TIMESTAMPS:

[00:20] Health Insurance Misconceptions

[02:27]Health insurance perceived differently compared to other types of insurance

[04:14] - Insights from a hospital CEO about billing challenges and frustrations with payers.

[07:09] - Exploration of the complexities of premiums, deductibles, and copays.

[10:39] - Examination of U.S. health outcomes compared to other countries.

[22:00] - Direct primary care as a potential solution in healthcare.

QUOTES:

• "If you want different results, employers, employees, patients, do the opposite. Instead of following the traditional paths that have led to frustration and inefficiency in the healthcare system, consider taking a bold step back and re-evaluating how you approach healthcare and health insurance. Challenge the norms that have been ingrained in us and explore alternative methods that could lead to better outcomes for everyone involved." -David Contorno
• “And so another way to think about that is when you go and get care and you throw down your BUca based id cardinal that has a buccal logo on it, you are preordaining contractually, not subjectively, not hypothetically, but contractually preordaining you and your health plan to paying the highest price, not just in healthcare, not just in the US, but frankly, known to humans ever in the history of humankind.” -David Contorno
• "It is not impossible to build a health plan that allows an employer to pay 100% of the air quotes premium for that plan and make it so that there is no deductible and no out of pocket, and they would still save more money than signing that contract with a Buca." - Emma Fox

SOCIAL MEDIA LINKS:

David Contorno
LinkedIn: https://www.linkedin.com/in/dcontorno/

Emma Fox
LinkedIn: https://www.linkedin.com/in/emmamariefox/

WEBSITE:

E-Powered Benefits: https://www.epoweredbenefits.com/

Emma Fox: https://emmamariefox.com/

TIMESTAMPS:

[01:38] Discussion on compensation

[05:01] Conference Insights

[11:09] Importance of representation & transparency

[14:49] - Employer responsibility regarding their healthcare plans.

[22:20] Awakening brokers and consultants to the realities of the healthcare system

QUOTES:

• "At the end of the day, I think the entity, the stakeholder with the most leverage is the one who's the most quiet, which is the employer, because they're not only managing the dollars they're spending, but they're essentially responsible for managing the dollars that the employees are spending, whether it's the contribution out of their paycheck or their out of pockets." -David Contorno
• "And I think you're absolutely right. Severity is not so much of an issue. Really? Right? And so one of the talking points around, specifically around GLP one, because it was a big topic. And so it was a very big point of discussion. But someone brought up the rebates. And I said on the stage, I think you mean bribes, because rebates only benefit those that they get returned to." -Emma Fox
• "And so many have said that that awakening changed their path, and that's really what we need at the employer level, at the doctor level, and at the broker level, because if we can get a large enough group to change their path, then we can actually make a difference in how the system works."- David Contorno

SOCIAL MEDIA LINKS:

David Contorno

LinkedIn: https://www.linkedin.com/in/dcontorno/

Emma Fox

LinkedIn: https://www.linkedin.com/in/emmamariefox/

WEBSITE:

E-Powered Benefits: https://www.epoweredbenefits.com/

Emma Fox: https://emmamariefox.com/

In this eye-opening episode, David Contorno and Emma Fox dive into the harsh realities many face in accessing life-saving medications for chronic conditions. They share a heartfelt story of an 11-year-old boy desperate to help his mother, who lost access to her crucial MS medication due to an unexpected change in her health insurance plan. The discussion sheds light on the complexities of health insurance, the hidden options available, and how unaffordability can strike without warning. Emma and David provide practical advice on navigating these challenges, from leveraging manufacturer assistance programs to sourcing medications internationally. Join them as they unravel the tangled web of healthcare, offering hope and actionable strategies for those struggling with similar issues.

TIMESTAMPS:

[01:06] Story of an 11-year-old boy asking for help for his mother

[04:33] High-deductible HSA plans vs. copay PPO plans

[07:28] Manufacturer assistance programs, coverage issues, qualification requirements

[10:33]How drug coupons work and their impact on self-insured plans

[17:31] GLP-1 drugs (e.g., Trulicity, Ozempic) pricing and sourcing strategies

[24:49] Importance of consulting doctors when considering medication alternatives

[29:14] Emphasis on the responsibility of benefits consultants to impact company and employee finances

QUOTES

• "It has these horrific downstream effects, like eleven year old boys who are asking practical strangers to help his mom. You know, it really hurt my heart."- Emma Fox
• "But I wanted to explain that because coupons are, if you're in a fully insured plan, I, when I say I don't care, I do care a little, but I don't care nearly as much as when you're in a self-funded plan." - Emma Fox
• "Imagine if you were compensated for figuring out the things that we're talking about here. [...] You're impacting the money coming into their house and the money coming out of their house to a very large degree." -David Contorno

SOCIAL MEDIA LINKS

David Contorno

LinkedIn: https://www.linkedin.com/in/dcontorno/

Emma Fox

LinkedIn: https://www.linkedin.com/in/emmamariefox/

WEBSITE

E-Powered Benefits: https://www.epoweredbenefits.com/

Emma Fox: https://emmamariefox.com/

Mixed & Edited by Next Day Podcast

info@nextdaypodcast.com