Shows / Self-Funded
Self-Funded
Self-Funded, hosted by Spencer Smith, is the definitive resource for benefits consultants and employers who are ready to challenge the broken healthcare status quo. Each week, you'll get an insider's playbook of actionable strategies from industry leaders that help make healthcare better, together.
Episodes
Self-FundedKeep Your Doctors, Ditch the Big Carrier Networks | with Jarred Pierce
“The worst thing and last thing you want is a bunch of your employees complaining about, I don’t have access or my kid’s pediatrician’s not in the network.” -…
Self-FundedSelf-Funding Is Simple. We Make It Sound Complicated. | with Carrie Cherveny
“They’re taking these 40, 50% increases because they just are afraid or don’t understand self-funding, and won’t move into an alternate risk environment.” -…
Self-FundedMark Cuban Says Healthcare, Not AI, Is Killing Jobs | with Sebastian Sanchez
“You talk to the janitor or the field worker making hourly pay and looking at these figures, knowing we better stay healthy this year, because there’s no way…
Self-FundedThe Problem With PBM Rebates | with Steve Ditto
“Rebates, I’ll go out on a limb and say, they’re almost inherently evil... Your sickest employees are paying for that rebate.” - Steve Ditto PBM rebates are…
Self-FundedGiving Employees Free Healthcare Saves Employers Money | with Chris Mathew
“The idea with WellGenie is, what if we can increase access and remove the cost burden? Then we give the opportunity for people to not delay care.” - Chris…
Self-FundedThe Diabetes Reversal Program That Refunds You If It Doesn’t Work | with Dr. Jeffrey Hockings
“Medical physicians are trained that [diabetes is] not reversible... Still to this day, I would say 95% of medical physicians do not know it’s reversible.” -…
Self-FundedHow to Stop Paying for the Wrong MSK Care | with Tom Weber & Peter Krahn
"He went from injury Friday night to in front of the correct surgeon on Monday afternoon." - Dr. Tom Weber, MD Ortho Most MSK spend goes to the wrong care: ER…
Self-FundedHow AI Is Inflating Hospital Bills & ICHRA's Big Rebrand | with Stephen Carrabba
"[AI] absolutely is an arms race, and this is what we're dealing with on a daily basis." - Stephen Carrabba, ClaimInformatics In this episode of Last Month in…
Self-FundedThe Company That Pays Surgeons Not to Operate | with Matt Eurey
"We pay them a $2,500 flat fee for the time that they spend with the patient and make that recommendation for no surgery. If you don't, then you've wasted…
Self-FundedHow to Actually Manage Cancer Claims In Self-Funded Plans | with Peter Bridges
"Over 90% of the time, there is some change recommended to the care path someone is on. Oftentimes we make two to four separate recommendations." - Peter…
Self-FundedThe Right Way to Buy Stop-Loss in 2026 | with Monique Burke
Monique Burke buys more stop-loss than almost anyone in this business, and the rate is the last thing she looks at. She built OneDigital's stop-loss center of…
Self-FundedThe Program That Wipes Out Catastrophic Medical Bills | with Brett Morris
Two kids called Brett Morris to tell him he saved their father's life. The man had cancer and had decided not to fight it. He'd spent his working life saving…
Self-FundedThe $17B Aon-USI Deal & August Healthcare News | Last Month in Healthcare
"I look at it as an opportunity for everybody else. You're already seeing people on LinkedIn saying, I can't wait for the disruption." - Lamont Thurston…
Self-FundedThe Surgeon Who Flies Himself To Every Operation | with Ronen Elefant
There are roughly 9,000 ambulatory surgery centers in the United States, and most of them aren't running at capacity. Ronen Elefant figured out that he didn't…
Self-Funded2027 Renewal Season Prep with Imagine360 - LIVE!
This episode was recorded live on LinkedIn with Bill Dembereckyj, CFO of Imagine360, and it's a look at renewal season from the seat that ultimately signs off…
Self-FundedWhy Employers Should Cover Whole Genome Sequencing | with Joshua Resnikoff
Whole genome sequencing costs about $1,000 today. Ten years ago it was fifteen. Clinical guidelines already say kids with epilepsy or developmental delay…
Self-FundedThe "Wild West" of Peptides | with Rick Manuel
Half of what this pharmacy compounds is GLP-1s. The other half is a category most benefits professionals have never had to think about, and probably will…
Self-FundedThe Right Way to Cover GLP-1s in Your Health Plan | with Embla
Everyone in this market is optimizing for the wrong thing. Consumers want the most weight loss for the cheapest price, and up to 40% of what they're losing is…
Self-FundedNobody In Washington Understands Employer Healthcare | with Katy Talento
Katy Talento ran healthcare at the White House Domestic Policy Council and helped push through the price transparency executive order. Now she runs health…
Self-FundedThe Switch: Why Employers Want To Be Led, Not Sold | with Billy Potter
My guest this week is Billy Potter, now CEO of Snellings Walters, and we spend this episode on "the Switch," his firm's process for moving employers from fully…
Self-FundedTrump's Generic Drug Tariffs & The 14% ACA Hike | Last Month in Healthcare
"Generic drugs are not the costly drugs. A 100% increase on a relatively inexpensive generic may not even be noticeable." In this episode of Last Month in…
Self-FundedOutlier Clauses: Healthcare's Best Kept Secret | with Ryan Bojrab
"If you're expecting to pay $50k, but it hits an outlier clause, you could be paying upwards of three, four, five, six hundred thousand dollars." What if the…
- Self-Funded
The HCC 2026 Stop-Loss Report: My Key Takeaways
"What used to be a once-a-year catastrophic claim is now happening every single week across the stop-loss market." We're back for the fourth year in a row with…
Self-FundedWhy Every Broker Needs A Fiduciary Co-Pilot | with Charlie Gragg
"I relate it to one of the Wizard of Oz characters... I've seen behind the curtain. I know how it's all put together." What happens when a man who spent nearly…
Self-FundedThe 2026 State Of Healthcare Spend | with Dena Bravata M.D.
"Employers have the right to expect much more from their benefit consultants than ever before. This isn't just about managing the fully insured renewal…
Self-FundedThe Philosophy of U.S. Healthcare (And Why It Resists Change) | with Tom Stein
"This is why insurance is such a beautiful problem... there is no solution. There are only psychological or philosophical answers to it." What if the rising…
Self-Funded$6.5B DOJ Crackdown, Medicare GLP-1 Shifts, Hospital Price Tags | with Sid Sinha
"When you see $6.5 billion in healthcare fraud, we all end up absorbing that in the commercial market." In this episode of Last Month in Healthcare, Producer…
Self-FundedHow One App Could Save U.S. Healthcare | with Matt Taylor
"Fee-for-service has led to transactional primary care where providers have 10 or 15 minutes to code as much as they can just to keep the doors open. We’ve…
Self-FundedThe 2026 Employer Health Plan Playbook | with Mark Cuban
"The most unused cash in the country right now is the money you're wasting on healthcare... If you save a million dollars a year, that's $20 million in market…
Self-FundedManaging the Exploding Costs of Specialty Drugs | with Jake Velie
"There's no reason why I should be able to do an infusion for 50% of the cost of what it's currently being allowed at. We've seen allowed amounts between…
Self-FundedYou’re Probably Wrong About Reference-Based Pricing | with Jeff Bak
"We did this survey with a third-party consulting group who talked to 2,000 brokers. Their perception was that 25% of bills are going to be balance bills; it's…
Self-FundedMarty Makary Resigns from FDA + May's Biggest Healthcare News | with Jonathan Lopez
"The average marketplace deductible grew by about $1,000 per person in 2026. Premium payments increased by an average of 58%... We might be seeing the death…
Self-FundedThe ERISA Fiduciary Crackdown is Here | with Jay Gepfert
"Within five years of calling us charlatans, that hospital system was sued for multiple millions of dollars by their participants... You can go from charlatan…
Self-FundedA Health Benefit That Actually Makes Employees Healthier | with Superpower
"Insurance is there for when you're sick or when something goes incredibly wrong. It's not there for prevention." The traditional healthcare system is designed…
Self-FundedThe 2026 Benefits Consulting State Of The Union | with Seth Denson, Chris Hamilton & Taylor Rogers
"To quote my business partner, a broker makes you broker." To celebrate the 5-year and 250th-episode anniversary of the podcast, we recorded a special live…
Self-FundedWhy Self-Funded Employers Are Abandoning National Networks
"If we can do it for Whole Foods, which is a very large organization, why can't we do this for other employers?" Is the era of relying on national, opaque…
Self-FundedAdvanced Primary Care 101 (With Ben Miller)
"Employers are at a point where they want to help create that ideal healthcare system, not the one that they have been dictated to." Is your company's health…
Self-FundedState Healthcare Regulations, ACA Shifts, Hospital Funding Loopholes | Last Month In Healthcare
Welcome back to Last Month in Healthcare! This month, Spencer and Nathaniel sit down without a guest to unpack the biggest healthcare headlines and regulatory…
Self-FundedThe Financial Case Against Fully Insured Health Plans | with John Kountz
"I would rather take this risk because I will never give another dime to a fully-insured carrier as long as I live." In an era of double-digit medical trend…
Self-FundedRob Gelb’s Huge Announcement: The Future of Vālenz & Self-Funding
"I'm going to leave the ladder, I'm going to leave the window open, I'm going to leave the lights on." This week on the podcast, I am joined by Rob Gelb, CEO…
Self-FundedMedical Cannabis As An Employee Benefit?
"We are not going after the high. What we're going for is symptom relief. Based on our research, employers are going to be saving $5,000 per participant per…
Self-FundedShifting the Risk: A New Way to Account for Healthcare
"Revolutions are never won by the ruling class... if you want to fix healthcare, you have to be willing to accept a negative sum game. Someone is losing." Why…
Self-FundedWhy Traditional Networks are Failing (And What’s Replacing Them)
"I can't fathom a world where employers are expected to budget and create a plan for their future without understanding what the costs of their healthcare are…
Self-FundedA New Way To Predict (And Price) Healthcare Risk
"There’s no bad risk, there’s just mispriced risk... we helped one carrier achieve a 29.1% improvement in their loss ratio just through better risk selection."…
Self-FundedMarch Healthcare Headlines: GLP-1s, PBMs, and The $233M Scam | with Jeff Bak
If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.Each month on Last Month In Healthcare…
Self-FundedThe New Era Of Cash Pay In Healthcare
"We are in a $5 trillion US healthcare consumer market with no consumer in it... I basically decided we had been surgically removed from the US healthcare…
Self-FundedHow J&Q Codes Are Sabotaging Your Stop-Loss Renewals
"I've got a patient in Washington state. He's traveling 100 miles every other week to receive an infusion. We moved this patient into the home and saved the…
Self-FundedWill PBM Reform Actually Happen? | Last Month In Healthcare
If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.Each month on Last Month In Healthcare…
Self-FundedBuilding The TPA Of The Future
"We don't view ourselves as a TPA, we view ourselves more as a platform... our goal is to simplify and reduce the barriers of entry into the TPA space." The…
Self-FundedWhy Venture Capital Is Betting Against Insurance Carriers in 2026
“Show me an incentive structure and I'll show you human behavior... until employers realize they have more power than they give themselves credit for, this…
Self-FundedWhy Health Plans Pay $10,000+ For Drugs That Don't Even Work
"Why are we paying $10,000 for a $30 drug?" My guest this week is Pramod John, a former Silicon Valley tech entrepreneur who entered the healthcare space to…
Self-FundedThe Physician Burnout Crisis: Why DPC Is The Only Way Forward
"My wife would come back to check on me late at night, asleep at the keyboard, and she would be like, 'Is he dead?' The burnout, what we call moral injury, is…
Self-FundedRecapping January's Biggest Healthcare Stories | with John Kountz
If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.Each month on Last Month In Healthcare…
Self-FundedLet Doctors Be Doctors: Why Providers Shouldn't Be Debt Collectors
"If you ask the surgeon how much time they have to spend thinking about the business side of their practice, it's too high... Let's let doctors be doctors." -…
Self-FundedThe "Next Generation" Insurance Agency: What AI-Native Means
"If financial services and healthcare are 10 years behind everybody else from a technology adoption standpoint, insurance distribution is usually 10 years…
Self-FundedAlcoholism in the Insurance Industry | with Chris Leverett
"I stopped doing what I didn't want to do anymore. It’s not hard to stop doing something you don't want to do... I didn't want to drink anymore." - Chris…
Self-FundedIs This iPhone App The Future Of Primary Care? | with VivaScore
"Imagine getting a real-time snapshot of your health just by looking into your phone’s camera for 30 seconds." - Simon My guests this week are Simon Spurr…
Self-FundedUniversities Failed HR. Kyle Minick Is Fixing It
"I asked him, 'What is it that you're teaching undergraduate students about benefits?’’…Just two slides. That blew me away." - Kyle Minick My guest this week…
Self-FundedWhy Employees Actually Use Onsite Clinics (Convenience Is King!)
"Whoever makes patient care more convenient is likely to win." - Chris Yarn My guest this week is Chris Yarn, Founder of Walk On Clinic, who joins me to…
Self-FundedTier-Ranking the Biggest Healthcare Stories of 2025 | Last Month In Healthcare
If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text. Each month on Last Month In Healthcare…