In this episode of Benefits Influencer, host Dennis Carlson interviews Steve Santangelo, Chief Revenue Officer at Garner Health, about their unique approach to healthcare cost management through provider quality assessment. The conversation offers benefits brokers and consultants valuable insights into innovative solutions for addressing rising healthcare costs at a time when employers are seeking more effective alternatives to traditional health plans.

Steve Santangelo brings his decade of carrier-side experience to explain how Garner Health uses data analytics to identify high-quality healthcare providers and incentivize employees to choose them, resulting in both better care and lower costs. The discussion explores:

1. Provider Quality Focus: Garner Health analyzes physicians on over 500 metrics using data representing 320 million patients to identify high-performing providers. Their approach connects patients to top doctors within existing networks, finding that higher quality care typically costs less, delivering average savings of 27% per healthcare episode.
2. Market Transformation: We've reached a "tipping point" in healthcare where employers are actively seeking alternatives as costs become unsustainable. CFOs are now directly involved in benefits decisions, and previously "too disruptive" solutions like reference-based pricing are gaining traction as companies face higher healthcare cost increases.
3. Broker Strategy: Successful benefits consultants need to develop multi-year strategies for clients rather than temporary solutions. Vendors should work closely with brokers throughout the client lifecycle, focusing on delivering promised results that help brokers demonstrate value when renewals arrive.

The episode also covers insights on price transparency developments, how self-funded employers can leverage concentrated membership for direct contracting, and why brokers remain essential partners in implementing innovative healthcare solutions.

In this episode of Benefits Influencer, host Dennis Carlson sits down with Sina Chehrazi, founder and CEO of Nayya. Nayya is an AI-powered platform that unlocks the value of Health & Wealth programs for employees in real time. They discuss how Nayya is transforming employee benefits by connecting disparate data points to create a personalized experience throughout the benefits lifecycle - from enrollment decisions to ongoing usage and claims. Sina shares insights about the fragmented benefits ecosystem, the critical role of employee benefits consultants, and the future of benefits technology integration.

1. Personalized data integration is transforming benefits: Nayya connects previously siloed data (prescriptions, HSA, medical claims, financial accounts) to create truly personalized recommendations for employees during enrollment and throughout the year, helping employees make better benefits decisions based on their specific situation.
2. Benefits consultants remain crucial: Far from becoming obsolete, consultants are becoming more important as the benefits ecosystem grows more complex. They serve as trusted advisors to employers navigating point solution fatigue and emerging options like captives that could increase competition in major medical.
3. Integration is the future: The benefits technology market is splitting between closed ecosystems and open integration approaches. Sina predicts that platforms embracing integration will ultimately win, similar to how Salesforce has grown through its integration marketplace, creating value for all stakeholders.

More info at www.nayya.com

In this episode, Dennis Carlson sits down with Kristen Rivers, SVP of Sales at ParetoHealth. They discuss how mission-aligned benefits consultants and employers can access premium healthcare solutions typically reserved for large companies through captive healthcare models, highlighting the limitations of traditional fully-insured and level-funded plans while emphasizing the value of actionable data transparency and stronger contractual protections available through alternative funding approaches.

1. The healthcare market is at a watershed moment where employers are seeking alternatives to unsustainable cost increases in traditional fully-insured plans, with many consultants becoming catalysts for this change.
2. Contrary to popular belief, level-funded plans are often "fully insured, repackaged with a little more data" but without the ability to meaningfully act on that data to control costs.
3. Pareto Health's model provides stronger contractual protections (no-new laser provision and 30% rate cap for the entire membership duration) while giving employers access to cost-saving levers like alternative drug sourcing and patient assistance programs.

To connect with Kristen Rivers or learn more about Pareto Health, reach out to her directly on LinkedIn or contact any member of the Pareto team in your market.