Downstream Effect of the ACA Subsidies that Went Away

Good Luck With That Referral

Send us Fan Mail [https://www.buzzsprout.com/1949549/fan_mail/new] A referral can feel like help, but when you’re the one making the calls, waiting weeks, guessing at quality, and praying the bills “make sense,” it’s not coordination, it’s homework. I’m Justin Futrell, a benefit advisor at True North Companies, and I’m digging into what happens when primary care isn’t enough and the stakes move from routine care to specialty care. I walk through a simple migraine example to show two very different paths. One is the familiar “good luck” referral where you search on your own, hope the specialist is in network, and hope the care is actually high quality. The other is what direct primary care and concierge health can do when it’s working at its best: an independent primary care relationship that knows the specialists they trust, understands outcomes, and can guide you to the right next step like a vestibular therapist or another specialist who can actually move the needle. We also talk openly about incentives. If urgent care is owned by a hospital system, how often do you think they send patients to a competing system, even when it might be a better fit? That’s why employer-provider partnerships matter, especially for self-funded employers that can contract with transparent, collaborative, accountable surgery centers, imaging facilities, and specialty groups so employees aren’t entering specialty care blindly. If you’ve ever wondered who should choose your specialist when it really matters, this is for you. Subscribe, share with a coworker, and leave a review if you want more practical breakdowns like this. Music by Alex Lambert. Support the show [https://www.buzzsprout.com/1949549/support] Contact Justin via text 740-525-5259 or via email JFutrell@TrueNorthCompanies.com I welcome the opportunity to hear your feedback from this episode! Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits.

Stop Chasing Health Insurance Renewals ~ Start Building The Solution

Send us Fan Mail [https://www.buzzsprout.com/1949549/fan_mail/new] Most benefits conversations start with the renewal. I want to start somewhere else: the moment an employee actually needs care and has to figure out where to go, who to call, and how long they’ll wait. That is the “front door” to healthcare, and if it’s broken, no amount of clever insurance math fixes the experience. On a trip to Springfield, Missouri, I spot something that stops me in my tracks: a building tied to Bass Pro Shops offering primary care and urgent care. When I look closer, it’s a dedicated clinic built for covered employees and their families with primary care, preventive care, chronic condition management, health coaching, a pharmacy, and virtual care. It’s a clear signal that some employers are shifting their benefits strategy from healthcare financing to healthcare access. From there, I lay out two routes. Route One is what most people live with today: weeks to get in, scattered providers, hard care coordination, and bills that show up months later. Route Two starts with an accessible primary care relationship where someone knows your name, you can get same-day appointments, visits are long enough to matter, and you get navigation when specialty care is needed. That is how we move from an emergency response system to a health maintenance system. If you’re an employer, HR leader, or benefits decision-maker, this is an invitation to think like a healthcare architect and ask what path you’re putting your people on. Subscribe, share this with a colleague, and leave a review with your biggest healthcare pain point so we can tackle it next. Music by Alex Lambert. Support the show [https://www.buzzsprout.com/1949549/support] Contact Justin via text 740-525-5259 or via email JFutrell@TrueNorthCompanies.com I welcome the opportunity to hear your feedback from this episode! Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits.

A Better Front Door To Healthcare

Send us Fan Mail [https://www.buzzsprout.com/1949549/fan_mail/new] I compare today’s healthcare experience to moving to a city with no signs or maps and explain why that confusion keeps people from getting care. I share a real data point showing 57% of members skipping preventive exams and argue for a better front door led by a trusted physician.  • the “no directions” problem in healthcare navigation for employees  • why people with insurance still delay care  • what 57% missing preventive exams signals for long-term risk  • how late care can turn stage one into stage four  • the burden of finding in-network care, scheduling, follow-ups, specialists and bills  • why a trusted primary care physician can guide decisions and improve outcomes  • the employer question that matters most: do employees have a front door to care  Let's talk more next week.  Music by Alex Lambert. Support the show [https://www.buzzsprout.com/1949549/support] Contact Justin via text 740-525-5259 or via email JFutrell@TrueNorthCompanies.com I welcome the opportunity to hear your feedback from this episode! Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits.

Downstream Effect of the ACA Subsidies that Went Away

Send us Fan Mail [https://www.buzzsprout.com/1949549/fan_mail/new] Healthcare costs keep climbing because utilization is rising and high-cost drugs are changing the baseline, not because of a one-time post-COVID bump. We break down what the end of enhanced ACA subsidies means for the individual market and why employers feel the pressure next.  • employer-sponsored health plans facing 8% to 9% cost increases  • inflation not the only driver, with wages and hospital consolidation raising costs  • higher utilization as the lasting shift, including more screenings and more prescriptions  • specialty drugs and new therapies reshaping pharmacy spend, including GLP-1s and gene therapy  • ACA subsidy expiration triggering major premium spikes and more uninsured people  • tighter individual market making employer coverage more critical  • cost shifting dynamics that will hit employer plans  What can employers do? Practical employer moves, including challenging renewals and reviewing loss ratios. Focus on value through utilization management and a clear pharmacy strategy. Curious to explore what's possible? Let's connect.  Music by Alex Lambert. Support the show [https://www.buzzsprout.com/1949549/support] Contact Justin via text 740-525-5259 or via email JFutrell@TrueNorthCompanies.com I welcome the opportunity to hear your feedback from this episode! Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits.

Gene Therapy Part Two: Miracle of Medicine & Financial Landmine 💥

Send us Fan Mail [https://www.buzzsprout.com/1949549/fan_mail/new] Gene therapy can cure diseases that once felt untouchable, but it can also trigger the biggest claim a self-funded employer may ever face. We focus on the hidden costs around the drug, why network contracting matters, and how transparency and preparation protect the health plan when rare cases hit. • Gene therapy risk for self-funded employers beyond the drug price • Hidden cost drivers like hospital stays, administration, and follow-up care • Contract loopholes and vague network terms that inflate total allowed cost • Why specialized gene therapy networks can run cheaper on average • The real-world math on how often gene therapy and transplant cases occur • Preparing for financial earthquakes with better planning and transparency The urgency that gene therapy is already here, not years away. Let me know if you want to discuss how to get more control of your outstanding risk.  Music by Alex Lambert. Support the show [https://www.buzzsprout.com/1949549/support] Contact Justin via text 740-525-5259 or via email JFutrell@TrueNorthCompanies.com I welcome the opportunity to hear your feedback from this episode! Thanks again to my musically gifted friend Alex Lambert for the music. Also thanks to Kevin Asehan for the edits.