Episode # 130 – Patrick Spain Founded First Stop Health and with 550,000 Members is Growing 60% Annually in all 50 States. Primary Care and Mental Health has Never Been this Easy for Employers.

In this episode Ron chats with Patrick Spain, Co-Founder and Executive Chairman of First Stop Health. Here, Patrick discusses the first stop health telemedicine platform and how their goal as an organization is addressing two problems in healthcare: high costs and convenient access to care. Patrick also shares the terrible healthcare experience his family member had that inspired him to make a difference in the healthcare industry. First Stop Health has since grown into all 50 states plus Guam and Puerto Rico. First Stop Health sells directly to employers and sells on a free to the employee basis. What they give the employer in exchange for that is a guarantee that they will save them money measured purely by the number of diverted visits from ERs, doctors offices, urgent care, and more.

Patrick started First Stop Health because of his own unsatisfactory experience with the healthcare system and his desire to improve that experience for others. He is a serial entrepreneur who has founded or co-founded four Internet-based companies.

After graduating from law school, Patrick worked for Extel Corporation, a manufacturer of telecommunications and computer equipment, first as a lawyer then as a business executive. Extel was sequentially owned by Dow Jones, Rolls Royce and JWP from 1979-1990.

Co-founder and long-time chairman and CEO of Hoover’s, Patrick led the company from a small book publisher in 1992 to a profitable, publicly traded online business information services company with $31 million in revenue in 2001 with a sale to D&B in 2003 for $119 million.

Patrick was also the founder, CEO and Chairman of HighBeam Research, which he started in 2002 and sold to Cengage Learning in December 2008. He also co-founded and serves as executive chairman of Newser, a news filtering and summarization service with an audience of over three million readers each month.

Patrick serves as a board member of Owler, a Silicon Valley-based company information service that uses crowdsourcing and AI to revolutionize data collection, quality and delivery. He also serves on the board of Occasion, a Chicago-based calendaring and payment platform for small merchants.

Patrick is a member of the Library Council at the University of Chicago and is a member of the Board of Governors of Opportunity International, the largest and best capitalized micro-lender in the world. He has worked in the technology industry since 1979 and has a bachelor’s degree from the University of Chicago in Ancient Roman History and a law degree from Boston University.

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Episode # 129 – 24 Million Patients Globally – 3 Million US – Agree Babylon Health Deserves 5 Star Ratings Over 90% of the Episodes of Primary Care…Watch Them Go Public this Month. Chief Medical Officer Darshak Sanghavi Lays Out How “Babylonians” Accomplish this With Only 1,300 Primary Care Providers.

This episode Ron chats with Darshak Sanghavi, Global Chief Medical Officer for Babylon Health. Here, they discuss the Babylon health model of taking on full capitated risk for their patient population. He also does a deep dive into how their model includes more than primary care by including a significant amount of behavioral health. Darshak explains the organizations commitment to preventative and proactive care utilizing cutting edge AI, but also giving people access to high quality care when they need it. He also shares with Ron the importance of having happy and engaged patients and providers.

Darshak Sanghavi, MD, is Global Chief Medical Officer for Babylon Health, the global end-to-end digital health care provider serving over a dozen countries and millions of people, with the mission of bringing “affordable and accessible health care to everyone on Earth.” He is the former Chief Medical Officer of UnitedHealthcare’s Medicare & Retirement, the largest U.S. commercial Medicare program with over $90B in annual revenue, where he oversaw all major national clinical and affordability programs. Earlier, he was Chief Medical Officer at OptumLabs, running a large portfolio of industry-leading projects with dozens of academic, government, and industry partners. Before then, he was a member of the Obama administration, as the Director of Preventive and Population Health at the Center for Medicare and Medicaid Innovation, where he directed the development of large pilot programs aimed at improving the nation’s health care costs and quality. In this capacity, he was the architect of numerous initiatives, including the $157 million Accountable Health Communities model, the 3 million member Million Hearts Cardiovascular Risk Reduction model, and the $1 billion Medicare Diabetes Prevention Program. Dr. Sanghavi was also a fellow and a managing director of the Brookings Institution, and associate professor of pediatrics and the chief of pediatric cardiology at UMass Medical School. He is an award-winning medical educator, who has worked in medical settings around the world and published dozens of scientific papers on topics ranging from the molecular biology of cell death to tuberculosis transmission patterns in Peruvian slums. A frequent guest on NBC’s Today and past commentator for NPR’s All Things Considered, Dr. Sanghavi is a contributing editor to Parents magazine, a health care columnist with Slate, and has regularly written about health care for the New York Times, Boston Globe, and Washington Post. His best-seller, A Map of the Child: A Pediatrician’s Tour of the Body, was named a best health book of the year by the Wall Street Journal. He previously worked for as a U.S. Indian Health Service pediatrician on a Navajo reservation. Educated at Harvard and Johns Hopkins, he completed his pediatrics residency and cardiology fellowship at Harvard Medical School and Children’s Hospital Boston.

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Episode # 128 – Dr. Paula Muto Established UBERDOC as a Nationwide Platform for Consumers and Employers to Pay Experienced Docs Directly at Fair Rates. 4,000 Doctors Agree. And So Do Many Employers.

In this episode Ron chats with Dr. Paula Muto, Co-Founder & CEO of UBERDOC. Here she discusses the UBERDOC platform and how the organization’s mission is based on the philosophy of patient choice. She firmly believes in putting control of healthcare back into the hands of the patient. UBERDOC offers patients a wide variety of doctors and there are no referral or network restrictions. Patients then pay online a transparent and affordable price for the healthcare services they receive. Paula also shares what inspired her to start UBERDOCS.

 

Paula M. Muto, MD FACS, is a practicing vascular and general surgeon in solo practice and the owner of the Vein Center at Mutosurgical. She is a member of a family of physicians and surgeons who have collectively practiced medicine in Massachusetts for over 50 years. She is an outspoken advocate for patient care and is passionate about women’s health issues.

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Episode # 127 – Talented Katy Talento Brings it on the New Transparency Breaking Out All Over (That She Drove), On this POTUS doubling Down, On Direct Contracting and its Power, and on Next Gen Benefits Advising. Round 3. Ding! She was a Nun, is a Harvard Trained Epidemiologist, and Advised 5 Senators and 1 President on Healthcare.

In this episode Katy Talento comes back on the show for a third time to discuss her work on patient advocacy, surprise billing, and more. Katy talks about how healthcare has changed since the last time she was on the show, how Biden’s presidency has impacted the healthcare landscape, what she sees happening in the future, and more.

Katy Talento, president of KFT Consulting, is a licensed health benefits consultant, veteran health policy advisor and epidemiologist. She recently left the White House as the top health advisor to President Donald Trump on the Domestic Policy Council, where her job was to advance the president’s agenda to increase health care price transparency and price competition, end surprise medical bills, lower prescription drug prices, expand affordable options in the individual and group/ERISA markets, reduce the burdens of the Affordable Care Act, promote innovative employer sponsored coverage models, expand health IT interoperability, combat the opioids and other drug addiction crisis, eliminate domestic HIV/AIDS, and promote bioethics in life sciences.

 Prior to her White House appointment, Katy served five U.S. Senators over a 15-year period, including as top health advisor and manager of legislative staff and oversight investigators. She also worked in the private sector helping multinational energy companies protect their global workforce from infectious diseases such as malaria, dengue and the largest community-based HIV/AIDS service organization in the US. On the faculty at Georgetown University Medical School, Katy managed the Washington site of a multi-site NIH-funded pulmonology study. 

 A compelling communicator, Katy has delivered speeches to large audiences, served as Director of Speechwriting for the Republican National Committee during the successful 2010 election cycle, and has written a number of published opinion pieces, web copy, and video scripts. She spent two years as a Catholic nun and has worked with the poorest of the poor from East Africa, to industrial Russia and inner-city America. Katy received a Master of Science degree in Infectious Disease Epidemiology from Harvard School of Public Health and an undergraduate degree in Sociology from the University of Virginia. She lives in suburban northern Virginia with her husband and two children.

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Episode # 126 – Meet Dr. Juliet Breeze of Next Level Urgent Care Who is Now Serving Texas Largest School District and Others with Directly Contracted Digital First care. She offers the Same for her 520 Employees. It is the Best Retention Tool Ever.

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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Episode # 125 – AJ Loiacono runs Capital RX – A Transparent PBM Which Has the Highest Satisfaction Scores in the Industry. Hear Why on This show.

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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Episode # 124 – Marshall Allen is Back! His Outstanding Healthcare Reporting at ProPublica Led Him to Write “Never Pay the First Bill”. Here are His Tips on How to Take Control.

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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Episode # 123 – Dr. Elisabeth Rosenthal is Editor-in-Chief at Kaiser Health News, Which Started a Press Snowball Effect by Outing UVA‘s Aggressive Legal Strategy Chasing Thousands for Bills they Generated. It is Over Now, but a Dozen Other Press Outlets did the Same. Hear What Will be Her Encore! Her Book “An American Sickness” Offers Strategies to Protect Yourself from the Bigs.

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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Episode # 122 – Zach Zeller Created in ScriptCo Pharmacy, the First Membership Based Pharmacy Where You are Assured Access to Generic Meds at Wholesale Rates for $150/Year. This Changes Everything.

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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Episode # 121 – We Welcome Back Dave Berg with Redirect Health. He Has Delivered Affordable Primary Care, Physical Medicine and Labs to Over 1,000 Businesses Nationwide. There is No One Better at Squeezing Wasteful Spending from Primary Care than They Are. Hear How.

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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