AH057 - How First-Movers are Taking Control of their Health Plans in 2025, with Jeff Hogan

On Episode 57 of the Astonishing Healthcare podcast, host Justin Venneri welcomes Jeff Hogan, President of Upside Health Advisors, back to the show to discuss the major trends he observed in healthcare procurement and plan management in 2024 and areas of focus in 2025. Jeff highlights the evolving role of employer fiduciaries under the Consolidated Appropriations Act of 2021 (CAA), building on Episode 30 and re-emphasizing the necessity of real-time data access and process-driven strategic decision-making. He explains how employers must take greater accountability for healthcare spending, moving beyond reliance on traditional insurance networks (BUCAHs) and considering alternative care delivery models; and adds that provider organizations must adapt to align care delivery with consumer needs or risk obsolescence.The discussion also covers the increasing use of analytics - including platforms like HOMA Health - or outside resources, like Nick Welle explained on Episode 52, to help plan employer plan sponsors manage costs and their vendor contracts, PBM reform, and point solution fatigue. Finally, Jeff outlines key priorities for 2025, including fiduciary compliance, confirming the removal of gag clauses from contracts, and greater transparency in broker compensation to ensure better alignment between healthcare purchasers and providers.Related ContentReplay - Strategic Well-Being: Rethinking Health Benefits to Empower Employees and Drive ImpactAH030 - Plan Sponsors Need a Source of Truth; Get Your Data Now & Find It, with Jeff HoganBest of '24! AH041 - ERISA Litigation Outlook and Meeting CAA Requirements, What Can Plan Fiduciaries Do?Signs it is time to change your PBM vendor, and how to overcome common hesitationsTo learn more about Upside Health Advisors, click here, or you can find Jeff on LinkedIn.Resources MentionedVizient - 2025 Trends Report: Strategy is (finally) back in the driver’s seatPeterson Health Tech Institute - Virtual Musculoskeletal Solutions (June 2024)ICER - Peterson Health Tech Institute: Assessment Framework for Digital Health Technologies (Sept. 2023)Peterson Health Tech Institute - Digital Diabetes Management Solutions (March 2024)For more information about Capital Rx and this episode, please visit Capital Rx Insights.