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This episode features Dr. Juliet Breeze, CEO at Next Level Urgent Care. Here she and Ron discuss Next Level Urgent Care’s business model and how they focus on providing immediate care for non life threatening injures. They are significantly quicker on average and five to ten times less expensive than an emergency room visit. Next Level facilities have x-ray equipment on site and employ providers who are trained to handle acute urgent medical conditions that are not life-threatening. If a patient presents a condition that is beyond Next Level Urgent Care’s scope of services, the visit is free and the patient is referred to the emergency room. Juliet also discusses working with employers and the benefits they can see from working with Next Level.

Dr. Breeze graduated from Northwestern University. She earned her medical degree from Baylor College of Medicine. After working in family practice for several years, she moved her focus to the business of medicine. As a serial entrepreneur, she developed several large group medical practices, two private hospitals, and two surgery centers. Dr. Breeze has also served on the Board of Directors of several healthcare tech start-up companies. Currently, she is vice-president of Vantage Hospice and the founder and CEO of Next Level Urgent Care.  Through Next Level, her commitment to cost-effective, accessible medical care has led her to launch Next Level PRIME a hybrid model of telemedicine and nearsite clinics serving the Greater Houston area.

She has been honored to be a regional finalist of the Ernst and Young Entrepreneur of the Year 2017 and 2018. In 2019, she was also named a “Most Admired CEO” by the Houston Business Journal and one of Houston’s Top 30 Influential Women by D-Mars.com.

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This episode features AJ Loiacono, CEO of Capital RX. Here Ron and AJ discuss the unique way Capital RX is offering cheap prescription drug prices. AJ shares how their Clearinghouse Model pricing framework is inspired by the stock exchange. By removing the artificial wall between pharmacies and plan sponsors, they take the mystery out of prescription drug pricing. They also discuss the AJ’s plans for the future of Capital RX.

AJ is a serial entrepreneur with over 20 years of experience in pharmacy benefits and software development. As the CEO of Capital Rx, a pharmacy benefit manager that is bringing transparency and fair pricing into an otherwise opaque industry, his mission is to change the way prescriptions are priced and administered to create enduring social change. AJ spent his career studying the pharmaceutical supply chain and producing engineering solutions that have continually redefined the pharmacy benefit industry. At its core, Capital Rx is a technology-first company that has received multiple awards for the innovations that have propelled the company to record growth (Accenture Health Technology Champion, AMCP Gold Ribbon, EHIR Innovation Award, NYC Digital 100, etc.).

Prior to Capital Rx, AJ was a co-founder of Truveris, where he served for eight years as CEO, CIO, and Board Member, leading the company to rapid expansion (Deloitte FAST 500 and Crain’s Fast50). Before Truveris, AJ co-founded SMS Partners, a joint venture with Realogy (RLGY), and in 2010 exited the partnership with a buyout. In his first venture, AJ started Victrix, a pharmaceutical supply chain consultancy, and successfully sold the company to Chrysalis Solutions in 2007.

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In this episode Ron welcomes healthcare journalist Marshall Allen back on the show. Here Marshall discusses his new book “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win”. He does a deep dive into the many issues he has uncovered in his 15 years of investigating the healthcare industry. He offers patients a plan for fighting against the predatory billing practices found in the American healthcare system. This includes solutions such as: analyzing and contesting bills, obtaining pricing in advance, getting an appropriate treatment clause before singing financial documents, advice for small claims court, and more.

Marshall Allen Is a journalist who investigates why we pay so much for health care in the United States and get so little in return. He is the author of “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win.” He is also the founder of Allen Health Academy, which produces a curriculum of short on-demand videos to equip and empower employees to navigate the health care system. Marshall has investigated the health care industry for 15 years, including a decade at ProPublica. And he’s spent a decade as an educator at the Craig Newmark Graduate School of Journalism at CUNY. His work has been honored with many journalism awards, including some of the top business reporting honors, the Harvard Kennedy School’s 2011 Goldsmith Prize for Investigative Reporting and twice as a finalist for the Pulitzer Prize. Before he was in journalism, Allen spent five years in full-time ministry, including three years in Nairobi, Kenya. He has a master’s degree in Theology. For more info, go to marshallallen.com.

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In this episode, Ron chats with Elisabeth Rosenthal, Editor-in-Chief at Kaiser Health News. Here she discusses her career in healthcare journalism and what she views as the most important stories that she has ever covered. She also does a deep dive into the shady practices of some of the bigs and how despite that, there are organizations out there that are doing things right and making a positive difference in American Healthcare. Ron and Elizabeth even discuss some potential topics for her to cover in the future.

Elisabeth Rosenthal, Editor-in-Chief, joined KHN in September 2016 after 22 years as a correspondent with The New York Times, where she covered a variety of beats from health care to environment and did a stint in the Beijing bureau. While in China, she covered SARS, bird flu and the emergence of HIV/AIDS in rural areas. Libby’s 2013-14 series, “Paying Till It Hurts,” won many prizes for both health reporting and its creative use of digital tools. Her book, “An American Sickness: How Healthcare Became Big Business and How You Can Take It Back” (Penguin Random House, 2017), was a New York Times best-seller and a Washington Post notable book of the year. She is a graduate of Stanford University and Harvard Medical School and briefly practiced medicine in a New York City emergency room before converting to journalism.

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In this episode, Ron chats with Zach Zeller, Co-Founder and President of ScriptCo Pharmacy. Here, Zach does a deep dive into the value proposition his company offers to both patients and employers. He shares how people can go on the ScriptCo website and calculate their potential cost savings by utilizing their program. He also discusses some of the shady tactics of big pharma and his long-term goals for the company.

Zach Zeller grew up in Flower Mound, Texas, and attended the University of Texas on a Track and Field scholarship. Zach’s work ethic lead to him to become a school record holder, All American, and multiple time Big 12 Champion.

After graduating from UT, Zach took a role with DePuy Orthopedics as Trauma Representative, where he earned the second-highest percentage increase growth in the United States in 2006. After being in the operating room just shy of 10 years years and offering guidance to surgical teams and surgeons in over 5,500 surgical procedures, Zach chose to move out of the surgical space and into the pharmacy market.

In 2017 Zach co-founded Texas-based ValueScript Pharmacy.

As a pharmacy owner he saw firsthand the intentionally designed lack of transparency in the marketplace created by pharmacy benefit managers that surrounds access and cost of medications when using health insurance. Zach and the ValueScript team were trying to figure out a better way to provide access and value to consumers.

After exhaustive research we felt that the best way to reach our goal of solving the cost and access problems that revolve around prescription medications could be solved by starting the first and only membership-based wholesale pharmacy in America, ScriptCo.

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In this episode, Ron welcomes back Dr. Dave Berg, Chairman of the Board & Co-Founder of Redirect Health. Here, Dave discusses the changes in the healthcare landscape since his last time on the show, specifically with how COVID-19 forced American healthcare to evolve. He also discusses how his organization has continued to grow and provide the best and most affordable options for employers, especially during the pandemic. Dave does a deep dive into the kind of cost savings one can expect when working with Redirect Health.

Dr. David Berg is Co-founder and Chairman of the Board of Redirect Health, a national leader in healthcare innovation. Dave is focused on creating an amazing healthcare member experience, and he does this by simplifying traditionally complex systems that most believe could not be changed. With deliberate and strategic, outside-of-the-box thinking, he innovates new ways to deliver easy and affordable healthcare to people everywhere.

Dave majored in Physics and Biology at the University of Toronto before earning his Doctor of Chiropractic degree in 1990. That same drive can be seen in his uncompromising belief that everyone in America deserves easy and affordable healthcare. Dave believes that America is better when its people are privileged with clean water, great education, safe infrastructure, and healthcare that works for everyone.

Mr. Berg is passionate about making healthcare work extremely well for people and their families, and that’s why he created Redirect Health. With more than 20 years of healthcare leadership experience, he has a successful track record for smart system design and has pioneered Redirect Health – a new healthcare model that provides affordable healthcare without additional cost by systematically eliminating healthcare waste, unnecessary administration, and confusion.

The companies that Dave founded have healthcare costs that are among the lowest in the nation, and he is able to provide all employees and their families with free healthcare. Dave is so passionate about helping businesses offer free healthcare to their employees that he wrote The Business Owner’s Guide to Fighting Healthcare – a how-to guide that teaches business owners how to leverage healthcare as a competitive advantage. Companies in 40 states have adopted and greatly benefited from this solution because of Redirect Health.

With his unique leadership approach, Dave is accomplishing what many said couldn’t be done, which is to make healthcare easy and affordable for everyone. Dr. Berg’s vision is to have healthcare working so well in America that businesses can offer it to their employees for free.

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In this episode Dave Chase, Co-Founder and CEO of Health Rosetta comes back on the show. Here Dave discusses the story of Forgotten Frank, the hypothetical middle America hardworking guy that has not seen a wage gain in over 20 years. Not because the employer isn’t spending a bunch more money on Frank, but because all of those dollars have been stolen away by the bloat and waste. Dave also does a deep dive into what the waste and bloat is, how Americans are sick of it, and how the pandemic has impacted it. He shares some real rays of hope in that healthcare is fixed, you just have to know where to find the fixes.. Luckily, Dave and Ron discuss where to find them.

Dave is the creator of the Health Rosetta and cofounder of the Health Rosetta ecosystem.

Co-founder of the Health Rosetta that consists of 2 main pillars:

1. Impact: Education/accreditation that is building the LEED-like ecosystem for healthcare; Media that includes the film and books. The Big Heist is the first fiercely non-partisan film to tackle healthcare. We also publish The CEO’s Guide to Restoring the American Dream: How to deliver world class healthcare to your employees at half the cost and The Opioid Crisis Wake-Up Call;
2. Investment: Backing the transformation of healthcare including the Quad Aim Fund, a seed stage venture fund and working with family offices on special purpose vehicle investments in healthcare’s transformation.

Chase’s TEDx talk entitled “Healthcare Stole the American Dream – Here’s How We Take it Back” sums up healthcare’s devastation of the middle class and the redemption coming via a bottom-up movement. Chase was named one of the most influential people in Digital Health due to his entrepreneurial success, speaking & writing. He delights in sharing how high-performing organizations have solved healthcare’s toughest challenges. Chase co-authored the healthcare Book of the Year in in 2014.

Chase was the CEO/Co-founder of Avado, acquired by & integrated into WebMD & Medscape (the most widely used healthcare professional site). Before Avado, Chase spent several years outside of healthcare in startups as founder or consulting roles with LiveRez.com, MarketLeader, & WhatCounts. He also played founding & leadership roles in launching two new $1B+ businesses within Microsoft including their $2 billion healthcare platform business.

Chase is a father of two great kids/athletes, husband & oxygen-fueled mountain athlete. His 2014 team placed 3rd in their division & 24th overall (of 500 teams) the US’ oldest adventure race where Dave tackled the Nordic ski leg. Dave was a former PAC-12 800 Meter competitor.

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In this episode Ron chats with Dan Thompson, CEO of Clinical Wellness Network & Thompson Risk. Here they discuss the work Thompson Risk is doing developing direct contracting solutions for employers. He also does a deep dive into the benefits employers see, such as cost saving, when it comes to direct contracting. Dan also shares information on the SAS platform that they created.

Dan Thompson’s foundation has been built on 20+ years of experience working as an advisor with companies such as Paychex, Schwarz Pharma, ADP & 13 years with a large independent insurance brokerage, where he became partner of the firm. Dan is a certified ACA expert and preferred healthcare consultant for many industries.

As CEO of Clinical Wellness Network & Thompson Risk, Dan works with Carriers, Benefits Advisors, Physicians, Employers to bring a new collaboration to the broken healthcare system.

Clinical Wellness Network was created as a SAAS platform that provide technology and business support services to medical providers.

Thompson Risk is founded on the principal that there is much more to offer consumers than insurance for employee benefits. While Thompson Risk has access to 50+ traditional carriers, it also provides insight for employers around developing direct contracting solutions. Thompson Risk is one of the leading agencies in the healthcare sharing space. Thompson Risk is licensed nationwide with it’s principal offices located in Naples, Florida.

Dan Thompson’s philosophy is to disrupt status quo, drive innovation in healthcare by pioneering new ideas to help fix a broken system. This has led companies to improved benefits, higher quality healthcare, lower costs and happier employees.

Dan Thompson is a member of an elite National Next Generation Advisor group, Ascend. He belongs to the Agency Mastermind Growth Network and supports the Association of Insurance Leadership where Dan was awarded the National Innovation Award for 2018.

Dan Thompson was selected as a 40 Under 40 member by Gulfshore Business in 2010. Dan has been featured in National Publications such as Benefits Pro, Rough Notes, SIIA (Self Insurance Institute of America) EBA (Employee Benefit Advisor). Dan was featured as a cover story in the November 2017 edition of Benefits Pro. He is often cited in trade publications and is a sought after writer / speaker for content in various publications in the industry.

Dan Thompson has an open sharing network to help advisors that participate in the Next Gen Mastermind network by growing through education on prospecting, marketing, social media and next level / best practices strategy innovation.

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In this episode, Ron welcomes Clinton Phillips back on the show. Clinton is the Founder & CEO of Medici and Founder of 2^nd.MD. Here he discusses how the healthcare landscape has changed during the pandemic and how his organization was uniquely situated to grow and meet the needs of patients by providing cutting edge virtual care. Clinton also talks about the different types of employers they work with and how they ensure that their clients have a dedicated team of docs for their staff to utilize, thus being able to develop a real relationship with their docs despite it being virtual. Clinton and Ron also do a deep dive in to what they think the future of virtual care will look like.

Clinton Phillips is currently the founder and CEO of Medici, a global healthcare communication platform. Medici has raised over $40m dollars, has acquired DocBookMD and Chiron Health and now has over 20,000 doctors communicating on its platform monthly.

In 2005, Phillips created the Aspen Back Institute at the St. Regis. Backed by the acclaimed founder of Starwood Hotels, Barry Sternlicht, Aspen Back became a global destination for people from over 40 countries and helped over 1,900 people avoid spine surgery.

Prior to Medici, Phillips created 2nd.MD in 2011 after his daughter suffered a stroke and was left paralyzed. 2nd.MD is a virtual 2nd opinion platform that provides video access to the world’s best doctors at the top 17 US hospitals. 2nd.MD now does more virtual 2nd opinions than the top hospitals combined and has over 10million members. 2nd.MD’s clients include Morgan Stanley, KPMG, EY, United Healthcare, Aetna, Bloomberg, Waste Management and 30 other Fortune 100 companies.

In philanthropy, Phillips is recognized as the largest sponsor of orphans at World Vision and other organizations. In sports, Phillips is recognized as the US National Champion for the 400m and javelin by the USA Track & Field Masters. Phillips has enjoyed the opportunity to speak at Rice, MIT, Princeton and churches across the country and has been featured on CBS, ABC, Forbes, Tech Crunch, Robb Report and more.

Residing in Austin, Texas, Clint has three children with his wife Jade.

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In this episode Ron chats about his experiences with direct contracting and his insights into how it is a better way to do healthcare in America. He discusses how direct contracting is better for the doctors, consumer, payer and how it lowers costs for all along with is better for population health. The outcomes from those with direct care are undeniable. Direct care patients have 30%-60% less meds, stays in hospitals, ER vists, imaging, specialist visits, and procedures than non direct care patients. He also dives into how giving patients better and more convenient access to their docs changes everything.

For more information, here are the links referenced in the episode:

https://www.cms.gov/Medicare/Medicare-Contracting/ContractorLearningResources/Downloads/ja0421.pdf

https://med.noridianmedicare.com/web/jeb/topics/claim-submission/mandatory-claims-submission#:~:text=Mandatory%20Claim%20Submission,Medicare%20patients%20for%20services%20rendered.&text=Violations%20of%20the%20requirement%20may,and%2For%20Medicare%20program%20exclusion

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