Episode 7: Doug Aldeen--Connecting Employers to Providers (Part 1)

Cristy Gupton and Doug Aldeen have a great discussion about fiduciary duty and how the new transparency law is going to make it easier for those charged with that task to honor their duty.

Timestamps:

00:00 Introduction

02:20 Doug Aldeen's background

03:28 So, what is the price?

04:30 If you're uninsured or underinsured you need to be asking for your hospital's Financial Assistance Policy

05:50 Quizzify's emergency consent is a gift to all people who might need emergent care...thank you, Al Lewis!

07:14 If you're being asked to sign something in the ER you must advocate for yourself or there's no turning back

08:00 No judge in the country would disagree with paying a fair price for ER services

09:11 Mark Watson of Union County, NC--a true fiduciary. Go back and listen to this episode https://www.custombenefits.work/news/2019/3/28-episode-6-t955b-362c7

10:18 Leon Wisniewski of Health Cost Labs, he's publishing hospital pricing online.

10:50 Information seeing the light of day means fiduciaries can't sit on their hands much longer

11:33 ERISA--the 2 faced law of convenience for health plan fiduciaries

13:00 Hey fiduciary! Start today!

13:46 "Turbocharging"...what's that?

14:55 Coming out of COVID, self-preservation efforts should lead CFOs to start looking at their health plans as ground zero

15:30 The transparency bill...should we get excited or roll our eyes?

16:10 The fine is no biggie, that's why eye-rolling might commence

16:40 But if hospitals really thumb their nose at it, will it jeopardize their Medicare status?

17:50 In light of value-based payments from Medicare, why do hospitals work so hard to get better payments from Medicare if it doesn't cover the costs?

18:43 So, does Medicare actually cover the costs or not? 7-9% margin in the aggregate.

19:30 Medicare Payment to Cost Report

21:21 Can't we all just get along? Willing buyers and willing sellers in mutually beneficial exchange. I could get behind that.

22:05 Employers come to the table...that's what starts the conversation.

22:30 Having some market intelligence when you come to the table at least gets the conversation started.

23:10 DPC rose from the underground during COVID, see also this video from Custom Benefits Solutions

23:55 First patients in the door are usually uninsured

24:23 Referrals are going to need to happen at some point

24:47 Never say "what do you charge"

25:08 Instead say "what would you accept if I pay cash"

25:55 A quasi-contract seed was planted right then

26:31 Employers can benefit from this arrangement without having to do all the work

26:52 The contracts are pretty straight forward especially when there are 2 willing partners

27:30 This is why being an independent doctor is so important

28:21 The ACA gave hospitals the license to steal

28:40 DPC is the smartest cost-containment strategy and if you start with it first it leads to many other innovations

29:00 Thank you! #letsfixhealthcare, www.custombenefits.work.