Confronting Soaring Emergency Care Costs (feat. Al Lewis)

Confronting Soaring Emergency Care Costs (feat. Al Lewis)

ER visits account for roughly six percent of health plan spend, with costs rising faster than almost any other hospital service. Why is ER spending is spiraling out of control? And what should we do about it? Al Lewis, founder of The Validation Institute and the gamified health literacy platform Quizzify, has built a career exposing the financial sleights-of-hand many healthcare programs use to drain employer budgets. Lewis joins us to break down how hospitals have transformed federal mandates like the Emergency Medical Treatment and Labor Act (EMTALA) into high-margin profit centers through aggressive pricing and "up-coding" tactics. Lewis also shares strategies for individuals and employers to challenge the lack of transparency that often characterizes emergency department charges. Find the transcript of this episode at movingtovalue.org/transcript/lewis [https://www.movingtovalue.org/transcript/lewis] ________ Sign up for our email list. [https://www.movingtovalue.org/subscribe] Thank you to our members [https://www.movingtovalue.org/supporters] who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership [http://movingtovalue.org/membership].

Winning the Benefits Market Attention Economy (feat. Chris Fisher)

Tired of muddled pitches, point solution fatigue and hours of endless meetings? You're not the only one. Chris Fisher is on a mission to fix one of the biggest bottlenecks in the employee benefits industry — the noise. As the founder of BenefitsAlly, Fisher created the 3x3x3 Challenge, which asks vendors to explain what they do, how they’re different and who they’re for in three minutes. This format levels the playing field for vendors while giving brokers, consultants and business leaders a faster, clearer way to evaluate new ideas. Fisher joins us to discuss the virtues of radical brevity. ________ Sign up for our email list. [https://www.movingtovalue.org/subscribe] Thank you to our members [https://www.movingtovalue.org/supporters] who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership [http://movingtovalue.org/membership].

How to Curb Profiteering and Reclaim True Value (feat. Wendell Potter)

The American healthcare system is facing market failure driven by consolidation by industry profiteers. Perhaps no one has a clearer view of how this took place — and what to do about it — than Wendell Potter. Called ‘the ideal whistleblower’ by Time magazine, Potter was a senior executive at insurance giants like Humana and Cigna until a crisis of conscience in 2008. As the Editor-In-Chief of the HEALTH CARE un-covered [https://healthcareuncovered.substack.com/] newsletter, President of the Center for Health and Democracy and bestselling author of Deadly Spin and Nation on the Take, Potter has since dedicated his career to exposing the tactics insurers use to prioritize shareholder returns over patient outcomes. He joins us to discuss the strategies employers, clinicians, policymakers and patients can implement to reclaim a system built on actual value. Find the transcript of this episode at movingtovalue.org/transcript/potter [https://www.movingtovalue.org/transcript/potter] ________ Sign up for our email list. [https://www.movingtovalue.org/subscribe] Thank you to our members [https://www.movingtovalue.org/supporters] who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership [http://movingtovalue.org/membership].

Taking On Healthcare's Trillion Dollar Crisis (feat. AJ Loiacono)

"We could probably think of dozens of brilliant ideas on this very podcast to improve healthcare," says AJ Loiacono, Co-Founder & CEO of Judi Health. "Good luck implementing any of them on our aging infrastructure." Loiacono founded Capital Rx, transforming the pharmacy benefit manager (PBM) industry by introducing a transparent, flat-fee model. Now, that mission has evolved into something even more ambitious. With the launch of Judi Health, Loiacono and his team are tackling the trillion dollar problem of administrative waste in healthcare. They’ve built the industry’s first unified claims processing platform, a system that puts medical, pharmacy, dental and vision claims onto a single ledger. Modernizing healthcare's technology infrastructure, Loiacono believes, will empower solutions that improve value for patients. Find the transcript of this episode at movingtovalue.org/transcript/loiacono ________ Sign up for our email list. [https://www.movingtovalue.org/subscribe] Thank you to our members [https://www.movingtovalue.org/supporters] who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership [http://movingtovalue.org/membership].

Leveraging Association Health Plans for Small Employers (feat. Grace Brangwynne)

"Now is the time to strike when the iron is hot. People need healthcare." Join us in the halls of the Connecticut General Assembly, where lawmakers are considering a bill to authorize Association Health Plans in the state. This would let small employers pool risk and receive health insurance as one group, boosting their power to negotiate better value for employees. Grace Brangwynne, Policy Director for Healthcare, Insurance and Housing at the Connecticut Business and Industry Association, describes the "breaking point" of double-digit premium hikes facing small employers across the state. She talks us through the guardrails built into the current Association Health Plan proposal, the tension between market innovation and state regulation and why the survival of Connecticut’s mom-and-pop shops depends on a fundamental shift in healthcare purchasing. Find the transcript of this episode at movingtovalue.org/transcript/brangwynne [https://www.movingtovalue.org/transcript/brangwynne] ________ Sign up for our email list. [https://www.movingtovalue.org/community] Thank you to our members [https://www.movingtovalue.org/supporters] who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership [http://movingtovalue.org/membership].