Episode 6: Hope for Rural Healthcare with Carl Schuessler (Part 1)

00:00  intro

00:42  who is Carl Schuessler

00:50  rural health is in jeopardy

01:08  community healthcare gets a boost with Carl's new client

01:33  hospital systems are employers too...and they need help

02:24  started in 2017

02:36  Lee Gross, DPC guru and visionary

03:05  rural hospitals all over the country are struggling

03:28  demographics and local economy are huge factors

04:25  even sending their own employees were having to go elsewhere for certain procedures

05:05  some hospitals haven't learned how to think outside their own box

05:32  hospitals need to get their own house in order

06:28  current systems were not minding the store

06:48  Carl identified a variety of risks that were not being attended to

07:19  remove ALL barriers to employees who need to do better 

07:40  be like George Costanza and do the opposite!

08:03  made the hospital their own PBM

08:20  pharmacy spend should see dramatic reduction

09:00  pharma savings should outpace Reference-Based Pricing savings by a lot in this case

09:23  avoidance of care because of disconnected care is a problem

09:47  bringing Direct Primary Care right into the hospital setting for hospital employees was important

11:00  integrating DPC right into the plan design

11:43  partnering with a DPC provider is key

11:56  80% of employees enrolled in the DPC option

12:27  identified specific employee needs that were resolved immediately

14:21  preconceived notions don't apply here

15:07  Carl talks about his early steps with new client

16:09  Fair Co$t Health Plan effective 1/1/2019 for new client

16:31  hospital should see increased revenue just because of this change

16:45  community outreach planned

16:58  community built healthcare vs. insurance company built healthcare

17:17  partnering with local, independent pharmacy

17:43  plan design steerage

17:53  assemble the local care team

18:16  dis-intermediate the players and create the love triangle

18:42  employers paying extra for so many layers of extraneous intermediaries

19:17  it only took a 157-employee group to get it done

19:40  local employers within vicinity will benefit

20:20  pregnancy claims mitigated with cash based negotiating

22:20  social determinants of health?  quit talking and start doing!

22:43  wrap up

22:51  thank you and #letsfixhealthcare  visit us at www.custombenefits.work