Transforming Healthcare: Rebuilding a Broken System with Dave Chase, Co-Founder & CEO of Health Rosetta

Dave Chase shares how Health Rosetta is creating a blueprint for employers to deliver world-class healthcare at half the cost while building an entirely new healthcare supply chain model. As a former Microsoft executive who founded Health Rosetta after witnessing a friend's death due to healthcare system failures, Dave explains how the current system is collapsing and why it needs complete replacement rather than incremental changes.

• Health Rosetta consists of a framework, ecosystem, technology platform, and Nautilus Health Institute for open-sourcing solutions
• System collapse evidenced by hospital closures, provider burnout, and 100 million Americans in medical debt
• Alaska Native healthcare system transformation provides proof that community-owned health plans can achieve world-class outcomes
• Access to claims data is essential for employers to understand and optimize their health plans
• The Plan Grader tool helps employers objectively evaluate their health plans and create improvement roadmaps
• Open-sourcing successful strategies accelerates healthcare transformation across communities
• Employers implementing Health Rosetta principles reinvest savings into employee benefits like education and expanded healthcare access
• Rosetta Fest brings together benefit advisors, employers, clinicians and solution providers to share successful strategies

Join us at Rosetta Fest in August to learn from employers implementing successful healthcare strategies and access resources from the Nautilus Health Institute.

Episode Transcript

Speaker 1 (00:01):
You're listening to Risk and Resolve.
And now for your hosts, benConner and Todd Hufford.

Speaker 2 (00:08):
Welcome to another episode of Risk and Resolve.
I'm your co-host, ben Conner,along with Todd Hufford.
Today, our special guest fromthe Pacific Northwest is Dave
Chase.
Just for our audience, abackground on Dave.

(00:30):
Dave is a visionary healthcareentrepreneur who founded Health
Rosetta Looking forward todigging into more about that,
but that organization isdedicated to catalyzing a
transformation in the UShealthcare system through
practical, scalable solutions.
Dave has an awesome backgroundin not only healthcare but tech

(00:53):
as well, as a former executiveat Microsoft and then later
co-founded Avado.
Others may know Dave throughhis writing ventures as an
author for some of hisbest-known books the Opioid
Crisis Wake-Up Call and theCEO's Guide to Restoring the

(01:17):
American Dream.
Dave, we're glad to have youand welcome to the show.

Speaker 3 (01:23):
Yeah, looking forward to it, Just catching up on some
of your backup episodes overthe weekend, so I appreciate the
opportunity.

Speaker 2 (01:30):
Yeah, excellent.
Well, if you could as we getgoing, let's just dive right in
and if you could give a briefexplanation of what Health
Rosetta is and is doing andreally the mission that you're
on through Health Rosetta.

Speaker 3 (01:49):
Yeah.
Yeah, it's not always theeasiest to summarize Sometimes.
You mentioned the books, andthen there's one more recent
book called Relocalizing Health.
So the book titles you know thesubtitle.
They sort of explain what we doand kind of the mission.
The subtitle of the CEO's Guideto Restoring the American Dream

(02:10):
was how to deliver world-classhealthcare to your employees at
half the cost.
So we're definitely focused onthat.
My TED talk was titledHealthcare Stole the American
Dream.
Here's how we take it back.
So it kind of speaks to themission and then Health.
Rosetta itself is really fourthings and are kind of three

(02:31):
plus one.
I count how you're counting it.
It's a framework.
That's this kind of blueprintthat you know.
I joke that I was anarchaeologist, you know, digging
around for healthcare's RosettaStone, and we didn't claim to
invent anything.
We just sort of discovered whatwas out there that allowed

(02:51):
people to crack the code.
So it's a framework.
It's an ecosystem.
That's what people tend to knowus about.
That's where we have a benefitadvisor program, where we train
and tool out benefitsprofessionals and that's where
we have the event, rosetta Fest.
That's the second thing, anecosystem.
The third thing a lot of peopledon't know about because we're

(03:12):
a little weird in that we are atech company as well and, you
mentioned, I have a prettystrong tech background, but it's
only sold through our sort ofecosystem, so there's not any
real reason for us to beadvertising that on our website.
But that's the bulk of our teamis actually our technology and
services team, and we can talkabout what that's about.

(03:35):
And then the fourth piece isoriginally it was called Health
Rosetta Institute.
It's now called Nautilus HealthInstitute.
It was always our intent to opensource what worked, and we
needed to prove out what worked,and ultimately we realized that
what we're trying to do issometimes people talk about

(03:58):
having a supply chain mindset.
That's certainly good at themicro level.
What I'm talking about is theindustry supply chain and, to be
really candid, it's prettyapparent that we're going
through a system collapse rightnow and there's really no saving
the current system.
You can definitely do things tomake it suck less, but
ultimately a new industry supplychain has to emerge, and we

(04:20):
have some background doing thattype of thing, and so it has to
be way bigger than has to emerge, and we have some background
doing that type of thing, and soit has to be way bigger than
Health Rosetta, and so we opensourced.
After we go through a term, westole from you a performance lab
.
We have 400 employers that wework directly with in tandem
with advisors.
So once it goes through that,there's about 400 employers and

(04:43):
then there's about 10,000employers stewarded by advisors
in our program, further battletesting and then eventually we
make it available for anybodyfor free, and so that's kind of
the long-winded four things thatwe do and some of our mission.

(05:36):
So what launched you in thisdirection, to where you were
digging around and found thishealth Rosetta Stone?
What propelled you in thisdirection?
It was actually a friend'sdeath.
That was a system failure bythe healthcare system.
She'd had a similar careertrajectory get cancer, um,
within two years, their lifesavings are drained.
As if it's not bad enough toget cancer, you're ruined
financially.
So she left behind a 10 yearold daughter uh, you know,
basically bankrupted, and ruinedher financially, emotionally,

(06:00):
um, and physically.
And I'm one who tries to findsome meaning out of, uh,
tragedies, and that's what gotme digging and it's like it was
evident it was a system problem.
It wasn't like there was asingle bad doctor.
And in that journey I find that, um, you know, the third
leading cause of death inamerica is a preventable medical

(06:23):
mistakes.
That doesn't even include wrongdiagnoses, which is sort of a
similar number of people.
And so it became evident thatyou had to rebuild from the
ground up and that the statusquo was so bad.
You know the way I was raised.
I was one of the lucky ones.
I had amazing parents, great,involved parents, you know,

(06:45):
couldn't have had a better rolemodel than my dad, and you know
the way they raised me.
If you see a wrong and youdon't do something about it,
you're complicit.
I had a job when I got out ofcollege and then I had a career
that was pretty successful, butultimately, to me, the ultimate

(07:07):
place to get to is it's acalling.

Speaker 2 (07:16):
You find out your purpose for being here and I
know what I'm going to be doingthe rest of my life.
Moving from career to callingis just hard to describe, but
it's just no longer a job oreven a profession, it's just.
You know, I've similarly feltlike I've made that change and

(07:39):
it's actually very difficult todescribe.
Anyway, so you founded HealthRosetta.
Through this experience withyour friend, what did you set
out to fix?
And maybe how has that changedsince you started?

Speaker 3 (07:56):
Yeah, no, it's funny, you know originally just
thought, oh, I could write aboutit.
I'd done that with directprimary care and wrote the
seminal paper on direct primarycare and had a bunch of docs say
, um man, I, I read your stuffin Forbes and this, and that
these other publications and andI've pulled, you know finally
made the change I thought.

(08:17):
I thought health Rosetta wouldbe like that.
You know, I could just writeabout it and some people would
do it.
And it turns out that's not thecase.
They were like no, you shoulddo it.
I'm like no, you should do it.
And so initially we thought, oh, this is, you know, we can
train and educate people on thisand they'll pick up and run
with it.
And we still do that.

(08:39):
That's still really important.
But it really came down to, ohyou know, kind of an obvious
point in retrospect, if you'resuggesting something as bold as
an entirely new industry supplychain needs to emerge, of course
there's a whole new tech stackto enable that and of course no

(09:01):
startup in their right mindwould ever pursue a tiny, tiny
market, which it was at the time.
You know, it was like maybefive or 10 employers doing this
around the country versusmillions.
But we were very mission drivenand, you know, made the bet.
Oh, you know, as we got in, youknow, once we launched this
program basically it launchedalmost eight years ago,

(09:29):
basically it launched almosteight years ago and we got in
and saw some of the best whatthey were doing and we're like,
oh my gosh, this is amazing,it's working at all.
It's, you know, it's just kindof a cluster and bubble gum and
bailing wire and just it's atestament to how bad the status
quo is.
That that could work.
And, you know, credit to thosepeople.
They were workhorses and theystill are right.
That's really necessary step.

(09:49):
You always want to figure outthings analog and kind of
inefficient before you automateit.
Um, but ultimately we realize,oh, you know, this is a new tech
stack, you know, as we say inthe tech business basically
almost like an operating systemfor rebuilding health plans from
the ground up, and so there'slike a project management

(10:10):
element to it.
There is basically a kind ofmarketplace.
You know, there's all thesevendors you know some are good,
some aren't and ultimately beingable to have, you know, what we
found pretty early on was thebest health plans in America.
The single most common elementwas they had full, complete,

(10:34):
unfettered access to theirclaims data.
People are, you know, there'spoint solutions and people
trying to do this, and they'reall duplicating effort for
something that's actually notdifferentiating them.
Like, let's say, they got somediabetes solution, well, you got
to prove it.
So you develop some engine totake in the claims data and make

(10:55):
sense out of it, dah, dah, dah,and to do it right, you're
probably into it for $3 millionor like this is crazy, like we
need to just invest in this andthen make it available to
everybody.
We got to figure out a model tomake that possible financially,
but we figured that out and sothat's, you know, ultimately
very different than what weexpected to be doing when we

(11:19):
started out.
But in retrospect it's kind oflike oh, we should have figured
that out, you know, from day one.

Speaker 1 (11:26):
Dave, I see your constituents can be not only the
benefit brokers but also theemployers.
How has that shifted from whenyou started?
Did you start with one andmigrate to another, or did you
always start kind of thinking ofthose two constituents from the
get-go?

Speaker 3 (11:46):
Well, I think we kind of intuitively knew we would
need to work with them at somelevel.
But the benefits advisors werethe tip of the spear, right.
I wrote a piece a couple yearsbefore even founding Health
First that I said this job couldsave America, referring to
benefit consultants, benefitadvisors.
And they play such a pivotalrole and will as far out as I
can see.

(12:06):
But ultimately, you know, theyhave huge influence but they
don't dictate what the employerdoes.
And so just in the last coupleyears we went from we would have
these annual gatherings calledHealth Reset, a Summit.
That was just basically ourcommunity, our benefit advisors,

(12:27):
some solutions.
But we really realized, oh,this is a team sport.
We have to have the employersor unions if they're involved in
the plan.
We also have to have theclinical leaders.
So today, if you look atRosetta Fest, like last year, it
was pretty evenly split about250 benefit consultants,

(12:50):
advisors, about 250 employers,about 250 clinicians, about 250
solutions and tech companies.
So you know, a little up ordown those numbers, but roughly
it was split evenly.
A little up or down thosenumbers, but roughly it was
split evenly.
And that's one thing we realized, particularly as we're doing
this tech platform.
We needed to be kind of theconnective tissue between these

(13:11):
industry silos.
You know you could go to, youknow perfectly good events for
orthopedic surgeons or benefitconsultants or tech or whatever.
Right, it's all good, but atthe end of the day, it needs to
be brought together and that'swhy we did that.
And as we took more of thisindustry supply chain and tech
ecosystem mindset, it kind ofbecame clear that we needed to

(13:35):
do that and we also for this.
You know you can.
One way you can look at this isthis is a revolution, this is a
social movement.
This is not something that'sjust going to be.
Oh, there's a new photo app andeverybody runs to Instagram
Like this is a different type ofthing and you needed to have
these other folks involved.

(13:55):
And, as we've seen in ourcommunity and there's some other
great communities Ben, you knowhe's in the NextGen thing as
well there's like these nicecommunities that have really
been very collaborative and opensource.
We needed the same thing on theemployer side and, frankly, the
industry has done a prettyplayers the carriers and whatnot

(14:16):
kind of peel them off one byone and sooner or later you
realize you know you need to beyes, do what's right by your
business and all that, but youneed to more lock arms and like.
Health Transformation Allianceis a good example.

(14:36):
It's a cooperative of largeemployers and one of the members
of the Health Rosetta programLee Lewis, is, you know, is one
of the senior guys there and somostly we're working with
mid-market employers like below5,000.
But we're happy to work withthe larger ones and sometimes
when they do good stuff, it'svery helpful and complimentary.

Speaker 1 (14:59):
At the top of the show.
You mentioned that the industryis clearly in collapse.
Joe, you mentioned that theindustry is clearly in collapse.
Can you give us, from yourperspective, some of those news
articles or, above the fold onthe newspaper, things that are?

Speaker 3 (15:15):
happening in your mind that signify that the
industry is collapsing?
Yeah, there's a few differentthings.
One that's pretty known, whichis rural hospitals right,
they're closing, maternity wardsare closing.
Which is rural hospitals right,they're closing, maternity
wards are closing, and it'sreally devastating to the health
of those communities and yousee that more and more.
And they basically get they'resort of vultures who come in and

(15:36):
sort of or maybe vampires is abetter metaphor to kind of suck
the life out of these things andjust sell them for, you know,
parts.
So that's one element.
Also, critical access you knowyou go to some parts of big
cities and their medical deserts, even though you know in the
richer parts of town there'splenty of hospitals, for example

(15:57):
.
So that's one element.
There's also the cliniciansrecord levels of burnout and
suicide amongst nurses and docsand you know you saw an
acceleration of, like, nursesleaving the profession and I
think it was 300,000 nurses atleast that left one year during

(16:20):
COVID, during COVID, and youknow, just having nurses day
once a year and giving them somepizza isn't going to, uh, make
up for the moral injury that'sbeing inflicted on them.
Um, and then you see, uh, youknow, we all see, right what it
means for employers andemployees to where, um you know,

(16:41):
tens of millions of peopleprobably the majority of the
workforce are functionallyuninsured.
Their life savings are lessthan their deductible Like and
when you have 100 millionAmericans in debt to healthcare,
that's not a bug in the system,that is a feature, and so to me
that is an element of thecollapse too.
So I wouldn't start there, butthere's probably other things we

(17:04):
could go into as well.

Speaker 2 (17:06):
Well, in part two of that statement, dave, you said
that more or less the systemcan't be fixed, it has to be
replaced.
Was that apparent when youfirst saw that experience with
your friend?
Or has that been an evolutionfor Health, rosetta?

(17:27):
For hey, we're going to helpfix the system, and then again,
as you continue to dig and find,you're like, no, this thing has
to be totally replaced.
And ultimately, what doesreplacement look like from your
perspective?

Speaker 3 (17:45):
Yeah, it was an evolution, and it's one of those
things where you just sort ofit just kind of grows and all of
a sudden it's like dang, it'sso obvious, like how did I not
get that before?
And then you know, you thinkabout you know these guys.
You know, you think about youknow these guys.
We didn't get these smartphonesby tweaking.

(18:07):
You know landlines and rotaryphones, like it's always the
case.
And healthcare goes throughmajor shifts every 50 to 70
years and it's overdue.
And so I started studyingrevolutions and social movements
and even just tech ecosystemshifts and as you did that, it
became obvious that's the natureof the change.

(18:28):
And then the question is whatwill replace it?
You know, our general pointwith Health, rosetta, is to
recognize that no matter whereyou are in the world, people are
problem solvers, and maybe theydon't have all the resources in
the world, but one way oranother, maybe they don't have
all the resources in the world,um, but one way or another they

(18:51):
get by and they fix things.
And and that was really the thegist of my archeologist
metaphor Just dig around who'swho's got it going, um, and I
don't care where they are in theworld.
Can we pull something out ofthat and and really what we're
about is repeatability andverifiability.
Like you have the Rosens of theworld you had.
You know the smattering ofemployers doing stuff, but the

(19:13):
pace we were going, you knowit's going to take till like
year 3000 to have all theemployers and all the
communities have it.
And so they're like, oh my gosh, how can this happen more
rapidly?
And certainly what we comingout of tech, where open source
is something that you know,there's this term that you

(19:33):
sometimes hear in healthcarenobody ever got fired for hiring
IBM and you know old big blue,I'm like, yeah, but I was there,
you know, dot dot, dot.
Until they were like, yeah,absolutely they were.
And IBM in a few years wentfrom their most profitable year
to being on track to losing $16billion.

(19:54):
Guess what.
They got open source religionpretty quick.
And it's in the pantheon of beenmost compelling to me, one in
the US, one outside the US, andI just came up with the term

(20:18):
community-owned health plan forwhat they're doing and it's kind
of like health rosette, it's asmuch an idea as a super precise
thing.
So in the US you have theAlaska Native peoples where, the
way you know, basically theywere getting their health care
was through the Indian HealthService and it's one of those

(20:41):
scenarios where, you know, intothe late 90s, worst health
outcomes in America, some of theworst in the world, you know.
Check all the difficult boxesgeographically spread medical
desert, substance abuse, obesity, like you name it right, as
hard a challenge as you canimagine.
With the IndianSelf-Determination Act there is

(21:01):
a method of taking over controlof that and they rebuilt from
the ground up and they calltheir care model the NUCCA model
, n-u-c-a, and today it's asystem that many consider the
best in the world.
Only two-time winner of theMalcolm Baldrige Award in the
healthcare industry, like that'sthe Nobel prize of business,

(21:23):
basically.
And people from all the worldSingapore, sweden, you name it
come there.
It's incredible.
People from all the worldSingapore, sweden, you name it
come there.
It's incredible, incrediblytough situation, right, and they
just don't make excuses.
Like you know Douglas Eby, who'stheir chief medical officer,
you know they're dealing withrural medicine all the time.
Does anybody think that we'regoing to snap our fingers in the

(21:43):
next year, two years, even 10years, and solve?
Not, they're not being enoughdoctors in some of these remote
areas, like nobody raises theirhands like, okay, let's move on.
How do we solve that?
They saw, there's telehealth,there's people.
When people come in, there's,there's always a solution.
Even in a remote island, in theillusions in alaska, you can

(22:04):
come up with solutions and theydo that.
And so amazing outcomes and itreally goes beyond just the
traditional health care.
You know there's been a lot ofunemployment, other challenges.
When they took over the system,there were three people that

(22:25):
were Alaska Native people inthat entire system and there was
oftentimes, you know, six,eight hour wait when you went to
the doctor.
You know it was like one dochad the dubious record of seeing
160 patients in one day andthey're like that's terrible,
right, I don't even know howthat's possible.
I know Like that's a, it's justlike incredibly bad, and so

(22:51):
they one of the things that theydid, they ended up taking over
a community college.
Now half of the 3,000healthcare you know, or staff
basically in this system, areAlaska Native peoples, from
medical assistants to doctors,to the.
You know this longtime CEO.
She was a MacArthur uh geniusgrant winner.

(23:11):
Um, she was a 16 year oldsingle mom receptionist at one
time and became this incredibleperson, so that and they've been
open source about what they'redoing.
So very inspiring.
Um, outside the U S?
Um Jan Chopin, sweden, um, they, they, uh, people perceive

(23:32):
sweden to be a monolithic,nationalized system.
Well, yeah, they have anational framework.
It's actually governed at moreof water, fire, congressional
district, school district scalelike 25 to 500 000 seems to be
the sweet spot.
Um, so we're like, okay, how dowe create these?
You know, we're relativelyearly in that journey and we

(23:53):
could talk about that.
There's a guy, bryce Heinbaugh,I know, you know, who was kind
of the OG on, like, hey, do youwant to be our guinea pig on how
to do this?
Right?
And the thing with the wordcommunity is a community.
Most people think of as aplace-based thing and that's
indeed appropriate, particularlyin health care.

(24:13):
But you know, a company is acommunity, a union is a
community, a faith-based, youknow, organization community is
a community.
So there are different ways topull that together and what it
does is say, hey, you look atthe dominant players.
Blue Cross doesn't say, oh,acme Corp comes up to them and

(24:35):
like, okay, we're going to builda new health plan from scratch.
Every time they have certainpackage solutions that you know
you could argue whether theydeliver value, but people buy
them and some might be great fora small business, some might be
great for, you know, macy's.
They don't have infinitedifferent solutions.
And so we're just saying, kindof like what happened in tech?

(24:56):
You know, microsoft and Intelstarted breaking up the IBM
hegemony and then open source,you know, blew that open.
But then there was this kind ofreassembling of this
heterogeneous set of tools sothat you can go to Amazon or you
know Azure for Microsoft andkind of boop, boop, boop Like
you don't have to, you know,build your own.
You know data centers andservers and you know all the

(25:20):
different components, so you cankind of get the best of both
worlds.
That's what we look at it aslike.
How do we make this moreLego-like?
I've been a part of twolarge-scale industry ecosystem
shifts and one in healthcare,one not and what I have found is
that for those to be successful, you need to have three things

(25:41):
One, proof that your thing isbetter ideally 10x better.
Two standards to make adoptioneasier.
And three, kind of education tolet people know about it.
And when you do that, that'show these things grow much more
rapidly and they go from youknow.
So you know we still have along ways to go within the
Health Rosetta ecosystem.

(26:01):
But you know, when I wrote thatCEO's Guide, I managed to find
five successes.
We now have thousands ofsuccesses in the Health Rosetta
ecosystem.
I know there's more than that.
Do we need tens of thousands, ahundred thousands, absolutely.
We got a long ways to go, butyou can't get lucky for five,
seven years, across thousands ofcompanies.
We've actually, as a communityagain, we don't take all the

(26:23):
credit by any means We'vecracked the code.
We just need to continue tolower the burden, like, yes, the
benefit was up here, you know,relative to status quo, but
guess what?
The effort was up here too.
We're just trying to ratchetthat down.
So it's just as easy to buy aworld-class health plan as it is
easy to buy a cruddy status quoplan.

Speaker 2 (26:46):
Yeah, Can we double-click into no pun
intended, into the concept ofopen source and the way I

(27:09):
understand it is in the techworld in particular, it's a,
it's a, it's a used term, whereclosed source means it's a kind
of a scarcity, like.
This is all mine kind of kind ofmindset, and usually in
industry or organizations areclosed source when they're
winning, when they're leading,and the idea of open source is

(27:31):
for basically the competitors tocatch up where they're sharing,
you know, basically foundsuccess and really they're
building on each other's successto go faster for, you know,
obviously for their corporatebenefit, but for consumer
benefit as well.
How do you see that type of andplease correct if I didn't

(27:54):
describe it very well but how doyou see that helping to win in
healthcare when, in my opinion,when I look at healthcare and
insurance and everything that'saround, what we do, everything
is closed source.
Hey, I just got a good deal,but I'm keeping it for myself.

(28:15):
Or I have a direct contract,but that's just for you or just
for me, no one else.
So how does open source, whatdoes that look like and how can
that change healthcare quickly?

Speaker 3 (28:28):
Yeah, I mean you're right on in terms of the way the
industry is operated, but itcan go into if you look in tech
and you look at the internet.
The operating system of theinternet is Linux, right, it's
got the majority market share.
The most common contentmanagement system, you know that

(28:48):
puts all the content on the webpages, is WordPress, and in
both cases there is the opensource.
You know, like Linux Foundation, wordpress Foundation.
In the case of WordPress, youknow powers, like at least half
of the websites have that theyalso have a for-profit company
called Automatic.
It's like with two Ts at theend, for because the founder's

(29:11):
Matt Mullenweg, so it'sM-A-T-T-I-C at the end of
Automatic and so you have theboth.
And the idea is that there'sactually a guy pretty early in
the open source I think it wasBill Joy from Sun Microsystems
said no matter what organizationyou are, the smartest people in
the world are outside yourorganization and if you can

(29:32):
harness and get them together,um and do that, um, it can, you
know, move much faster and, asyou see, it can work incredibly
well.
Um, and even like you look atthat, um, uh, you know ev market

(29:56):
right now, um, tesla, they opensource their charging standard.
Um, so it used to be just go tothe tesla stations and just
tesla vehicles had that chargingstandard, and there was this
other one called ccs.
Now all the car makers aregoing to the north american
charging standard, which isbasically Tesla standard.
So, like you see it outside oftraditionally, just like you
know, information technology,computing, and there's lots of

(30:17):
examples like that, and sowithin our context, one of the
things that's been verygratifying is, yes, we came out
of tech and a lot of peopledon't necessarily know you know
that.
The three founders of Health,rosetta, we came out of tech and
a lot of people don'tnecessarily know you know that,
uh, the three founders of ofhealth was that all came out of
tech.
So we understand that and thissort of the way we think.

(30:41):
I guess, um, and I've been atMicrosoft, I saw open source,
you know, swamp Microsoft andultimately Microsoft, like IBM,
sort of embraced it, um and so.
And also, you know we are notgonna, you know, do the.
You know, imagine if therevolutionaries had done a
frontal assault with the Britisharmy, like they were gonna get
squashed.
You have to do asymmetricstrategies and go where they

(31:03):
ain't, you know, and do thingsthat are very counter-cultural,
and so the fact that you know weslogged away, you know it's
been a grind and we stillcontinue to get kicked in the
teeth every day, but, like youknow, we've been around.
Basically, we started when Ileft WebMD 10 years ago and

(31:23):
launched about almost eightyears ago and you know, we just
finally had a break, even yearof last year, like, we've
deferred a lot of gratificationon this, but have managed to
grow.
You know, and and not lookingfor any um sympathy we made that
choice, um, but we then opensource, gave away you know,

(31:46):
translated, gave away basically$4 million of investment.
Now that investment had beenamortized across all these
employers.
Right, that's how we made itwork, because we didn't take
venture money, because we knewthat would put us down a bad
path.
And people, one of the thingsthat's been really cool,
especially since we officiallylaunched Nautilus Health

(32:06):
Institute at Rosetta Fest lastSeptember, is, you know, you
kind of get this.
You know people tilt their headand, oh, why are you doing that
?
And then what we found is thatthe people who are the best in
the industry let's say they'rePBM, they're TPA, contracting,
whatever these people areincredibly busy and they see the

(32:30):
dysfunction in the market.
They want it to change.
There's no lack of opportunityfor them to help people for a
long time and they're givingpeople.
People call them.
They'll go on podcasts and talkabout what they're doing and
basically we have thisdiscussion where it kind of ends
with their go.
Okay, you're saying if I pourmy intellectual property into

(32:52):
this thing you've created,you'll make sense out of it and
when people come knock on mydoor, I can just point them
there and it's going to befreely available.
Yes, and it is granted a lot ofwork to organize that make it
digestible.
You know, in terms of our ownecosystem, like it can be a mess
, but once we make it availableto anybody and kind of toss it
over the fence like we're notthere, it needs to be more

(33:14):
packaged and it just gettingthis virtuous loop going.
Now you're hearing about I don'tknow if it was because of us,
but like now Mark Cuban'stalking about open sourcing
hospital contracts.
You know we, the NationalAlliance of Healthcare Purchaser
Coalitions.
You know they represent there'sabout 90 million employee lives

(33:36):
represented in all theseregional coalitions that they
have back.
Um, I think earlier this year,late last year said hey, dave,
do you guys have something tohelp employers select a benefits
consultant, because we thinkthey really need help there?

(33:57):
Um, I'm like, yeah, actuallywithin our system we've had a
rfp that's available.
Um, I'm like we could opensource that.
And they're like, heck yeah.
And so I was just there, youknow, at their, their national
gathering for their strategicleadership um, just last week,
and they I mean man that meetingtalk about people realizing

(34:23):
they really, um, and not news toyou but the status quo, big
benefits consulting shops havedropped the ball and not
delivered value to them.
There's some severe conflictsof interest and there's some
real anger there.
And so they announced we'reputting together a committee
advisory council of how we dothis.
And we said, hey, you know thisbroker compensation disclosure

(34:46):
form, which is one element ofthat.
That was the template for theConsolidated Appropriations Act.
Right, take it right Again.
We didn't create that out ofthin air.
We got that from a bunch ofinput from people.
And so those types of thingspeople go.
You know what, if you look atthese health plans, when they've

(35:09):
got great primary care, they'vegot things like centers of
excellence, there's no barriersin front of getting medications
to people that actually work.
Not all do, but the ones thatwork.
Why would you put a barrier infront of those things?
If you look at the healthoutcomes, this is a pretty
dramatic statement, but I'llstand by it.
If you could put that into apill, it would be the

(35:31):
blockbuster drug of the century.
There is no medication everthat has that level of positive
health.
This is better than cure forcancer.
And you know, todd Ben, I'msure if you had the cure for
cancer, you would share it,right.
You would want all these livesto be saved.
You would share it, right.
You would want all these livesto be saved.

(35:52):
Once that light bulb goes onlike this is not like, oh, we're
just going to add a penny ofEBITDA to some random, you know
company on the New York StockExchange.
This is life and death andthat's dramatic.
But it's absolutely true andthat's, you know, one of the
reasons we're all willing to eata lot of dirt and, you know,
get kicked around because thisis hard.

(36:12):
What you do is incredibly hard.
What we're doing is hard.
But guess what?
You know, the best sportsoutcomes, the best marriages,
the best parenting, those areall hard, right, they always are
hard.
And when?

Speaker 2 (36:27):
it's a call-in, you're doing it.
Well, that's right.
Always, um.
And when it's a call, well,that's right.
So, when you look at systemdisruption or open sourcing to
change the system, what parts ofthe system are at biggest risk
for disruption or significantdevaluation?

(36:52):
Is that's a word?
Yeah?

Speaker 3 (36:54):
yeah, um, yeah, not.
You know, having had trevor onyour podcast, you know not
breaking news pbms, there's alot of abusive stuff, the whole.
You know supply chain there.
Um, there's the um, you knowthe whole, you whole.
Ppo shenanigans it's just aboutas bad.

(37:14):
There's spread pricing there,the dollars are bigger and so-
let's double click into that forthe listeners.

Speaker 2 (37:22):
PPO disruption or spread pricing, meaning that the
bill that the employer ispaying is not what the hospital
is receiving.
There is a delta there that isbeing retained by the insurance
company, correct?

Speaker 3 (37:38):
Yeah, I mean, this is a real example.
Granted, it's an extreme, butsmaller versions of this example
.
This is public record.
Chris Deacon has talked aboutthis.
This was a case that I thinkabout a year ago was publicly
available.
It was an inpatient, it wasactually an inpatient site

(37:58):
provider I believe that it wascalled TML Recovery, I think and
they had a $996,000 bill andthen, uh, then the fun began.
Who knows whether that allthose charges were legit.

(38:18):
Generally, you know, we see alot of questionable charges and
bills, but let's just say thoseare 100 legit charges for the
sake of argument.
Uh, signa said no, no, actuallythere was 11 million dollars of
billed charges and then theyquote unquote saved $7 million
because they had a sharedsavings program.
So Cigna made $2.5 million.

(38:42):
Multiplan, who was theirpartner in that, made $667,000.
The employer paid $4 millionfor that.
Less than one million dollarbuild charges and the provider,
I think they got eight hundredand seventy thousand or
something like that.
So, granted, that one's extreme, but that's public record and

(39:04):
that type of thing happens everyday.
So why do they keep you fromwanting to get access to your
claims data?
There's a lot, of a lot ofmonkey business going on.

Speaker 2 (39:20):
Closed source right.
They're in control of a veryprofitable system.
I've been thinking about overthe last year or so of like, how
do we really solve this andwhere are the problems really
lie?
And I think there are a lot ofconstituents that have their
hand in the pot, no questionabout that.
But I think to your point thatyou just made.
You know you go through thesupply chain in and of itself
and you're like, hey, you knowwhat is egregious.

(39:42):
And the reality is you look athospitals, physicians and drug
manufacturers.
They certainly could have theirhand in the pot and they do
have their hand in the pot, butit's pretty necessary to the
supply chain of health care.
You kind of need a doctor andthe hospital and the drug
company and the PBM and you lookat the revenue extraction

(40:17):
versus the value delivered.

Speaker 3 (40:20):
Yeah.

Speaker 2 (40:21):
And the value of like an insurance company is in
their network, which there's noreason to even have a network.
Why do I need to be told whereto go, especially if every
single doctor's in your networkanyway?
Just total excuse to extractrevenue, um, and then obviously
we have another podcast forothers to listen to with trevor
about the pbm side of things.

(40:42):
But you know, it seems if wemove uh the employer, um the
community, if you will closer tothe care deliverers, then we've
improved the system.
Maybe it's that 10x number thatyou said, even with those

(41:06):
simple actions, because once youremove waste from the insurance
company or PBM, that canprobably dictate action from a
hospital, uh, with maybe some,you know, extra money they're
charging to fund a lot of theirinternal operations and that
sort of thing.
So it's just kind of afascinating.
So I I arrived at the samepoint you did, dave.

(41:26):
The system can't be fixed, ithas to be uh replaced um, and
there's a bridge.

Speaker 3 (41:33):
It's not like I mean it could.
There's some pain along the wayand and that's already
happening I don't know if it'sany worse than what's already
happening um, and certainly wewant to have as much care, but
the more we can be proactiveabout it, the more we can lean
into it.
Um, yeah, I'm doing a prettymajor rewrite of um, my last

(41:56):
book, relocalizing health,because so much has happened in
the last five years, both in ourworld and, you know, the
broader world and, um, theconclusion of my book, and I'm
working on right now kind ofediting um is editing is really
around.
All this dividend fromreclaiming that waste is really

(42:19):
vital as we have this transitionto an economy that's going to
be very impacted by AI.
And to me it's super clear thatthere's not going to be some
magic solution coming from DC toaddress the AI challenges, but
there is at the community levelif we take a proactive stance.

(42:40):
And so I go into that insignificant detail and you know
I'm not a Pollyanna person, butthere is a very positive future
that can happen, and that's whatyou see and that's, you know,
we call this health presenteddividend.
I mean I was just with RussellDuBose of Pfeiffer, this company

(43:00):
out of Alabama, at the NationalAlliance meeting last week and
it's so inspiring what they'redoing for their workforce by
reclaiming that waste.
They're funding collegescholarships and separate
enrichment programs for the kidsand opening up clinics and they
have some really novel stuffthey're dealing with, you know,
wellness and GLP-1s, and notjust like just rolling the dice

(43:25):
on that.
And then the latest thing he'slike hey, you know what we're
doing, the latest thing.
I'm like cool, what are youdoing, russell?
He's like we have, I think, twoor three clinics and he's like
we have some capacity and wehave retirees who don't have a
primary care medical home.
There's 300 of them.
We're letting them use ourclinics for free.
There's no obligation for themto do that, yet they're doing it

(43:47):
Super cool.
And the thing is, healthcaredoesn't start in a pill, doesn't
start in a hospital.
It starts with mom and dad athome and then fans out from
there.
And that's what we're you know,we that into fertilizer for
restoring the American dream,like there's so much money there

(44:16):
, like more than the entireRussian economy, is what we
waste every year.
It's pretty gross.

Speaker 2 (44:21):
Kind of the idea of um.
You know, I'm part of a C12,which is a Christian CEO peer
group, and one of the keysayings there is, you know, no
margin, no mission.

Speaker 3 (44:32):
Yeah.

Speaker 2 (44:32):
Or if you're not running a healthy business, you
can't invest in missionalaspects that your heart's desire
.
And, to the point of what youjust said, when we're removing
waste, it's creating margin andfor that organization, they are
able to use that margin toinvest in retirees, to have

(44:55):
primary care, medical home, foryou know to care for people.
Yeah, imagine that you knowusing extra funds to care for
people.

Speaker 1 (45:06):
Dave, I was going to ask you we've got this education
piece where we're educating theemployers and the brokers.
We've got the tech piece, whichI want to dive into a little
bit.
But before we get there, isthere any comparable in another
industry that looks like whatyou guys do?
You know you're kind of partassociation, part college part.

(45:29):
You know you're kind of anamalgamation of different
functions.
Do you guys ever say, do youguys ever reference some other
organization that looks likewhat you guys are doing, but
maybe in a different industry?

Speaker 3 (45:41):
Yes, yes, definitely.
You know, no analogy is perfect.
You know you pull from what youcan from different places, but
the one that I've used the mostis the way.
There's an organization thathas they're called LEED
Standards, the US Green BuildingCouncil.
True, right, 25 years ago or so30 years ago, they came up with

(46:02):
this concept and they basicallyhad a framework blueprint.
They trained you know, quoteunquote well, not literally
architects I call what we'redoing architects of health plans
, right, that's where the airquotes comes in.
And then they developed acertification.
So you go into a lot of newbuildings and a lot of public

(46:24):
buildings.
They meet their procurementstandards.
So an entirely new supply chainemerged.
I use that because the builtenvironment's kind of like
healthcare.
It's like this incredibly local, entrenched thing.
You don't just like one day,all these inefficient, you know
polluting buildings that youknow have bad air for the
tenants, they're all raised.
The next day they're allmagically green built.

(46:45):
Now, the old wanes over time,the new, you know, grows over
time certain locales or earlieradopters of it, and then it
disseminates.
But it's just the way thingsare done.
Initially it was kind ofenvironmental zealots who are
doing it.
Now it's just like it's themost cost-effective way to own
and manage, build on and managea building.

(47:05):
So there's been a lot oflessons and ended up meeting the
guy who was the chairman ofthem during their hyper growth
phase.
So we've learned all we couldfrom that and there are a lot of
analogies there.

Speaker 1 (47:17):
Yeah, that's actually that helps me a lot because
I've got a good friend in Denverwho works on lead projects.
She's a civil engineer by tradebut does everything from
landscaping to structure andeverything in between.
And you're right, when theproject gets that rubber stamp
of being a lead certifiedbuilding, sometimes that comes
with extra dollars but itdefinitely comes with a

(47:39):
different level of efficiencyand a certain level of pride as
well when they know it's been aLEED project.
So that's actually a goodexample On the tech services
team.
So still kind of interested insort of the business model and
revenue sources Is this apotential revenue source or is
this still today one of theexpenditures?

Speaker 3 (48:00):
Yeah, yeah, no, it's definitely both.
In that, yeah, I mean ourbusiness model.
We're pretty fairly transparentabout it.
You know, you join the program.
There's an initial fee and anannual fee.
It's like $1,500 to renew.
We have the typical eventeconomics.
You know we want to at leastbreak even with our event, but

(48:24):
then the way the 400 employerspay us is on a per-employee,
per-month basis and they pay upto $5 with our current offering
and that includes this dataplatform and the tech and
handles all the claims.

(48:44):
And it's called METL, which isMedical, etl, which is Extract
Transform Load that's kind of aterm in tech and it's cleaning
up the data and adding value toit and then putting it into
other systems that can work.
And so the worst result thatwe've driven when we've been
involved for that $5 PPM thatemployers pay is a 200 PPM

(49:06):
reduction.
So it's a pretty clear ROI andthat's what funds our tech
development for this platform.
And you know, a key part of itis something we call a plan
grader.
So it took us probably four orfive years to come up with this
concept of being able to score aplan.
We thought, gosh, this is weird.
You know, we have, we can go toAmazon and my silly example

(49:29):
here I'm waving for people onaudio is a Bic pencil and
there's 55 55 000 reviews forthis stupid little big pencil
probably cost 19 cents 20 of theeconomy.
There was no objective marketvalue of health plan um, so we
it took us a while to figurethat out um, but it was the
largest project we did at thetime.
Largest content project we didat the time.

(49:50):
Largest content project we didat the time.
You know it started with mefilling out 800 different cells
of content depending on whatpeople answered, and we have a
rules engine and documentmanagement system.
So it's like kind of magichappens um behind the scenes,
but it was real work.
Um that you know.
Some advisors said you knowreports like this, particularly
for larger employers.

(50:11):
You know people would havespent 20, 30,000 bucks to get a
report like this, these customrecommendations and scoring.
And you know benchmarking andas more people do it, we can do
more geographic and industry andsize benchmarking.
So we have more to do there,but it becomes a pretty powerful
tool.
So people can see gosh, youknow what.

(50:32):
We got a 17 out of 100 on ourplan grade.
Like I'm not some health planwomp, you know, as a CFO, ceo,
but like that doesn't sound likea passing grade and, granted,
we're really tough graders, butthese things aren't impossible.
We have people getting 60s, 70s, 80s, even 90s right.

(50:55):
It starts to shift some of thatmindset, you know, because
that's by far the biggestobstacle.
Like most people think solvinghealth care is like trying to
solve Middle East peace, youknow, and it seems kind of out
of their control and maybehopeless.
Well, if you believe thatyou're right, but if you don't
believe that you're also right,it gives people a good roadmap
and that that you're right.
But if you don't believe thatyou're also right, it gives

(51:15):
people a good roadmap.
And that's another good use oftech, where we kind of aggregate
all this wisdom and experienceand iterate and then be able to
give people kind of almost likea gps and, you know, google maps
on how to get there the visualI'm getting is a serpentine belt
on your car where it's, youknow, driven off of the main
engine, but then it powers youralternator, powers your fan.

Speaker 1 (51:35):
So your technology is really the serpentine belt that
the engine is the data from theemployer and if it's not hooked
up to anything, nothing happens, nothing gets improved, you're
not able to take that energy andapply it.
But as soon as you lock thatserpentine belt in there, it
just moves around and startspowering.

(51:55):
Probably what it sounds like ismaybe a lot of these other
vendors that you guys work withand are doing very specific
things, but without that veryspecific data can't do much
without it.

Speaker 3 (52:07):
Yeah Well, and going back to the Linux and WordPress
examples, there's a wholeecosystem of solutions built
around that.
Right, they're not having toredo that plumbing level.
Likewise with us.
You know we launched it with alimited beta, so it's not yet on
GitHub, which is where opensource is.
But we have seven companies inproduction, from TPAs to point

(52:27):
solutions to underwriters and,you know, putting it through its
paces in addition to us.
And then there's 20 in kind ofan evaluation phase.
Eventually it'll be available toeverybody.
That's why we're raising somemoney so that we can actually
support that level of.
But it means that not everybodyhas to reinvent the wheel Like,
oh, let's take this module,maybe somebody's got great thing

(52:49):
using the NCI care protocols,the National Cancer Institute,
on.
You know, for this you want tofollow this care protocol and
all kinds of examples wherepeople can build around that.
And back to our earlierdiscussion things can move a lot
faster and it was funnysomebody mentioned, you know,
here we're the scrappy littleorganization and they're like

(53:11):
you know you've open sourcedmore stuff to the healthcare
industry than UnitedHealthcare,which has a two more bucks than
us.

Speaker 2 (53:18):
And so, yeah, you know we have a little bit of
good Just on the plan graderreal quick, just.
I think that is an incredibletool, dave.
So I'm really thankful for youand your team for creating that,
because what I think that itdoes is it allows an employer to

(53:38):
get outside of the bias and oreducation of their advisor
capability or capacity is forthem as a, as a purchaser of
healthcare.
Uh, because it goes through ahuge um and it's not hard Um.

(54:03):
You know, I completed for ourcompany.
I completed it in probably 35minutes, I get.
I am an insider in the industryso I kind of know some of the
answers.

Speaker 3 (54:12):
I wouldn't take more than anybody else more than an
hour.
Yeah, I mean it in the industry, so I kind of know some of the
answers.
It wouldn't take anybody elsemore than an hour.

Speaker 2 (54:15):
Yeah, I mean it really isn't, the barrier is not
huge, but it really allows usto see some of those questions
You're like, oh, yeah, yeah, man, we need to get on that.
That definitely needs to be thenext thing, or tell me about
this, or how would this strategyfit within our organization?
So I think it allows employersto get outside of the bias or

(54:38):
capacity of their own advisor.
Another thing I found that isreally helpful in communication
on the plan grader is there is amisconception that fixing your
health plan or solving healthcare for your community or for
your workforce is reserved forbig companies.

(55:00):
Well, I'm not SouthwestAirlines, I'm not Coca-Cola NRN
said large company, I'm not them.
So I can't, we don't have enoughpeople, we don't have enough
premium and that's just not true.
There are employers of allsizess, which is actually pretty
high for a plan grader and it'swork, but we're really trying

(55:38):
to solve healthcare and be anexample, that performance lab,
to our clients.
I think.
Another thing with largeemployers which is interesting,
because small employers say,well, we're not the large
employer and the large employersays, hey, we're not the small
employer.
It's hard, we have to navigate60,000 lives and we can't
disrupt that many people, butthe reality is there are large

(56:02):
employers that are scoringreally well also by managing
their community and reallyputting in extra, extra effort
to deliver excellence in theirinstance.
So it's kind of interesting howthere's like this perception
like finger pointing over thefence.
Well, we're not them and we'renot them, but they're all

(56:24):
finding success in your platform, which I think is a testament
to what you've built and atestament that it works.
It's doable.
The question I had, dave, you'vewritten several books.
You talked about relocalizinghealthcare and even taking

(56:44):
another bite at the apple onthat book.
Where did your passion for, forwriting come from?

Speaker 3 (56:52):
oh, it's funny, you know, I, I hated english in
school and didn't like writing,and they forced it in journal
and like, like people, like I'vegot a goal to write a book,
I've got a goal to never write abook, was what you know.
I would say um and uh.
And it's funny because I'm byfar the worst writer in my
family.
My kids are exceptional writersand editors, my wife is too.

(57:15):
Yet I'm the one who's publishedbooks and it just started out
early on.
You know, I was in the Internet.
There was a thing calledblogging that came along, and
I'm kind of one who's anexperiential learner.
I'm like, ok, I'm just, I gotto learn this.
It seems to be.
It was kind of like almost thefirst social media and um, so I

(57:40):
just like, okay, well, you know,it actually kind of forces you
to crystallize your thoughts.
Um, that's kind of a good thing.
Um, and then like, oh, man,people are reading this, what?
Um, and then you realize that Ican have influence.
And then I, it just kind ofgrew and I kind of went for, oh,
somebody wanted, you know, meto guest blog on their thing.
And then some trade pub, andthen, you know, huffington post
and Forbes asked me to do somestuff, and, and I was like, oh,

(58:02):
wow.
And then there's some peoplewho are perceived like they
think I'm a writer, which isstill kind of hard for me to
self-identify that way, um, andand so it just, you realize it
is a very powerful medium, um,and it does really force you to
crystallize your thinking and ifyou have a good editor, you
know, you can look halfwayintelligent, you know, when
you're, uh, with the finishedproduct, and I've definitely had

(58:24):
good editors, um, and so that'sreally been the.
The journey is, um, well, andactually, you know, sort of a
little kind of my first book Iwrote was a co-writing, where
somebody asked me to contributeto a book, and so that's, like,
you know, a little fun fact.
The first book wasn't in healthbenefits, it was around patient

(58:47):
engagement, um, and it waspublished by HIMSS, which is the
trade organization for thehealth IT industry, and so that
kind of demystified it, where Iwas the co-editor and I
contributed a chapter or two ofthat and I was like, oh, that's
not impossible.
And then I wasn't really thathappy with the way they marketed
it and I have a number offriends who published through

(59:08):
through, um, you know bigpublishers and they're like,
yeah, they, you know they don'tdo that much.
You know, I mean they do filterbooks and that's good, but, um,
so it just kind of demystifiedit, um, and I was like heck, I
just I have all this body ofwork I've been writing now If I
can make some sense out of it,maybe there's a book there, and

(59:32):
so turns out there was, and thensome people read it and you
know, you kind of get the youknow attaboys and like, okay,
well, I guess I can continue todo this.
And so that's my weird littlejourney on the book writing
front.

Speaker 2 (59:43):
Well, you do a great job and you certainly catalyzed
many advisors employers toaction and a meaningful cause of
solving healthcare.
Before we get to our lastsegment of our questions that we
ask everybody, I wanted tohighlight Rosetta Fest, which is

(01:00:04):
the conference for healthRosetta that's coming up at the
end of August, and just wantedto get a sneak peek from you
about Rosetta Fest and maybesome of the things that you're
excited for and maybe somethings that employers can expect
to learn, or maybe for peoplewho have never attended, why

(01:00:30):
they should.

Speaker 3 (01:00:31):
Yeah, yeah, um, great question, I would say.
You know, one of it is the factthat you have people across the
industry coming together acrossthe different industry silos,
people who attend for the firsttime.
Like wow, a lot of thehealthcare events you go to it's
pretty dismal.
Um, people are pretty down andthis is a can-do group, not like

(01:00:51):
techno-utopian can-do, butthey've actually done it.
And so I would say number oneexcited about is getting all
these employers together, themcreating the community and them
sharing their playbook.
Much of the agenda of the eventis these rosy award case
studies where the people who'veactually done it are sharing how

(01:01:14):
they do it.
So you know we have a bunch ofpublic sector employers, so
there's going to be kind of atrack around that.
There's actually a bunch ofco-ops and ESOPs.
You know your credit unions,your grocery co-ops, your ESOPs
right, there's a bunch there.
And then there's a bunch ofmanufacturing.
So you find there's birds of afeather.
So to me like seeing thosepeople connect and being

(01:01:37):
inspired and kind of raisingtheir game.
You know the verse ironsharpens iron.
It's big time there, right.
And then I'd say number two isNautilus.
What I talked about we're goingto have a major drop of new
resources.
We're going to have a PBM fieldguide, we'll have an update for

(01:01:58):
the TPA field guide and if yougo and look at that, you know,
you just go to nautilushealthorgand fill out the little form.
It's going to be just verysimple.
We threw out that website in aday, kind of off the side of our
desk, but it sends you adocument, opens up a Google Doc
that goes to other documents,but you go to the TPA one.
You'll go there and you go,whoa, like this is a 60-page

(01:02:23):
document, right, that's kind ofthe playbook of the best of the
best, and at the bottom there'sa link off to like eight or 10
other documents or spreadsheets,and so it's really helpful.
And we've got, you know, 16,000company employees using
employers, using this for RFPs.
You know the advisor, rfp isone of the other resources and

(01:02:47):
you know I, mark Cuban, we'reexpecting the hospital open
source contracts to come in, andso it's both creation that we
do but also curation, like withthe PBM.
There's more curation becausethere's already some good
resources, but then organizing,making sense out of it, um, and
so that's number two.
The other thing that's happeningis, um, you know know how

(01:03:11):
important DPC docs are in thedirect care industry, and so
Hint Summit has generally beenthe biggest direct primary care
event, and Hint Summit'sactually happening at Rosetta
Fest.
We're going to have a ton notonly direct you know specialty
care, but a lot of directprimary care care, but a lot of
direct primary care, and so I'mpsyched about that because

(01:03:32):
they're really play a pivotalrole.
And you know, again, it's nostate secret there's no
well-functioning healthcaresystem in the world not built on
great primary care, and sowe're all rebuilding it and
they're a big part of that.
So all those things and weactually.
The other thing I should mentionis non-health Rosetta advisors
are invited.
We want them to be able to geta taste of this we have again,

(01:03:53):
nautilus is bigger than HealthRosetta.
This is becoming kind of thestandard for how employers are
choosing folks.
So we want to give them a tasteof it.
They want to join the program?
That's awesome.
They want to just go use theNautilus resources?
Have at it them.
That's awesome.
They want to just go use theNautilus resources, have at it.
So I want to call that out.

Speaker 2 (01:04:15):
We definitely invite anybody to come.
Yeah, rosetta Fest is always ahighlight for me.
I know just thinking throughlast year of just some of the
insights I've picked up fromother consultants from around
the country.
Again, you talk about opensourcing.
Just a lot of knowledge to behad there.
That is an abundance mindset.
You know.

(01:04:36):
Last year you had Dr MartyMcCary speak.

Speaker 3 (01:04:40):
Launched his book at our event.

Speaker 2 (01:04:42):
He did launch his book.

Speaker 3 (01:04:43):
He did it for like five or six days.
That was pretty cool.

Speaker 2 (01:04:45):
Yeah, that was excellent.
Now he's the FDA director, andanother highlight for me was
Sonia Allen speaking about theMarshall Allen Project.
So just a lot of excellentcontent.
And you know, listening toemployer stories of how people
are solving health care indifferent forms and fashions,

(01:05:06):
and you know, sometimes you haveto ask, but other times people
are just sharing.
That's what we do.
If you want to know more, feelfree to ask.
It's really, really valuable.
Well, I wanted to get into ourlast segment.
We have two questions that weask every guest of the Risk and

(01:05:27):
Resolve pod.
The first question is what is arisk that you have taken that
has changed your life?

Speaker 3 (01:05:37):
Yeah, I'm going to talk to indirectly a little bit.
It was really just pursuinghealth rosetta.
All in right, as I mentioned, Ithought I could just write
about it and that it wouldhappen magically, and I had
actually like the Health Rosettaidea sort of came to me.

(01:05:58):
I think I registered thatdomain Health Rosetta like in
2013 or something, and that wasaround the time when my last
company, Avado, you mentioned,was acquired by WebMD and I

(01:06:23):
thought we might be able to doit within WebMD and they had a
big footprint on the clinicianside, consumer side.
That was not meant to be and itwas.
I was in Europe, hiking aroundthe coast of Italy, and I was
like it just came and I'mgetting goosebumps right now.
I was like this is it?
Like I don't know what this isgoing to be and how it's going

(01:06:44):
to take?
And actually another littletrivia like Health Rosetta
started as a little investmentfund with sean, my co-founder,
so it took us an iteration toget where we are, but I just
like this is the rest of my life.
I know what I'm going to bewhen I grow up.
You know not that I was thatyoung, um, and so that was a big

(01:07:04):
leap.
I had no idea what the businessmodel, what that would be, any
of that and and you know, it'slike probably like parenting.
If you knew how much work itwas going to be, maybe you'd
question it, but you're superhappy.
You know that.
You're that and it's the mostrewarding thing you've ever done
and for me, professionally,absolutely has.
But it was a big, big blindleap.
But you know, you, I have a lotof faith and that really guides

(01:07:27):
me and like, okay, you know, Ialways believe if you have a lot
of faith and that really guidesme and I was like, okay, I
always believe if you have agoal that you can achieve on
your own, without God's help,it's too small a goal and this
is a hard one and it's thegranddaddy of them all, but it's
an incredibly satisfying,rewarding journey, even while we

(01:07:49):
get kicked in the teeth everyday.

Speaker 2 (01:07:51):
So you were called into the arena on the coast of
Italy.
Yeah, that's, that's awesome.

Speaker 1 (01:07:58):
Dave, the second last question.
I feel like I've got to caveatthis for you.
You seem like a guy that wouldhave a lot of answers to this
question, multiple, so we kindof have to limit it to one.
So you got to pick your bestone.
But here's the question what isleft yet unfinished that you,
sir, have the resolve tocomplete?

Speaker 3 (01:08:20):
Doing it, doing what we've been talking about in my
own community.
So I've been in my community.
I was involved as the highschool track and cross country
coach.
That was kind of my communitygive back and I've enabled that
and we're like I got to make ithappen here.
I actually think our communityis well suited to do it and

(01:08:43):
while we have a lot of thehealth plan side of this figured
out, always more to learn we'renot perfect, just to be clear,
the way to engage the community.
We have not cracked that codeand so that is definitely
unresolved.
Like what am I doing to makethat happen?
That's like I'm literally one ofthe suggestions that I was

(01:09:04):
given by somebody who's kind ofbeen in this community a long
time is they said, go to thecounty and city council meetings
, they have public comments andstart to do public service
announcements, like they havekind of some crazies who come
there they're going to say, oh,this guy isn't totally crazy, or
at least he's crazy in a goodway, and you know they're big

(01:09:26):
employers themselves.
But you know, and I had ameeting, you know, a few days
ago with a group of employersand so it's bringing this into
the community and trying tofigure out how the HADC right do
as critical as benefit advisorsare they can't do it alone,
right, and it's going to take acommunity level effort and
figuring that out.

(01:09:46):
You know I got there was a.
There's a one of theseconversion foundations that's
you know I got there was athere's a one of these
conversion foundations that'syou know, focused on healthcare.
I participated in some stufflast week and, and you know we
need to have all ages, allpeople across the different
areas of the community to beinvolved, and so I'm trying to
figure that out.

(01:10:06):
It's definitely unresolved buthopefully it will happen before
too long.

Speaker 1 (01:10:11):
Are we talking the greater Seattle area or
something a little morelocalized?

Speaker 3 (01:10:16):
Yeah, I'm about 100 miles north of Seattle.
It's a county up against theCanadian border, about 250,000
people.
It's big enough but not too big.

Speaker 1 (01:10:26):
What town should we put into our BizWire automation
to make sure we're checking forthose public hearings?
What town is most close to you?

Speaker 3 (01:10:35):
Bellingham, washington.
All right, sorry for my dog, Iapparently am going over on our
time limit.

Speaker 1 (01:10:43):
I thought that was your phone alarm.
No.

Speaker 2 (01:10:47):
Dave, you're right, though, about not being able,
not doing it alone, as I'vethought about health care, I
think, in terms of like thestate of Indiana in particular,
and I think that it's aboutthree to four hundred courageous
Hoosiers that it will it willtake to solve health care in the
state of Indiana.

(01:11:07):
So you know, whatever thetransition is for Bellingham
Washington, it's got to be youand some others that go boldly.
So we'll be following, for sure.
So, dave, thanks for joining ustoday Always enjoy the
conversation and thanks to ourlisteners for tuning in to

(01:11:28):
another episode.

Speaker 1 (01:11:29):
Thanks for tuning in to Risk and Resolve.
See you next time.