The Paytient Podcast

The Paytient Podcast

The Paytient Podcast is a show about how people access and afford healthcare. We cover trends in health and benefits while talking to innovators who are empowering consumers to take charge of their health. We explore the implications of decisions made at the benefits level, with an eye toward how we can all lead healthier lives. The podcast is hosted by Dr. Jay Moore and J.R. Clark, who have decades of experience in healthcare and insurance. They excel at bringing their expertise to conversations with other leaders in the space — and having a great time while they're at it. To learn more, visit us at https://www.paytient.com/.

Episodes

October 5, 2022 46 min

This week on the Paytient Podcast, we're thrilled to welcome Dr. Leo Celi to the show.

Dr. Celi is a principal research scientist in IMES at MIT and an associate professor of medicine at Harvard Medical School. He was involved in a recent study published in Lancet Digital Health that focused on AI recognition of a patient's race based on medical imaging.

The team found that AI was able to accurately predict the self-reported ...

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On this episode of the Paytient Podcast, we're finally diving into ancillary benefits! Whether you're passionate about dental or vision care, this one is for you.

We welcome Alex Frommeyer to the show to talk about his personal journey in the benefits world as well as the origins of Beam Benefits. The company started as an IoT company in the dental space and eventually transformed into a fully fledged insurance and employee ...

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In our first official episode of the Paytient Podcast, we welcome Dr. Eric Bricker to the show. His popular YouTube channel AHealthcareZ offers facts about healthcare delivery in the U.S.; how benefits are set up and designed; and how the system affects patients, providers, and organizations.

Dr. Bricker recently became the medical director of SimplePay Health and Coupe Health, where he is helping them offer alternative health plans...

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In this installment of the Explanation of Benefits podcast, Dr. Jay and J.R. continue to reflect on the Affordable Care Act and its impact on health insurance.

Both Dr. Jay and J.R. were working in insurance at the inception of the ACA, and they saw some of these sweeping changes from the inside. A large portion of the conversation focuses on the three R's established by the ACA: risk adjustment, reinsurance, and risk corridors....

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In the latest installment of Explanation of Benefits, Dr. Jay and J.R. talk about the Affordable Care Act and how it has altered the healthcare world.

After discussing a few of the general provisions that the ACA put into place, they focus on three ways the act changed the game in terms of insurance: It introduced medical loss ratio restrictions, it established the idea of guaranteed issue, and it largely eliminated medical underwri...

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In our latest episode, Dr. Jay and J.R. talk about high-deductible health plans (HDHPs) and how these plans impact healthcare in the U.S. — particularly among people who have private or commercial health insurance.

Our hosts take a look at some recent research regarding whether HDHPs are working as anticipated (lowering healthcare costs while making people more engaged in their overall care). While these plans have been shown to dec...

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We're celebrating 10 episodes today! To mark this momentous occasion, Dr. Jay and J.R. do a deep dive into the various contracting methodologies that insurance companies use when talking to hospitals.

They start with fee-for-service models, which pay a set amount of money to providers for a given service. They also explain bundled payments, which see providers take a single payment for a collection of related services. And final...

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We're thrilled to welcome Josh Butler, president of Butler Benefits & Consulting, to the podcast to chat about everything from entrepreneurship and the changing nature of employee benefits to Texas barbecue. Josh is fresh from his recognition as the 2022 BenefitsPRO Broker of the Year, and he discusses that honor as well as some of the innovative strategies his firm delivers to clients.

If you'd like to connect with Josh...

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June 15, 2022 24 min

It's nearly Father's Day, and dad jokes are in the air! After making each other groan with some punny quips, Dr. Jay and J.R. delve into perhaps one of the most important functions an insurance company serves: creating a network of providers.

This episode touches on everything from why providers are willing to participate in networks to what is actually outlined in the contracts between the payors and providers. They also co...

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Dr. Jay and J.R. welcome a special guest to the podcast today: Scott Brewster, the executive vice president of sales and marketing at 90 Degree Benefits. Scott discusses life as a third-party administrator, including how the role has evolved over the years.

Scott also looks ahead to the Society for Human Resource Management's annual conference, which is slated for June 12-15, 2022, in New Orleans, Louisiana. Additional details ...

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This week, Dr. Jay and J.R. welcome yet another guest to Explanation of Benefits. And they didn't have to look far to find him!

Darius Chehrzad is Paytient's chief commercial officer and oversees the company's go-to-market strategy as well as business development and partnerships. A native of Canada, Darius is fluent in four languages and holds an MBA from the Tuck School of Business at Dartmouth College. Prior to joinin...

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We're trying something different for our fifth episode of Explanation of Benefits. Today, Jay and JR welcome their first guest! Chris Labrecque, president of Insurance Office of America's Employee Benefits Group, joins the podcast today to talk about the unique approach his consulting house takes in providing employee benefits and insurance information to employers all over the country.

Chris embraces a truly holistic view o...

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In our fourth episode, JR and Jay talk about the ways that insurance companies segment their business. After breaking down the differences between government and commercial business for insurance providers, they spend some time in the commercial space discussing how insurance companies split things up and generally look at the world.

Are you not sure about the difference between Medicare and Medicaid? Curious about what insurance co...

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April 6, 2022 24 min

In our third episode, Dr. Jay and JR talk food. Well, sort of. They discuss insurance using some brilliant food analogies.

Enjoy a piping hot bowl of acronym soup while learning about PPOs, EPOs, HDHPs, and more. Then, take a stroll through the benefits buffet to get a better idea of how these various approaches to insurance impact the benefits members receive. Bon appétit!

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Questions? Comments? Feedback? Email us at podcast@pa...

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In our second episode, Dr. Jay and JR take a deeper dive into the health insurance world. After discussing health insurance as a concept — looking at what a health insurance company actually does and does not do — they explore the basics of how a health plan is put together and created. Finally, they cover what those benefits look like in the real world for members of a given insurance plan.

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Questions? Comments? Feedback? Email u...

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March 9, 2022 34 min

Welcome to Explanation of Benefits! In our inaugural episode, Dr. Jay and JR explore the history of health insurance. Listen along as we journey from the inception of accident insurance in the 1800s all the way through to the Affordable Care Act becoming law in 2010.

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Questions? Comments? Feedback? Email us at podcast@paytient.com!

Interested in learning more? Subscribe to the Paytient newsletter for a steady stream of high-qua...

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