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In this episode Ron chats with Jamie Lagarde, CEO of Sedera, a medical cost sharing organization. Medical cost sharing is non-insurance where all members share funds for medical care. There is no provider network, and there is no insurance company. Here they do a deep dive into how medical cost sharing works and what differentiates it from an insurance company. They also talk about affordable it is and how it provides a much better “bang for your buck” than health insurance. Here, they also explore how medical cost sharing works alongside direct primary care and how the two complement each other.

Jamie is a successful serial entrepreneur and experienced executive with a consistent track record of rapidly accelerating top line growth, improving profitability, and building successful organizations. His functional experience spans new technology implementation, launching start-ups, streamlining operations, and he is seasoned in leveraging his background from a variety of executive management roles. He is a dedicated leader focused on developing and retaining top talent, and has a collaborative style that works extremely well with customers and partners alike.

As CEO of Sedera, Jamie brings over 15 years of healthcare experience and over 20 years of operational and information technology expertise to the Team.  His daily mission is to empower individuals to form better collaborative partnerships with their healthcare providers and to radically change the way we pay for healthcare, one member at a time.

Jamie is also an active member of the Austin community.   He serves on the Goodwill Central Texas Board of Directors and Executive Committee.  He is an active Board member of C12 and The Karis Group.  Jamie, his wife Alisha, and their three young boys are parishioners of Saint John Neumann Church, and are founding members of the Austin Legatus Chapter.

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In this episode, Ron chats with Dr. Lee Gross, the Founder of Epiphany Direct Primary Care. Here they do a deep dive into a more affordable and more effective model of healthcare. This model is built around direct primary care and price transparency. Dr. Gross also talks about the success he has had working with a rural hospital in South Florida. Lee is a pioneer in healthcare who is consulted by policy leaders from the local to the federal level. He has even provided formal testimony for the US Senate and provide consultation to CMS, HHS, and the White House.

Originally from Cleveland, Ohio, Dr. Gross is a graduate of The Ohio State University and Case Western Reserve University School of Medicine. He was elected chief resident of his family medicine residency program at University Hospitals of Cleveland.

After years in private practice in Florida, he and his colleagues had an “epiphany” about an affordable health care solution, free of insurance and government intrusion. Now, a Direct Primary Care revolution is sweeping across the nation, providing access to health care for those who have been neglected by the system for decades.

Dr. Gross is a pioneer in the Direct Primary Care delivery model, frequently speaking at national meetings, conducting media interviews about free-market health care innovations and writing articles for national publications. He is a health care consultant to physician practices, medical organizations, insurance groups, hospitals and private businesses. He is consulted by lawmakers and policy leaders on local, state and federal health policy initiatives, including formal testimony for the United States Senate and consultation with leadership at CMS, HHS, Labor, Treasury and The White House.

He serves as the president of the Docs 4 Patient Care Foundation, a national health policy think tank of practicing physicians committed to the establishment of an American health care economy which preserves the sanctity of the physician-patient relationship, promotes quality care, supports affordable access to care for all Americans and protects patient’s personal health care decisions.

D4PCF is the leading educator of DPC physicians. It has trained over 1,000 physicians in the Direct Primary Care delivery model through grant-supported national conferences since 2016.

Dr. Gross serves on the Board of Trustees of an HCA Hospital and as a Delegate to the Florida Medical Association. He is President of his county Medical Society. He is appointed to the FMA Council on Medical Economics and Practice Innovation. Dr. Gross is a recipient of HCA’s Frist Humanitarian award. He has received the Free Market Medical Association’s Beacon Award for his leadership in healthcare market reforms.

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In this episode Ron welcomes back Ashley Bacot and Kenneth Aldridge of Rosencare. Here, they do a deep dive into what makes the Rosencare model special. They discuss how their healthcare model gives them a financial, recruiting, and retention advantage over their competitors. They offer a whole health model for their employees that includes primary care, mental health, wellness classes that focus on fitness and eating right, and much more.

Since 1991, Rosen Hotels & Resorts has offered an innovative in-house healthcare program that has saved the company approximately $340 million (as of April 2018), affording the opportunity to provide associates incredibly low premiums and innovative programs. The plan features on-the-clock visits to primary care doctors and a variety of specialists at the onsite. company-owned and operated Rosen Medical Center, A Place for Healing and Wellness; minimal co-pays for office visits and prescriptions; and a focus on prevention and wellness/exercise programs. Although Rosen has never measured the soft cost savings such as increased productivity, reduced absenteeism and improved presenteeism, no doubt the savings are significant. These cost savings are truly astounding considering the diversity of the Rosen workforce and the large number of hourly associates who have emigrated from other countries, many who have never received regular healthcare, and some who have never seen a doctor. In January 2012, the Rosen Medical Center, A Place for Healing and Wellness, opened as a new, freestanding building at 7656 International Drive, near the Rosen Inn International hotel. The facility is approximately 12,000 square feet and took the place of the previous 3,500-square-foot medical center that was located within the hotel.

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This episode features Rachel Means, CEO of Employee Benefits Consulting (EBC) & Charlie Cano, CEO at Etex Telephone Cooperative. Here they discuss the U.S. health care system and how it is becoming increasingly complex and confusing to employees and employers alike, as health care costs continue to rise. Here, Rachel explores how employers need the right strategic partner and advisor to help them manage both their short-term cost control challenges as well as the longer-term issues of health program management, compliance, employee engagement, accountability, health, and well-being. Charlie explains the massive success story that Rachel was able to create in his company in terms of lowering costs and providing his employees better care.

Rachel Means:

With a background in Oil & Gas, Rachel began her career in benefits consulting in 2004 as an account manager for a Houston based consulting firm. Very shortly, she was hired away as a producer by a well-known, publicly traded firm, and began growing a block of business she ultimately purchased when she started EBC. Rachel’s primary role as a CEO is to assist clients with aligning their benefits strategy to corporate goals, vision, and organizational governance.

Critical to this role is plan design optimization, financial efficiency, and plan compliance with an eye on employee satisfaction. She continually seeks to deliver innovative ideas with maximum fiscal impact and benefit efficiency to clients. Time after time, Rachel peels away the layers of redundant costs and undisclosed compensation, replacing inefficiencies with lean, transparent benefit plans in which clients—public and private—have renewed confidence and pride.

Charline Cano:

He’s a 22-year veteran of the telecom industry with diverse work experience as an Outside Plant Design Engineer, a Project Manager, and Sales Director for a national consulting firm. He’s been with Etex for the last 18 years.

Utilizing his business and engineering knowledge, Charlie was responsible for guiding Etex through the Fiber-to-the-Home (FTTH) network remodel, deploying wireless technology and much more. His leadership, innovative approach, boundless energy and vision earned him the title of CEO / General Manager of ETEX in 2013. His focus since then has been the transformation of Etex customer care culture, obtaining regulatory balance for the communications industry and developing a sales channel to deliver the best in communication, information and entertainment services to residents of East Texas.

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In this episode, Marni Jameson Carey returns to the show for a third time. Here she puts nonprofit hospitals and health systems under a microscope and investigates the fact that they are not behaving the way people expect nonprofits to behave. Fancy billboards, skyboxes at sporting events, extravagant galas, offshore accounts; are these appropriate for an organization that is considered to be a nonprofit? Especially since it is done with their patients money? Listen here as she does a deep dive into this topic and more.

Marni is the Executive Director of the Association of Independent Doctors, a national nonprofit designed to support America’s independent doctors, stop the trend of health-care consolidation and, thus, reduce health-care costs.

An award-winning journalist, Ms. Carey worked as senior health reporter for Tribune Media, writing for the Los Angeles Times and the Orlando Sentinel before taking on her role at AID in 2014. She is also past president of a medical marketing firm, author of four books, a nationally syndicated columnist, and frequent TV guest and speaker. Since joining AID, Ms. Carey has been featured in over 50 media outlets including Forbes, NBC, FOX, Bloomberg, Becker’s, Modern Healthcare and Medical Economics.

Combining her health-care and communications experience, Ms. Carey now serves as the voice of independent doctors who don’t have the time, resources or clout to speak out against the formidable forces facing them, including pressure to sell out to hospitals, and excessive government regulations. A doctor’s advocate, Ms. Carey has addressed lawmakers and physician leaders on Capitol Hill numerous times and has spoken at many national conferences. She works closely with the Federal Trade Commission to enforce anti-trust laws, and regularly collaborates with like-minded groups to champion physician autonomy and keep the health-care relationship between doctors and patients. Ms. Carey received her bachelor’s degree in journalism from the University of Kansas, and her master’s degree in writing from Vermont College.

An award-winning journalist, Ms. Carey worked as senior health reporter for Tribune Media, writing for the Los Angeles Times and the Orlando Sentinel before taking on her role at AID in 2014. She is also past president of a medical marketing firm, author of four books, a nationally syndicated columnist, and frequent TV guest and speaker. Since joining AID, Ms. Carey has been featured in over 50 media outlets including Forbes, NBC, FOX, Bloomberg, Becker’s, Modern Healthcare and Medical Economics.

Combining her health-care and communications experience, Ms. Carey now serves as the voice of independent doctors who don’t have the time, resources or clout to speak out against the formidable forces facing them, including pressure to sell out to hospitals, and excessive government regulations. A doctor’s advocate, Ms. Carey has addressed lawmakers and physician leaders on Capitol Hill numerous times and has spoken at many national conferences. She works closely with the Federal Trade Commission to enforce anti-trust laws, and regularly collaborates with like-minded groups to champion physician autonomy and keep the health-care relationship between doctors and patients. Ms. Carey received her bachelor’s degree in journalism from the University of Kansas, and her master’s degree in writing from Vermont College.

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In this episode Ron chats with Carl Schuessler, Managing Principal, BenefitStrategies, LLC. and Mitigate Partners, LLC. Here they discuss how to bring back “neighborhood healthcare” to communities, eliminating the counterproductive barriers, getting back to to the “Marcus Welby, M.D.” way of healthcare. Carl talks about his experience removing PBM, the TPA, and BUCAHs from the healthcare equation. They do a deep dive into how healthcare can transform for the future, and how it already has transformed in some areas.

Carl runs an intentionally small “concierge” consulting firm offering a unique approach to benefits management to a select group of clients, Benefit Strategies provides Insurance, Risk Management and Employee Benefits Consulting.

Serving as a Population Health Manager specializing in Cost Containment and Risk Mitigation, the partners pride themselves on their ability to be creative in designing innovative, optimum plans and helping companies and individuals make the most of their financial resources by serving as a Fiduciary and Steward of health plan dollars. With more than 25 years of experience in employee and executive benefits consulting and financial planning experience, Carl offers clients improved cash flow, saves money and retains top talent with well-structured employee benefit and financial planning solutions. He is also an accomplished speaker and author.

After spending the last 4 years searching for the best in class Healthcare Solutions to solve the Healthcare Jigsaw Puzzle, by integrating these to significantly reduce his clients’ health plan spend, Carl created and trademarked FairCo$t, a health plan design he pioneered.

Carl has successfully networked with other trusted vendors such as insurance companies, PBM’s, TPA’s, health care destinations, employee benefit communication companies, and onsite clinics. To the delight of his clients, he has a proven track record of bringing comprehensive solutions to businesses regarding healthcare costs, benefit design, improved medical outcomes and improved employee communications. Carl is an employer advocate and provides easily understood solutions and encouragement to employers.

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In this episode Ron chats with Dr. Marty Makary, Johns Hopkins surgeon, thought leader and Professor of Public Health. Here they discuss primary care in a sea of change during COVID-19 and what it will look like after the pandemic. Hear a deep dive into the importance of preventative primary care and how transactional care does not align with better outcomes. They talk about how fee for service is an outdated model that will be replaced. The coronavirus pandemic is putting a spotlight on many of the broken aspects of healthcare, explored here.

Makary is a frequent medical commentator on NBC and FOX News and a leading voice for physicians, writing for the Wall Street Journal, New York Times and USA Today. He advises policy leaders at the highest levels of government on health care and leads an advocacy effort to re-build the public trust in American hospitals.

Dr. Makary is a champion of lifestyle medicine and the re-design of how people interface with the health care system. As gastrointestinal surgeon, he is a strong proponent of healthy foods and the impact of the microbiome on health.

His bestselling book The Price We Pay is a call to re-build the public trust in the medical profession.  He advocates for the new movement of relationship-based clinics that spend time with patients to address the social, economic, and lifestyle determinants of health.  His book has been described as “a must-read for every American” by Steve Forbes and a “deep dive into the real issues driving up the cost of health care” by Dr. Don Berwick.  His previous bestselling book Unaccountable was adapted for television into the hit medical series The Resident.

Dr. Makary has been elected to the National Academy of Medicine and named one of America’s 20 most influential people in health care by Health Leaders magazine. He is the Editor-in-Chief of MedPage Today and speaks frequently the future of health and health care. His current research focuses on the appropriateness of medical care and the impact of the health care cost crisis on low-income populations.  Using a non-partisan approach, Dr. Makary explains the current billing-throughput system of medical care and explains how the disruptors who are revolutionizing the way we get care.

Dr. Makary was the lead author the Surgical Checklist and later served in leadership with Atul Gawande on the World Health Organization Surgery Checklist project. Makary has published more than 250 scientific articles.

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In this episode Ron chats with James Dunavant, the Executive Director of the Free Market Medical Association. James is a champion for price transparency and the free market medical movement. Here they discuss the rising costs and worsening benefits in healthcare. They do a deep dive into what the free market with transparent cash pricing looks like and how it benefits every party involved.

The FMMA Matches a willing buyer with a willing seller of valuable healthcare services. That is the goal of everyone involved in this movement. They help identify patients willing to pay cash, doctors willing to list their prices, businesses attempting to provide affordable quality insurance, and providers/services/and patient advocates that are helping make everything work.

James Dunavant serves as the Executive Director for the FMMA. Mr. Dunavant possesses more than ten years of success in academic fundraising and managing comprehensive capital campaigns for private and public institutions. His extensive experience includes event management, corporate and foundation relations, and prospect management. Prior to his work in institutional development, Mr. Dunavant spent nearly ten years in the book industry managing major business to business client relationships and marketing programs across higher education and international markets.

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In this episode Ron talks to Cathryn Jakobson Ramin. Here she does a deep dive into her book, “Crooked: Outwitting the Back Pain Industry and Getting On the Road to Recovery”. Cathryn struggled with backache and sciatica for years. She turned her journey in the back pain industry into investigative journalism, uncovering many secrets around the political, psychological, and economic influences on various treatments. She uncovers and shares many of the problems with the industry and its effects on back pain patients.

Cathryn Jakobson Ramin is an Investigative journalist and author of “Crooked” a new book about the back pain industry, as well as the New York Times best seller Carved in Sand: When Attention Fails and Memory Fades in Midlife.

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