PODCAST · business
Self-Funded
by Spencer Smith
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
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The 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 excellence starting with a spreadsheet, an offshore data team, and one other person. It's doubled year over year since. Now it covers...
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The 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 for their education and he wasn't going to spend it on himself. Samaritan Fund covered his care, he changed his mind, and he beat it.…
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The $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, BeneRe In this episode of Last Month in Healthcare, Producer Nathaniel and I sat down with Lamont Thurston, founder and CEO of BeneRe, to break...
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The 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 need to build another one; he just needed to reach the ones already sitting half empty. My guest this week is a trauma surgeon in...
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2027 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 on it. Bill walks through three real cases: a 250-life senior living facility staring at a 50% increase, an 85-life restaurant group…
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Why 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 should be escalated to it, and more than half of them never are. My guest this week is Joshua Resnikoff, founder of Sunstone Health and a…
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The "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 within a few years. I got a tour of Optimal Balance Pharmacy's facility and sat down with co-owner Rick Manuel to talk through what peptides...
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The 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 muscle. My guests this week are Nicholas Syhler, a former cardiologist who left his residency to work upstream of the heart attacks he was...
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Nobody 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 plans for a living, including for the convent where she once lived as a nun. She spends this episode on why a post-network world keeps hitting...
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The 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 insured to self-funded. Billy explains why he thinks it has almost nothing to do with insurance and everything to do with changing who a...
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Trump'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 Healthcare, Producer Nathaniel and I sat down with Sean McGowan of Centivo to break down the biggest healthcare news stories of July 2026. We...
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Outlier 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 single biggest driver of your high-cost claims isn't your discount, your network, or your utilization, but a contract provision almost…
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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 our annual whiteboard review of Tokio-Marine HCC’s Stop Loss Report. Drawing from a massive block of over $2 billion in force premium…
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Why 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 five decades inside every corner of the self-funded industry decides his final act is to give the playbook away?My guest this week is...
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The 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 anymore." In this week’s special bonus episode, I’m joined by Dr. Dena Bravata, physician, healthcare entrepreneur, and Clinical Advisor for...
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The 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 cost of health insurance is a deeply ingrained philosophical problem? My guest this week is Tom Stein, CEO of American Trust Administrators...
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$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 Nathaniel and I sat down with Sid Sinha, founder and CEO of Avant/Nara Health, to break down the biggest healthcare news stories of June...
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How 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 moved away from the idea of primary care as the quarterback of the entire health ecosystem." My guest this week is Matt Taylor, VP of Sales…
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The 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 cap." Is your company treating its healthcare spend like a business strategy, or are you just writing a blank check to the major insurance...
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Managing 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 $57,000 and $80,000 for Keytruda. I typically can have that in the home at $29,000." My guest this week is Jake Velie, CEO and co-founder of...
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You’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 actually 3%." Is Reference-Based Pricing (RBP) still something that just creates endless problems for HR? My guest this week is Jeff Bak,...
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Marty 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 throes of the fully insured market." Welcome back to Last Month in Healthcare! This month, Spencer, Nathaniel, and special guest Jonathan...
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The 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 to change agent fast." Is history about to repeat itself in the health benefits world? My guest this week is Jay Gepfert, Managing Partner...
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A 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 to treat you when you are sick. You go to a doctor for 15 minutes, get a basic blood panel, and if you are within the "reference range,"...
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The 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 panel in front of an audience featuring three of the most forward-thinking minds in the benefits space: Chris Hamilton (Hotchkiss Insurance),...
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Why 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 "BUCA" networks finally coming to an end? My guests this week are Blake Allison, CEO of Employers Health Network (EHN), and Philip Eaves, from...
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Advanced 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 plan actually keeping your employees healthy, or is it just waiting for them to get sick? My guest this week is Ben Miller, Chief Revenue...
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State 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 shifts from April 2026. From state-level crackdowns on PBMs to a surprising loophole that allows urban hospitals to siphon rural hospital...
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The 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 and skyrocketing fully-insured renewals, is the traditional insurance broker obsolete? This week, my guest is John Kountz, a benefits...
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Rob 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 of Vālenz. Rob has led Vālenz through an era of explosive growth, transforming the company from a 60-person shop in 2018 into a…
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Medical 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 year." Is it time for employers to start covering medical cannabis? My guest this week is Emily Fisher, Founder of LeafWell. As a stage 4...
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Shifting 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 are self-funded employers still paying for healthcare on a "fee-for-service" basis, where every single transaction is billed separately…
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Why 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. Everything needs to be grounded in fact and truth." Is the traditional insurance network obsolete? My guest this week is Amy Wykoff…
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A 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." How do stop-loss carriers and self-funded employers accurately predict which groups are going to run well and which ones are about to see...
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March 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, producer Nathaniel joins me to discuss the previous month's podcasts, headlines, and listener-submitted questions.This month, we're joined by...
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The 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 system." My guest this week is Mark Galvin, a serial entrepreneur who successfully funded his own company's healthcare by pairing a $10,000…
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How 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 plan $700,000 on this one patient...on gout treatment." Why are infusion drugs quietly destroying your health plan's budget? This week, my...
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Will 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, producer Nathaniel joins me to discuss the previous month's headlines and listener-submitted questions.This month, we are officially in the…
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Building 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 role of the Third-Party Administrator is undergoing a massive evolution. No longer just a back-office claims processor, the modern TPA is...
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Why 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 can't continue." My guest this week is Norm Volsky, Managing Partner at DRI and Founder of MVP Growth Partners. Norm has spent the last…
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Why 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 tackle the largest economic problem in the country: skyrocketing healthcare costs. Pramod quickly realized that healthcare's dysfunction is...
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The 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 more real than anybody knows." - Will Steelman The American healthcare system is crushing its doctors. Faced with "assembly line" quotas…
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Recapping 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, producer Nathaniel joins me to discuss the previous month's podcasts, headlines, and listener-submitted questions.This month, we’re joined by...
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Let 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." - Ryan Wells My guest this week is Ryan Wells, Founder and CEO of Health Here. Ryan joins me to explain why the key to fixing the broken...
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The "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 behind that." - Will Johnson My guest this week is Will Johnson, Founder and CEO of Gyde, who is building what he calls the first "AI-native"...
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Alcoholism 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 Leverett In this incredibly vulnerable and powerful episode, we step away from the usual technical discussions of self-funding and insurance...
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Is 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, Founder of VivaScore, and Chris Burns, a veteran benefits advisor with over 40 years of experience at firms like Mercer and Sequoia. They…
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Universities 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 is Kyle Minick, Vice President of Employee Benefits at Summit Financial Group. Kyle returns to the show to expose a massive systemic…
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Why 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 explain why convenience is the ultimate currency in healthcare. Chris shares his journey from insurance broker to building a direct primary care...
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Tier-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, producer Nathaniel joins me to discuss the previous month's podcasts, headlines, and listener-submitted questions. This month, we’re doing...
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ABOUT THIS SHOW
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.
HOSTED BY
Spencer Smith
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Frequently Asked Questions
How many episodes does Self-Funded have?
Self-Funded currently has 306 episodes available on PodParley. New episodes are automatically indexed when they're published to the podcast feed.
What is Self-Funded about?
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.
How often does Self-Funded release new episodes?
Self-Funded publishes regularly with 306 episodes available. Check the episode list for the typical release schedule.
Where can I listen to Self-Funded?
You can listen to Self-Funded on PodParley by clicking any episode. We provide an embedded audio player for direct listening, and you can also subscribe via your preferred podcast app using the RSS feed.
Who hosts Self-Funded?
Self-Funded is created and hosted by Spencer Smith.
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