Fixing Healthcare Costs Without Cutting Benefits With Carl Pecoraro & Lindsay Leeder

Coming This Summer: Your Open Enrollment Gameplan

Open enrollment season is coming, and we're spending the summer getting ready for it. All season long, we're bringing in guests who've been in the trenches of OE to share what's actually working, what's flopped, and the creative ideas worth stealing. By the time October hits, you'll have a fresh playbook and a lot less dread. Making Healthcare Sustainable will drop new episodes all summer. Follow the show so you don't miss a single guest!

Are Your Benefits Solving the Right Problems? With Omair Ahmed

Most healthcare innovations fail for the same reason: they don't address the underlying incentive misalignment baked into a fee-for-service system. Omair Ahmed [https://www.linkedin.com/in/omair-ahmed/], Principal at Echo Health Ventures [https://www.linkedin.com/company/echo-health-ventures/], explains why solving that problem first is what separates the solutions that actually move the needle from the ones that just add to the vendor stack. In this episode, you'll learn: * Why incentive misalignment and data opacity are the root causes behind most of healthcare's thorniest challenges * How pairing quality analytics with benefit design nudges members toward better decisions and not just better information * Why local networks of high-quality providers outperform traditional center-of-excellence models * What benefits leaders who are early adopters are doing differently to evaluate solutions before they scale Highlights: (00:00) Meet Omair Ahmed (02:07) Centering the patient experience (04:14) Key challenges in healthcare incentives and data transparency (07:00) Distribution and integration matter more than product innovation (09:36) Lessons from public-private partnerships and Medicare innovations (11:07) Why cost, quality, and access don’t have to compete (13:00) Understanding how patients interpret cost signals (15:43) The power of surgical volume and appropriateness in decision-making (16:44) Evaluating ROI for high-cost, high-variability solutions (20:04) Learning from churn and variation across clients (22:38) Network of Excellence vs. legacy Center of Excellence models (25:53) How local care improves adherence and outcomes (27:07) Prioritizing high-impact solutions for employers (30:29) AI, analytics, and culture driving optimism for healthcare innovation  Resources: Nancy Ryerson’s LinkedIn: https://www.linkedin.com/in/nancyryerson/ [https://www.linkedin.com/in/nancyryerson/] Omair Ahmed’s LinkedIn: https://www.linkedin.com/in/omair-ahmed/ [https://www.linkedin.com/in/omair-ahmed/] Echo Health Ventures’ LinkedIn: https://www.linkedin.com/company/echo-health-ventures/ [https://www.linkedin.com/company/echo-health-ventures/]

Design Dictates Disruption with Lee Lewis

Healthcare costs keep rising, but many employers are still approaching benefits the same way they did 20 years ago. And those who are taking a more radical approach might want to consider these three words: design dictates disruption. Lee Lewis [https://www.linkedin.com/in/leewlewis/], Chief Strategy Officer and GM of Medical Solutions at the Health Transformation Alliance [https://www.linkedin.com/company/health-transformation-alliance/], shares a blueprint for getting the lower costs you need while rocking the boat (or pirate ship—tune in to learn more) just the right amount.  In this episode, you'll learn: * How to reduce healthcare disruption through smarter benefit design * Why simplicity helps employees make better healthcare decisions * The ABC framework employers use to strengthen healthcare benefits  Highlights: (00:00) Meet Lee Lewis (01:41) Why employers are embracing healthcare innovation (02:23) How alternative health plans simplify care (05:20) Does innovation always create disruption? (07:09) What makes a modern Center of Excellence work (12:00) Why employees just want "the good doctor" (17:10) The biggest barriers preventing change (19:55) Lee's playbook for improving benefits plans (26:27) Why behavioral health access matters (33:03) Why trust changes healthcare outcomes (35:07) Predictions for the future of employer healthcare Resources: Nancy Ryerson’s LinkedIn: https://www.linkedin.com/in/nancyryerson/ [https://www.linkedin.com/in/nancyryerson/] Lee Lewis’ LinkedIn: https://www.linkedin.com/in/leewlewis/ [https://www.linkedin.com/in/leewlewis/]  Health Transformation Alliance’s LinkedIn: https://www.linkedin.com/company/health-transformation-alliance/ [https://www.linkedin.com/company/health-transformation-alliance/]

Substance Use Treatment Today Isn’t What You Think with Suzette Glasner, PhD

Substance use disorder is a growing issue in workplace healthcare, but it often remains hidden.  Dr. Suzette Glasner [https://www.linkedin.com/in/suzette-glasner-ph-d-5846804/], Clinical Psychologist and Chief Scientific Officer at Pelago [https://www.linkedin.com/company/pelago-health/], discusses the hidden impact of addiction in your claims data, how employers are taking action,  and what might surprise you about the latest research on effective addiction treatment.  In this episode, you'll learn: * The physical impact of addiction on employees and how this trickles down to healthcare costs  * Misconceptions about addiction treatment and Dr. Glasner’s thoughts on the headlines around psychedelics as addiction treatment * Surprising research Pelago led on the right “dose” of human support for recovery Highlights: (00:00) Meet Dr. Suzette Glasner (02:07) The hype vs reality of psychedelic treatments for addiction (03:20) Why effective treatments are underutilized (07:13) The barriers of stigma, access, and insight (10:37) Why employers play a crucial role in addressing SUD (20:14) How harm reduction can engage people in treatment (28:49) Balancing human touch and AI in treatment approaches (32:10) What makes a recovery-ready workplace (39:44) Closing the gap with evidence-based solutions  Resources: Nancy Ryerson’s LinkedIn: https://www.linkedin.com/in/nancyryerson/ [https://www.linkedin.com/in/nancyryerson/] Dr. Suzette Glasner’s LinkedIn: https://www.linkedin.com/in/suzette-glasner-ph-d-5846804/ [https://www.linkedin.com/in/suzette-glasner-ph-d-5846804/]  Pelago’s LinkedIn: https://www.linkedin.com/company/pelago-health/ [https://www.linkedin.com/company/pelago-health/]

Fixing Healthcare Costs Without Cutting Benefits With Carl Pecoraro & Lindsay Leeder

Healthcare costs keep rising, and most employers feel stuck. Carl Pecoraro [https://www.linkedin.com/in/carl-pecoraro-93ab4142/], Chairman of the Cleveland Bakers and Teamsters Health and Welfare Fund [https://www.cbtfunds.com/], and Lindsay Leeder [https://www.linkedin.com/in/lindsay-leeder-msn-arnp-6a3740146/], SVP of Labor Union and Trust at Lantern [https://www.linkedin.com/company/lantern-specialty-care/], share how one fund changed that. Carl walks through building a plan with 21-point solutions and holding inflation to 1%. Lindsay brings the provider's view on what better care looks like. In this episode, you'll learn: * How to build point solutions that lower long-term healthcare costs * Why primary care access changes outcomes and spend * How better provider experience leads to better patient results Highlights: (00:00) How one fund beat healthcare inflation (00:28) Meet Carl Pecoraro and Lindsay Leeder (01:38) Think, feel, do on today's healthcare reality (04:11) Lindsay on primary care and better outcomes (07:05) Building a point solution strategy that works (11:25) Finding Lantern and moving to direct contracting (17:53) Driving utilization through better navigation (21:48) Who the members are and why benefits matter (24:43) Plan design: wellness incentives that actually work (28:59) Fund leaders have more power than they think (33:08) What happens when you get all your vendors in a room (34:46) What the future of healthcare could look like Resources: Nancy Ryerson’s LinkedIn: https://www.linkedin.com/in/nancyryerson/ [https://www.linkedin.com/in/nancyryerson/] Carl Pecoraro’s LinkedIn: https://www.linkedin.com/in/carl-pecoraro-93ab4142/ [https://www.linkedin.com/in/carl-pecoraro-93ab4142/]  Lindsay Leeder’s LinkedIn: https://www.linkedin.com/in/lindsay-leeder-msn-arnp-6a3740146/ [https://www.linkedin.com/in/lindsay-leeder-msn-arnp-6a3740146/]  Cleveland Bakers and Teamsters Health & Welfare Fund: https://www.cbtfunds.com/ [https://www.cbtfunds.com/]