrivenHealthcare #insurance #healthcare #healthinsurance #EmpoweringEmployers #IncentivePrograms #RiskManagement #AlternativeRisk #healthrisk #fixinghealthcare #selffunded #podcast

"It's progress we couldn't have envisioned decades ago." - Oscar

“I felt interested in being part of something bigger than my practice and something that will impact even more people that I was able to in the hospital.” - Carolina

Dr. Oscar Bronsther and Dr. Carolina Escobar from Interlink joined me this week to discuss the exciting and scary world of cell and gene therapy, CRISPR, and how we fund these amazing medical advances.

In addition to me attempting to act smart enough to be in the same room as these two, we covered their wholistic approach to this emerging scientific field, which promises potential cures for rare and debilitating diseases, but often comes with 7-figure price tags. The rare genetic diseases are known as “orphan diseases”, and there have been some recent incredible advances in detecting them early on in life.

We talked about what this all means for individuals as well as the insurance space as a whole, and how it has the potential to increase medical costs in this country even further.

Chapters:

00:00:00 Meet Oscar and Carolina
00:09:16 Genetic Therapy Solutions for Orphan Diseases
00:14:39 Detecting and Targeting Single Gene Mutations
00:26:52 CRISPR Technology
00:30:08 Equitable Access To Gene/Cell Therapy
00:37:21 How Do We Finance This?
00:46:13 The Ethical Concerns Of Cell/Gene Therapy
00:59:45 Economic Implications of This Technology

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Key Words:

Rare Diseases, Gene Therapy, CRISPR technology, CRISPR, Healthcare Skepticism, Healthcare Warranties, Medical Revolution, Healthcare Advances, Orphan Diseases, Cell Therapy, Healthcare Innovation, self funded, podcast

#RareDiseases #GeneTherapy #CRISPRtechnology #CRISPR #HealthcareSkepticism #HealthcareWarranties #MedicalRevolution #HealthcareAdvances #OrphanDiseases #CellTherapy #HealthcareInnovation #selffunded #podcast