Episodes

"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 actually not a technology problem - it is a deeply ingrained problem with economic incentives. In this episode, we dive into the murky waters of Pharmacy Benefit Managers (PBMs) and why the traditional...

"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 of 25+ patients a day, hours of unpaid administrative work ("pajama time"), and a suicide rate higher than that of veterans, physicians are fleeing the profession in droves. My guest this week is Dr. Wi...

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 John Kountz from Frost Insurance! We react to the record-breaking lobbying spend by drugmakers in 2025 and discuss the historic slump in Hospital M&A activity. We also cover the rising cost of medical re...

"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 doctor-patient relationship is getting providers out of the debt collection business. We explore how Episodic Care (bundled payments) can finally align the financial incentives of self-funded employers an...

"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" insurance brokerage. After spending a decade at Oscar Health, Will realized that while brokers are the critical "entry point to care," they are operating without the infrastructure needed to scale in th...

"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 captives to tackle a pervasive, often silent issue in our industry: addiction and sobriety. My guest is Chris Leverett, Executive Vice President and Managing Director of Employee Benefits at TexCap Insur...

"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 join the show to demonstrate a piece of technology that feels like science fiction but is actually here today: rPPG (Remote Photoplethysmography). We discuss how this technology turns a standard smartphon...

"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 failure: Universities are not teaching HR professionals how to manage their second-largest expense. Kyle shares the shocking story of how he discovered that major university HR programs dedicate almost zero ...

"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 (DPC) model that brings care directly to the employee's doorstep - literally. Chris breaks down the "Walk On" model, which combines mobile on-site clinics, near-site access, and virtual care to achiev...

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 something a little different to close out 2025. Instead of just looking back at December, we are ranking the biggest healthcare stories of the entire year on a Tier List, from "Not Impactful" to "Super I...

“I think the next stage of American capitalism includes co-opetition." - Dutch Rojas On the last episode of Self-Funded with Spencer in 2025, Dutch Rojas joins the show to expose the financial "arbitrage" that he believes is destroying independent medical practices in America. Dutch explains how current CMS incentives allow hospitals to buy independent clinics and immediately charge 165% more for the exact same services, which is a practice that is crushing employers and patients alike. In thi...

"Healthcare has had no star score, there's been no reliable pricing. It's all been just a black box." - Will Bruhn An estimated 21% of all medical care in the U.S. is completely unnecessary. My guest this week is Will Bruhn, CEO and Co-Founder of GAM (Global Appropriateness Measures), and he joins the show to explain exactly where that waste comes from and how we can fix it. Will argues that we've been measuring quality wrong. Instead of just looking at outcomes (did the surgery go well?), we ...

"Why in every other industry can we just check out and know exactly what it's going to cost? Why can't it be the same in healthcare? Why are we still mailing physical checks in 2025?" - Cory Morin My guest this week is Cory Morin, Co-Founder of Benji Card, who has developed a "virtual wallet" strategy that is revolutionizing how self-funded plans pay for care. Cory joined the show to explain how giving members and care coordinators instant access to funds can drastically lower medical claim cos...

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 Chris Hamilton! We talk about the J&J lawsuit being dismissed, Eli Lilly switching PBMs, AI in healthcare, and much more. We also play a Christmas game called Home Alone: The Wet Bandit's Bills, wher...

"Success leaves clues. And sometimes that clue is healthy leadership that is just able to take them from plateau to plateau." - Trey Marinello My guest this week, Trey Marinello of Houlihan Lokey, is an expert in a topic everyone is constantly talking about: Private Equity. Trey joined the show to demystify the world of investment banking and explain exactly why private equity firms are pouring billions of dollars into the employer-sponsored healthcare space. Trey breaks down the current trend...

"I love working with people who aren't afraid to own up to their mistakes. Integrity is the most important thing to me." - Cara Kirsch What is the secret to a perfect broker-partner relationship? My guests this week, Cara Kirsch and Libby Henry, join the show to answer that question. They share the story of how a single "virtual lunch" during the pandemic sparked one of the most effective partnerships in the industry. Cara and Libby break down the ingredients of their success: radical transpar...

"People do more research on buying a refrigerator than they do on buying their health plan. And so I saw that as a level of brokenness that I felt... we as consultants could actually make a profound impact." - Trey Halbert The old-school, transactional broker is dead. My guest this week, Trey Halbert, CEO of ExperINS, joins the show to discuss the rise of the modern "Strategic Consultant" and what that evolution means for employers. Trey breaks down the playbook for this new, elevated role. We...

"One out of seven people in the United States have some form of chronic kidney disease... 90% of those individuals have not been properly diagnosed." - Mark Masson My guest this week is Mark Masson, President of Renalogic, here to shine a light on one of the most expensive and hidden risks in every health plan: Chronic Kidney Disease (CKD). It's a "silent killer" that affects 1 in 7 Americans, but a staggering 90% of them don't even know they have it until it's too late. In this episode, Mark ...

"There needs to be a whole new suite of solutions that are forward looking and proactive and real time, and we gotta go and build that." - Sasha Gribov My guest this week, Sasha Gribov, founder of Milu Health, is on a mission to build the proactive, forward-looking solutions our healthcare system desperately needs. He joins the show to discuss how he's using AI to create an "early warning system" for health, moving our model from reactive to proactive. Sasha breaks down the Milu model, which u...

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 also joined by Kyle Minick! This episode is a bit different than usual as we focus on the many issues our physicians are dealing with in 2025, from AI to burnout to compensation. And we play a new game called ...

“Just because someone hasn't gone to the doctor in four years does not mean they're not a walking time bomb." - Garrett Jerue My guest this week, Garrett Jerue, argues that the key to solving our healthcare crisis is to think differently and build a truly cohesive healthcare ecosystem. Driven by his personal experience battling cancer and navigating a fragmented system, Garrett has dedicated his career to designing benefits strategies that actually work for people. In this episode, Garrett sha...

“I absolutely think we're in that tightening, hardening market... the days of the employers who were average risk seeing single digit rate increases, that's gone. It's going to be a double digit rate increase market going forward." - Jay Ritchie The president of one of the largest stop-loss carriers is here to deliver the State of the Union for our market. My guest this week is Jay Ritchie, President of Tokio Marine HCC, and he shares the current state of the market and what to expect for 2025-...

"The biggest shift was the consolidation that happened with the insurance carriers themselves. From 25 or more carriers to just four national carriers." - John Rutledge How did health insurance get so broken? My guest this week, 40-year industry veteran John Rutledge of Marsh McLennan Agency, joins the show to walk us through the last 40 years of decisions that led us to the consolidated, expensive, and frustrating market we have today. John explains how the market went from over 25 competing ...

"Eat your food as medicine or medicine will become your food." - Chef Austin Simmons Can better beef solve America's health crisis? My guests this week, Chef Austin Simmons of Chef and Rancher and benefits/nutrition expert Chris Pierron, believe it's a critical part of the solution. They join the show to discuss the deep connection between cattle genetics, our broken food system, and our exploding healthcare costs. Chef Austin explains his "hoof to fork" model for creating "better beef." We di...