Improving Healthcare Access Through Nontraditional Benefits and Discount Plans

Hey. How are you? Good to see you. What's up, man? Yeah. You good, alright? Yeah. Y'all need anything? Water? Yeah. Coffee? Good. Good. Alright. Here we go. We met these guys. These are engagement. Woah. Woah. This is Bruce. Hey, brother. How are you doing? Good. What's up, man? How are you? How are you? Welcome in. We got the swag session. What's up, Logan? What up? Gabby. How are you? Hey. So we have we have everything set up. Here we go. I'll be over here. Nice. Look at this view. Here we go. Look at this. Let's do it. What's up, everybody? My name is David. I'm your host of Highway to Health, and I appreciate you being here. This podcast, it's, it's really just a platform to celebrate the people, the organizations that are committed to improving access, experience, and outcomes for our patient population. There's a lot that goes into that. There's a lot of different parties that play their part. It's gonna take everybody. And today, we're gonna talk about, you know, the rising cost of health care, the rising cost of premiums, but also at the same time, the decrease in the value that's being delivered to the employer and to the patient. We're gonna talk about population health. We're gonna talk about some of the biggest topics affecting our patient population today and how individuals and employers can start taking advantage of some of the innovative entrepreneurial solutions that are in the market. That's why I'm really excited to have you on. Welcome to Highway, Highway to Health. Thank you so much for having me. I'm excited to be here. Yeah. Well, you're welcome back anytime already. We had a cool introduction. You're a good sport. Thank you for being that. Of course. Thanks for having a hype man. You know, everybody could use a good hype man. We're gonna get we're gonna get started, but, it's a question I love learning from my my guests. It's your healthy habits. What are you doing to make sure that you're at the top of your game mentally and physically so that you can perform for your family, for your organization, and for your community? Mental health is really important to me. It's a journey. You know? I'm, my early forties, and and I've, you know, learned so much more about myself over the last ten years and become more confident in who I am because of therapy. Yeah. So I I'm a big proponent of therapy. It's not it should not be seen as a negative, for anyone to say, sometimes, you know, we need that opportunity to it's okay to ask for help. Yeah. It's okay to get another person's perspective, especially someone who's trained and has gone to school, to to help us navigate the traumas and and challenges in life. So that's that's important to me. One thing that I've developed through my my therapy and different practices that I've learned, over the last few years is gratitudes. So every morning, one thing I always do is when I first get up, I have dogs, so I take the first thing we do is is go out, and I don't take my cell phone with me. I do not look at my cell phone, at least for the first thirty minutes after I wake up. I grab a glass of water before I get my coffee. And while we're going, you know, through the bathroom routine with the dogs and getting the coffee made, I focus on my gratitudes. So, what am I thankful for? You know, what are the things in my life that I, should be, you know, telling the universe, God, however you look at that perspective that I'm thankful for. You know? And, just simple as I'm thankful that I woke up this morning. I'm thankful for my health. Right? In my early twenties I'm sorry. My late twenties, gained a lot of weight and I was about seventy pounds heavier than I am right now. Yeah. And it was it it wasn't, you know, a a physical look thing that finally kicked in to let me know that that was an issue. It was a doctor telling me that I had high cholesterol, and I was, like, thirty one years old. And it, thank God, was a turning point in my life. And so one of the things that I've struggled with my weight over the years is because of depression and anxiety and using food and drink as a way to, you know, deal with certain things that were going on. And so I've really learned, you know, tried different diet techniques, but what it really comes down to is, you know, when you you sit down to eat a meal, once you're full, I just don't eat anymore. And and it sounds so simple. What I really what helped me get the weight off was as simple as as walking. Yeah. I do work out at the gym, but I'm not I don't love the, you know, the gym type workout. I don't love being on a treadmill and not going anywhere. I really like sports. So, you know, basketball is is a big thing for me. Bike you know, cycling outside or just walking. You know? Back to the mental health side, you know, walking is a huge benefit, especially if you take the AirPods off, you know, you listen to the sounds, you ground yourself in nature as best you can depending on where you live. And and then there's also studies that show as a couple, for instance, I'm newly married, got married earlier this year. Thank you. And as a couple, if you walk together, it mentally, you know, with mirror neurons helps you to connect together. Really? And to to to really create a more intimate and trusting relationship. So, exercise is so important to me. Also, going back to my mental health, you know, one of the things that my therapist always asks me is, what do you need to do to take care of yourself? Be thinking about that. One thing is listen to your body. If you're just exhausted, your body's telling you you need sleep. You need to disconnect. You gotta get away. Yep. And and then, just, you know, spending time, journaling and really not avoiding the the tough things that, you know, the mind brings up. And I'm a I am a an overthinker. So, you know, utilizing some of those tools, meditation's been a huge change for me. A great opportunity. There's a Guide to Meditation series on Netflix that I highly recommend. I think it's by Headspace. Yep. And it it really taught me I have so much trouble, shutting my brain off, and it's been a a huge change in my life since I started it. It's something that we all need to build a routine around. You know, the mornings are special to me too. You know, I've got about a fifty five, sixty minute drive into the office. And when people hear that, they're like, golly. I don't know how you do it. And I tell them, I don't know how I do it without it because, man, it's my time. You know? And the sun's usually on the horizon, and, it's just me and the road and my thoughts. And I get a chance to not only just prepare for the day and kinda mentally ready myself for, you know, the things I've gotta do, but it's hard. And I live out in the country. It's hard at that time not to look around and be grateful, you know, for what we get to appreciate you know, get to experience and appreciate. And so gratitude's a big part of of my routine as well. And if you're ever if you're ever having trouble finding a sense of gratitude, getting out in nature is is my hack, you know, because look around. It's an it's incredible. It's incredible what was created for us, and it's also incredible what we've created with what we've been given. I mean, we're right here in downtown Dallas. The wonders of the world are all around us, and, that's that's always a good thing for me mentally. It's just to look around and and appreciate what what we have access to. And then anytime you can work out is is and mornings are are good for me on there on that too. So mental, physical. And the last thing I'll say about this is it it's like being on a plane. What do they tell you? If you get into a situation on a plane, put your mask on first. Take care of yourself Yes. So that you can take care of the person next to you. But if if you don't take care of yourself, you can't take care of anybody else. It's not selfish to spend time and focus on yourself because that's how you help others. Absolutely. And so, first of all, I appreciate you sharing those things. And I think it's inspiring for others to hear you're busy. I mean, you're a busy guy. You have a lot of responsibilities, but without taking care of yourself mentally and physically, you wouldn't be able to perform at a level. And I hope everybody starts to realize that. It's not selfish to take care of yourself. Alright. So Carrington, awesome organization, right here in downtown Dallas, you know, North Dallas, I guess. But, you guys are are doing some incredible work, and we're gonna talk about, you know, challenging the status quo in this space of the industry. But something that sticks out in our preparation is this paradox, this dichotomy between rising premiums, rising costs, and decreasing value, of our benefits. And for those that haven't had exposure to you and to Carrington and some of this information, what does that mean? How is that possible where costs are going up, values going down? Well, from an insurance perspective and and, I'm not gonna be one of those people that sits here and says insurance is bad and they're they're evil. You may heard some local commercials where they specifically call insurance the devil. We work with insurance companies. We help insurance companies create a more valuable product and better savings. But there are our real core and our focus are nontraditional benefits, sometimes called savings plans, sometimes called, discount plans. They're basically non insured. There's no risk. So the problem that we see with with insurance today is that the premiums continue to rise with the rate of inflation, but the deductibles that we have to pay before that care kicks in and that coverage kicks in has increased. So, we're having to pay more before we get coverage. And, the maximums that are in place, you can only spend, you know, they'll only cover so much, has, has stayed the same since the eighties. You know, back take dental, for example. You know, it's still a fifteen hundred dollar annual maximum is what I see. Well, cleanings back in those days were twenty dollars. You know, getting a root canal and a crown may be a couple of hundred dollars. Today, it's five, six times, the cost it was then. And so, you reach that fifteen hundred dollar maximum So much faster. Exactly. And so, a patient gets into a situation where the prevention is so important in all of healthcare, not just dental using that as an example. And so, the policyholder as a patient is unable to get all of the prescribed treatment from their dentist under an insurance plan. So what we see happening is they will delay that important treatment that's been prescribed by their dentist until their maximum is renewed. And you see this in healthcare all the time too. You don't go get that scan done because you you haven't reached your deductible yet, or it's it's not covered unless you have a certain specialist that sends you there. So we have solutions that can sit outside of and complement insurance products to provide discounts to make these treatments affordable for for the patient. In many cases, what we're starting to see with employers now, and and we work with the broker community that's consulting those employers to provide the employee benefits, is they will utilize our products as a gap filler for the insurance as, an additional option. And then what's really cool about these products is sometimes it's really expensive to add your family onto an insurance policy. And so many of the employees will decide, alright, I'm going to cover myself with an insurance policy. But you can buy these nontraditional plans for a tenth of the cost of an insurance plan Okay. And give that to your entire family. And we're very, friendly with the allowing an entire household to use our products because what I said earlier, these discount and savings plans are not insurance. So there's no risk. An insurance company wants to discourage you from using the the the coverage. Yep. They wanna discourage you from having these high dollar Claims. Treatments and claims. And so, the discount plan is the complete opposite. There are no limits on use. There are no maximums that you have to worry about. You can get as many treatments performed as you want and always get a discount as long as you go to a participating provider. And that can be used, again, either before insurance kicks in with high deductible plans. It can be used once you've reached your maximum and you have no longer are able to use it. It can be used for those family members who aren't covered by insurance and they have these savings. Or things like I mentioned earlier with with lab discounts and being able to go get scans. Prevention is so important if you don't find it. And the longer you wait to find out what you're dealing with, the more critical and more expensive it's gonna be. So insurance companies are starting to see also that these nontraditional benefits help them. Yeah. And so it's a good partnership for everybody. Absolutely. I mean, it's obvious on the patient. You know, I've I've got a family of six. Obvious for me on on how it can help me save and then also get me access to things that would be costly otherwise. I can see how it's good for the provider because they're avoiding these huge episodes of care probably more often because you're getting more consistent information and and diagnosis and earlier diagnosis for them. But it's interesting. I didn't realize the the benefit that the insurance company would realize through a partnership in these nontraditional benefits. Absolutely. You know, we have one client that's based here locally, but they're one of the largest, airlines in the United States. And they have a very, very good for the employee dental insurance plan in place. However, I was talking about maximums earlier that they were continuing to get complaints from the employees that, hey. I'm reaching my maximum by summer. Then, I have other treatment that I need to have performed and I'm having to wait. And so, that's when, in the dental world, for instance, a simple restoration of filling turns into a root canal and crown or an implant. Don't you don't ever wanna spend that kind of money. Yeah. Keep your own teeth. Is one thing that our owner who's a dentist, would certainly tell you. Yeah. So, they use this, you know, as an employer group, this discount plan once they've reached the maximum and for things that aren't covered by the insurance. How does the insurance company, benefit from that? Well, those treatments that they were gonna wait to do next year when they got when their maximum renewed Yeah. And and they got their benefits back, were now, they were taken care of under a discount plan. The insurance company doesn't have to pay anything for that treatment. The patient, because of how deep our discounts are in the industry, is still paying about the same as they would for that treatment under an insurance plan because things aren't covered at one hundred percent when you get into that major or even restorative work. Right? It may be covered eighty percent, fifty percent. And with our fee schedules, we have fifty percent, sixty percent discounts. And, by the way, they're very transparent. The patient gets it before they walk in the door. They know what they're gonna pay for each treatment. The dentist knows exactly what the fee's gonna be. And so the insurance company avoids a lot of claim there, and they avoid that more major treatment that I was talking about when you wait. You know, preventative treatment is is is gonna help the longevity of, your oral health care, your overall health. Yep. And and so it's it's a benefit to everyone, like you said. Yeah. Agreed. So you you touched on, you know, the the transparency. Right? And and we've seen the no surprises act come through where, you know, these providers are having to, you know, tell you what you're gonna owe before you opt for those services. That's hard on the provider for a lot of reasons. It goes back to the fee schedules. How are you able to deliver that transparency to the patient, to the provider? Because it's also very valuable for the provider to be able to, you know, know what to expect in terms of reimbursement too. How how does that work with the nontraditional benefit? So, I'm, I'm sure your audience is familiar with, in network providers. Yeah. You know, that's part of all insurance plans. And what a lot of insurance companies have to do when they're building what we call the Provider Network, those practitioners that agree to be a part of the the network, they're agreeing to set fees which are a discount off their usual and customary fees. What they would normally charge any patient who came in the door without insurance, their full fee, or cash fees, sometimes called. So, in order to get enough providers to join that network, many times, they do one off, adjustments and negotiations. Sure. And so, it is not uncommon for an insurance plan to have hundreds of fee schedules across their network, that these providers agree to. So, it's virtually impossible to tell a patient before they go in as a policyholder what they're gonna pay per treatment because they have the ability to go to any of these in network providers. What Carrington has done to make it easier and because of what you said earlier with regard to these discounts and savings plans are a benefit to the provider because they don't have to deal with insurance. They don't have to be told by an insurance company what treatment should be performed. They're the expert. They're the doctor. They can decide with these discount plans exactly what needs to be performed. And so they're more willing to join a discount network many times than an insurance network for many of those reasons. Yep. And so what we've developed are only twelve fee schedules across the entire nation. K. And so we don't do the negotiation, and and confuse what the fee would be. So we tell the member whenever they join our plan, we send them a Welcome Kit that includes ID cards and we include in that Welcome Kit the fee schedule for the ZIP code where they live. And then, if they're traveling and they need to go somewhere outside of their area, They can go to our, website, search providers in their area, and then click and see the full fee schedule, that they're gonna pay at that specific provider. And Our flagship plan, the five hundred Series on the dental side, it only has seven fee schedules across the nation, and they're assigned per state. So you go anywhere in the state of Texas with that plan, which I do as an employee of Carrington, you know, you you that fee schedule is not gonna change. So when you talk about transparency, like, everybody says transparency, but what the heck does that mean? That's a really clear example of transparency. What transparency does for the patient, because health care is complex. And you confuse, you lose. You confuse in health care, you don't use in health care. Right. And when there's when there's transparency in this understanding of what to what you're gonna have to pay, what you're gonna owe, it drives access because it drives utilization. It's not it's not this scary ghost that lives in the closet anymore. I can I can anticipate what it's gonna cost, and then I can budget accordingly just like every other purchase that we make in our lives? That's been the biggest the biggest thing I've seen in with the patient impact is, man, if I know what I can cost, I can plan for it. And so that transparency is huge. Tell me a little bit more about, you know, how Carrington's discount savings plans think about this in a larger scheme of things. Like, population health's a buzzword right now. It's a big term. I can see I can start to make how make the connections on how this would affect population health in a really important way, especially with chronic manage you know, chronic condition management. Talk talk a little bit about that. So, you know, it goes along the the same lines as as why the value of these plans can be greater or or complement an insurance product. Because when you can afford the treatment and you don't have things like deductibles and maximums that are discouraging you from using the Plan and getting the treatment performed that you need, that helps the overall outcomes of a group. So, population health, you know, really is looking at a group and typically, you know, we see that on the employer side. Right? Most Americans receive their health care benefits through their employer. Yep. That being said, there is a big shift in the marketplace. The Affordable Care Act helped move many of the programs to this more voluntary basis. And, the challenge with that on insurance is that you don't have a group to spread that risk of utilization across. Now, you're dealing with insuring individuals and if they've never had health care insurance, let's say, and then they go buy it, they're going to use the heck out of it, you know, because because they need it. And so, that really is why insurers were are nervous about individual programs, but the Affordable Care Act has forced them into look at those things. So, these discount and savings plans that, again, can complement, they can fill the gaps of where insurance doesn't cover things, can be used after insurance's maximums have been reached. This ensures that the patient has a way to afford the care that they really, really need. And, so, the outcomes will be better because I keep saying it, prevention is key. And, focusing on doing everything you can to prevent those chronic illnesses is extremely important. There there are links, for instance, going back to oral health care, to, diabetes Oh, yeah. Preterm weight weight babies, artery disease, cardiac disease. By the way, I'm glad this is starting to get more and more mainstream. My dad was a dentist for twenty eight years, and he always talked about this growing up. You know, I'm thirty eight. So for the last thirty five years, my dad's been telling me, like, when he looks inside a mouth, he has a a pretty clear understanding of how healthy and what kind of lifestyle this person is living, and he said that forever. It's only been recently that you hear more about the importance of oral health when connected to overall health. Yeah. And I'm glad that's starting to get more of more more discussion because, man, I've heard it all my life. Absolutely. You know, that's just one area. You know, that's just one connection that I can talk about. And so, you know, the the the nice thing about these savings plans, if you are pregnant, you can have as many cleanings performed as you want. And, that's important to the potential of having preterm weight babies born and gives the mom some of that assurance that they're taking care of themselves and their baby. You know, some of the some of the other things, outside of oral care, you know, we have programs that help with durable medical equipment and diabetic supplies. And so especially folks who maybe can't get out of their house as well, We have programs where they'll deliver them through the mail directly to, to their home. What about virtual health? Virtual health has become a a a real focal point for our company. Okay. Even before the pandemic, virtual care is something that oftentimes can be looked at and say, What can you really do virtually? I think most importantly is the quick access to advice. And so, we have many healthcare advocacy programs including these virtual cares, whether it's medical second opinion, looking at your diagnoses, not having to go to another doctor, spend all the money and the time to do all the scans again, but utilize what you've already done with your primary physician and then getting a specialist to look at it for you. So, but because Carrington realized how important virtual healthcare was, we actually created our own company a little over a decade ago called DialCare. And, so, one of our sister sister companies to Carrington is DialCare. And we have your primary care, with urgent care where you can talk to an MD. When you have something going on, avoid going to a waiting room where you're gonna share illnesses with, other patients potentially. Avoid having to wait for an hour before you can get in to see the doctor. Exactly. Avoid a forty dollar, fifty, eighty dollars copay that you have to pay them. And, instead, either get on the phone or a video call with a physician. And, if they can determine what your diagnosis is, then electronically prescribe treatments to your pharmacy of choice. And I can tell you just the ease of use of something like that is massive. I travel a lot for work. And being able to do that anywhere in the United States is really important. Yeah. It's paid off with kids too, you know, where you talked about avoidance earlier of these big health episodes. For us, it's helped us avoid emergency room visits Yeah. That are costly. For everybody involved, it's expensive, right, when you take but in that moment, I'll pay for it later. I've got a sick kid or a hurt kid, and I just need them to be seen right now. Virtual care telehealth has been a huge tool that we've leveraged in our family to avoid those costs, but still get the information you need, especially when it's such a sensitive and, you know, in the moment seems like an urgent an urgent deal. Right. So, you know, this whole conversation has been about challenging the status quo, whether it's nontraditional benefits, virtual or telehealth, understanding that look. When people need health care, they should be able to access health care and not worry about, you know, the the hidden costs that come with it. Carrington and companies like Carrington are continually challenging the status quo and and and bringing access, outcomes, experience, improvement to all those areas of our lives. If if our listeners could understand one thing, Carrington's such a great company. This industry, this challenge is so big. But if you can narrow it down, what's, I mean, what's the one thing you want our listeners walking away understanding and be able to, you know, share with their friends, their family, their coworkers? You know, we live in one of the most progressive and, financially stable countries. We have access to water. We have all of the basics covered, and yet our health care system seems broken many times. It's also extremely confusing. Yeah. And so, you know, what what I would say to people is kind of most important is to focus on your health. Make it more important than anything else. You said something earlier that really struck a nerve with me, which is take care of yourself first. That's the only way that you can help your friends and family and those that that, you support. And, you know, you made the analogy just like on the plane when they say the air, you know, the oxygen mask drop, put yours on first before you help others. It's so important that we don't It's easy for us to tell other people. Yeah. This is important. You need to go do this. Go see the doctor. It's easy for me to tell my family members when they're being stubborn. For whatever reason as humans, it seems to be difficult for us to remind ourselves. And so, I would just remind everyone to say, if your body's telling you something or if you're feeling a certain way, that's your body telling you, what you need. Are you extremely tired? Are you feeling run down? You need rest. You need to disconnect. Are you sneezing and struggling with allergies? What's your environment? Are you sitting indoors all day long? Get out. Get some fresh air. Yeah. So just focusing on yourself first is the number one priority and then it gives us the opportunity to to help those that we love around us. Yeah. Well said. And, you know, for me, as I have these conversations, I learn a lot. Right? That's one of the biggest, side benefits of of having this podcast, having these conversations. I've been in health care the last thirteen years. I learned something new about the innovations, k, the nontraditional things that are coming to market that are available that's improving, you know, access to care experience, and outcomes. I would encourage everybody to to be curious too, you know, and and look into some of these things that you may be less familiar with. If you're an employer, you have that obligation responsibility to to do this, to look into these things, to learn for your employees. If you're an employee, if you're an individual, same responsibility for yourself and your family, your care your the the ones you care most about. The way you handle other areas of your life, other areas of your business with that entrepreneurial spirit, that curiosity, we should be treating health care and our own personal health with that same type of curiosity because there are resources, there are solutions, there are partners out there that can bridge these gaps that traditionally we didn't have answers for. Right. And so I appreciate you coming on and sharing some of that information for me and for our listeners and for everybody else. Yeah. That curiosity for our own health is so important. And, you know, it it it it's also important at all levels, but it starts at home. Yeah. And then it starts in our community, those that we impact and we're around. You know, that education, talking about mental health, and and that's another virtual care service that when the pandemic hit was just so imperative. And, now, that whole industry has completely changed because, now, you can get on a video call or a phone call with your therapist and they could be pretty much anywhere in the world depending on the law. And, you really have access to mental health in a way that we never have prior to the pandemic. But I would say being curious, focusing on the home and your local community, so important. And then, if you're inclined to be more of an activist, make sure that our government leaders know how important healthcare is. There are so many topics as we're here in an election year. Yeah. And next week, early voting starts here in Texas. Make sure they know. Healthcare is is should be number one. Again, like I said earlier, our country has an embarrassment of riches. The fact that we don't take care of our our family members, our citizens, as well as other countries who don't have those embarrassment of riches is really a sad thing, and and it should be a focus on all levels of the government. I agree. And there's a whole series of misaligned incentives that have led us down this path. And, there's a whole lot of money and a whole lot of influence going against the overall improvement of the individual's health. Mhmm. And we've gotta get that more aligned. Yeah. And you're right. Every four years, you know, it's the biggest topic because it impacts everybody. And, who knows where we go from here? But I think I think we have an opportunity individually and from the grassroots approach to really change the leverage point and and the the influence of power because we control more than we know we control. Yeah. And I like when you said, if you're an employee, tell your employer how important these things are. Tell them about things like nontraditional benefits because in our country, many times, it's this is the way we've always done it. And so, we're educating at Carrington the brokers. And so, if you're an employee, tell your employer about nontraditional benefits. If you're an HR manager at a company, tell your benefits man, employee benefits consultant, there are these other benefits. Why are we not using these to help with population health? Yep. And so on and so forth. If you're an employee benefits consultant, please get educated on these. Learn what's available and be teaching, you know, your clients, how we can make a change. If we don't make a change, then not you know, we can't fix it. Right. I mean, we collaborate on every other decision in our business and in our lives. Right. For a long time, we've just accepted whatever benefits package, whatever carrier, you know, we were given. It's time to have these conversations, because there's options available. Absolutely. Thank you. Thank you for having me. Love to talk all day about it. Yeah. We could. You're welcome back anytime. Sounds great, man. Thanks. Thank you.