Phia Group

Empowering Plans: P44 - The Phia Group “MVP” Post-Mortem

On June 12, 2018
Welcome to Empowering Plans a show dedicated to identifying waste and undo expense in the health benefits industry. Discovering ways to maximize benefits while minimizing costs, and empowering employers, administrators, and consultants to emphasize once again the benefit in benefit plan. Today’s episode is brought to you by the Phia Group Empowering Plans Since 1999, now here are your hosts the Phia Group’s own CEO Adam Russo, and senior vice president and general counsel Ron Peck, and Brady. ADAM: Hello everybody, and welcome to another episode of Empowering Plans with the Phia Group. I am your co-host, co-founder, CEO of the Phia Group, Adam Russo. With me as always is our senior VP, general counsel, my good friend, Phia Forum collaborator, whatever you want to call him, Ron Peck. Say hello Ron RON: Hello Ron. ADAM: In addition, as always the great, the infamous, Brady Bizzaro. Say hello Brady. BRADY: Hello Brady. ADAM: And as Ron likes to say, and I feel bad because I always talk about Pat at the end. Ron’s right nobody is listening by the end. Our great producer Pat Santos, say hello Pat. He has nodded, He’s waving. It’s amazing. Folks we have some exciting news, even though our internal HIPAA people, security people are frowning upon our decision. The minute this podcast ends Pat, Ron, Brady, and myself are going to tear down the room, take all the equipment out, and we are moving our studio into the hallway, into a corner, right near one of our unisex bathrooms. We will have yes, video not just audio, but now in the future you will be able to see all of us. You will be able to see the Phia swag, the bobble heads. We are going to make this way better than any ESPN studio, and we do not care if there is a concern that all the equipment is going to be stolen. If somebody wants to steal this stuff, we will find him or her and punish him or her. We are excited about the move. I think all of you (we have been hearing it over and over again) want us to have some live feeds occasionally. We are going to appease you. In addition to all the Phia Groupies out there who love our podcast, who decided this week to come to our Forum. Yes, they stalked Ron for a little bit. (Ron: they were not actually invitees of the event; they were just crowding around the stadium). When they hand write their name into the badge that’s when you know those are the people that weren’t actually invited, but you couldn’t say no to them because you are petrified they might do some bodily harm to you. (Ron: Yes, the smiley face with the googley eyes instead of the photo of the attendee was a dead giveaway.) We wanted to let everyone know. I want to thank personally Ron Peck for putting on a great show. I did all the actual live work at the event that people saw so I am the front man, but trust me the work that Ron did behind the scenes: every slide, every topic, and every speaker. We raised over $1300 for the Boys and Girls Club of Brockton with our silent auction, which was amazing. Ron’s choice of venue at Gillette Stadium was unbelievable. Seeing the Phia Group logo at Gillette Stadium right next to that horrible cheating Patriot’s logo (even though I hate the Pats), it was inspiring to see our logo up there on the field. RON: I have to tell you it was a lot of work from the original concept to actually seeing it come to life. It meant a lot. I was happy to see it all come together as it did. I just wanted to take a moment, if you don’t mind, Adam, to give some credit where it’s due, a lot of other individuals that helped me bring it to reality. (Adam: C’mon just say it you did all the work, its fine). I will admit that I was the seed of creation. I was the creative inspiration. (Adam: So now, you are calling yourself God). I’m not going to, but the other speakers were awesome, Adam. Your co-owner Mike Bronco did a lot of work with the venue, the people there. He obviously made a good impression because they threw many bells and whistles in that were not necessarily part of the package. Because of the reputation, because of the relationship he built with them. (Adam: That’s right). Mike’s right hand and left hand, Cindy Monfils, was on the phone, getting on people, RSVPs. The clients obviously, the attendees they were amazing. The people over at the Boys and Girls Club and the resources they provided to us, to help get that auction up and going, their connections were amazing. ADAM: Well, you know what I am noticing and hearing from Ron. What did Ron actually do? Sounds like everybody else did the work. Everything I thought Ron did he’s now telling me somebody else was doing. RON: Adam, what I actually did was I came up with concepts, and delegated the actual work. I’m learning from the best (Adam: I am the king of that.) I have to throw Hannah’s and Matt’s names out there too. They were helping with a lot of the packaging, the flyers, the folders, the swag that we gave out that I was in love with this year. ADAM: I don’t think our listeners need to know every person that made a box, or hung something up on a wall. Anyways I know we are going to get bombarded with this “why wasn’t I invited?” Folks this was an invitation only event. This was 9th year we have done this conference. Back in the day, we literally had it open to anybody, and hundreds of people came. However, we realized that we were going to get a lot more use of our time if we focused on our actual clients, our biggest clients. Not only the biggest in revenue, but also the clients that are most collaborative and willing to be our beta. The ones that have new ideas for us to come up with new services. Organizations that are leaders in our industry, and those are the folks that we wanted to make sure we had in the room. We invited 75. We got 75. Then we added about 20 people from our own organization as well because obviously we want them to mingle. It was a three-day event. It was unbelievable. Next year my goal is to have it at Progressive Field. Yes, Jacob’s Field in Cleveland for the 10th year anniversary of the Phia Forum. What better place than in the land. RON: Is that a rhetorical question or a real question? I thought you were trying to keep this podcast short. ADAM: This podcast already went over time. Couple of things I want to bring up. Pat Santos will be working very hard over the next two weeks to put together a nice, detailed, video, audio show that we can share with all of you. Just the highlights of the Forum, so even if you were not there, even if you weren’t cool enough to get the invitation to the Peck, Brady, and Russo party, you will still be able to watch it for free. RON: We were videotaping. We were audio recording. What better way to honor the Patriots at their own stadium than to have video and audio equipment everywhere. Tracking everyone’s movements, and listening to everything everyone said. BRADY: I think we left some behind too, for the practices. RON: It’s in the visitor’s locker room. ADAM: We had a podcast with Pat Patriot, and he can’t talk which is amazing. RON: That is innovation. That is how you do it. ADAM: I saw him in the corner with the cheerleaders. I wanted to find out if he was talking to them. He was not he is in character. That man thinks it’s 1776, the musket, he’s all about it.Okay. Folks just so you know we did an awesome survey during the Phia Forum. I think we learned a couple lessons from it. It was a live survey during the actual event. It told us a lot about not only where we are today as a company, but also what we need to focus on going forward. This is what I got out of it. What I learned was people are very interested in reference-based pricing. Not as the end, all be all solution to our health cost problem, but as a step in the right direction. I thought that was so amazing to hear that most of the people think that it is the right direction. Because there are some vendors out there, their whole marketing, their whole pricing model is based on RBP being the actual final solution to the problem. Whereas most of our industry thinks, it is just a step in the right direction. I think it is very important when you look at RBP you speak to different vendors that are out there doing it: What is it that they believe? Is it the end result or is it a step in right direction? RON: I think you are right, Adam. I think when you look at the way we have been pricing claims for so long, it’s almost like hitting things with a rock, and reference based pricing is a lot like a hammer. It’s a tool that is far more advanced than what we have been doing, but ultimately it’s still just one tool in the tool box. ADAM: Right. In addition, what people also care about is balance billing of patients. The biggest thing (and we are going to have a Webinar about it in July) is specialty drug trends. That is a huge issue that people have. Moreover, one of the biggest ones that we knew, but didn’t realize it was such a big problem is overpayments. So there are a lot of overpayments in our industry, and the reason why you don’t see a lot of information about it anywhere is because most TPAs and administrators are afraid to talk about them because it makes it look like they did something wrong. When most of the time there is no negligence on the part of the administrator, it is just because of their proactiveness they found something after paying the claim that nobody else would have found, but they are still afraid to come out of the shadows. RON: I think we need to start a trend. Have it go viral and push back against overpayment shaming. Because honestly the fact that people think the only reason there is an overpayment is because the claim’s processor made a mistake is OP shaming, and it’s not a good thing. How many overpayments occur because of fraud, or mispricing, or a mistake on the part of the provider? How often does an overpayment occur because of miscommunication on the part of some third party or whether somebody is actually enrolled or properly enrolled? Maybe a plan member reports somebody is their spouse when the truth is they are not actually married. That is not on the TPA, yet it is being wrapped up in this shame. ADAM: In addition, what I think we found is that finally people looked at themselves and were honest. Even though a TPA in their administrator’s agreement is not looked upon as a fiduciary, when we asked the audience what they thought; 80% of them said they were not confident that the actual plan makes the claims decision and not the TPA. 80% of the TPAs feel that an argument can be made that they are the ones making the claim decision, which is not good. That is why Ron is going to be sharing some information with our clients on how to get around that. But what more and more brokers and plans are also asking is that TPA to take on that fiduciary risk which is a big part of our PACE product, and something that I think is helpful. However, the biggest thing I think I realized more than anything else, and I’m not even talking about claim negotiation or Phia unwrapped. Here is what we learned: Folks I love doing these podcasts, we love doing the webinars. We get 5,000 people on a webinar, we get hundreds of people listening to the podcasts, we get emails from our Phia groupies across the country. Thank you by the way, keep those emails and love letters coming. But here is what we realized, the number one way people learn about our services isn’t from these podcasts. It isn’t even from our sales team, which you would think is the number one way. It’s from seeing us perform somewhere speaking, somewhere else at a conference. Number 1 way people learn about our services. So I guess I am on the road that is why we have all these people on the road all the time. I thought because of social media it may shift, but no, people still want to touch you, people still want to see you. Even though the voice is there, our studio is going to be awesome, nothing makes up for me actually being able to spit on somebody in the first row of my speech. RON: Adam, I think you are right it is great to watch a game high definition surround sound, but sometimes you have to go sit in the seat, feel the weather, see the players, and enjoy a beer. ADAM: So what am I missing Ron? What did you get out of the Forum? It’s great to see the clients. So many of them came to our open house the next day. So many of them saw where this podcast takes place, which is by the way going to be moving. But what else did you guys get out of this? As far as what I got out of it, I saw a huge interest in the industry. Something I didn’t bring up is a lot of people have that same belief and interest in getting future leaders involved. More and more people want young people involved in the industry. They are turning to Phia to help them know how to do it, and more importantly from a training standpoint; how we train, how we educate the industry about self-funding, and the right way to do it versus the wrong way is another big take away I got which I wasn’t necessarily expecting. RON: Tied to what you just mentioned, Adam. I was happy to see pretty much all the same faces when it comes to leadership at the organizations that represent our MVPs (most valuable partners). What I saw this year that I have not seen years in the past is that those leaders brought with them new faces, fresh faces, and a I feel that among these MVPs they are starting to expose that next level of leadership, those future leaders to their partners (that being the Phia Group). Kudos to those clients that did bring new people with them to expose them, and get them trained. The other thing that I noticed, Adam, was that a lot of our clients even though they think that their issues, their problems, and their concerns are unique to them, when we did these surveys and we asked “What’s troubling you? What are you seeing in the industry?” The vast majority of people all agreed. 75%, 85%, 95%, of people were all answering the same way, which goes to show you they all agree on what the problems are. The difference lies in the vision of what the solutions will be. Lastly, everyone seemed to mention that there is not enough collaboration in the industry. Not enough crowdsourcing when it comes to coming up with these solutions. The fact that everyone is having the same issues, one comes up with a great solution, but no one else ever hears about it, and then they end up suffering the same problem. That in itself is a problem. BRADY: Whenever you are asked to speak last it’s always the case that you have nothing left to say because it’s been said already. I think the topic of future leaders is huge, and I think I scared them when presenting and saying “look we are getting older as an industry, and millennials you may hate a lot of them but they are the future whether you like it or not. You got to take action now” ADAM: Just so you know while Ron was talking, I got two emails asking for more information of the future leaders program. So I’ll just forward those over to Brady. BRADY: Great. I’ll add that to my plate. But yes, that’s a big deal. I was also surprised about how popular direct primary care was. There was a number of questions asked during the presentation by Dr. Gule. I think that is the way of the future. People like the idea of less red tape, these direct contracts, skipping all the bureaucracy and all the administrators. ADAM: The only thing that I’m not surprised about is when we asked the one thing to improve about Phia. The answer was replacing Brady. I’m not joking folks we have the slides and results to prove it. Replacing Brady was number one. I want to take that slide and frame it, and put it in our podcast room. Replace Brady was by far there’s not even a top three. It was replace Brady and then everything else. BRADY: I think that is because they want me to work for them. RON: Sure, they want to be a free agent. I’ll actually tell you a quick, funny story because you know we were at Gillette Stadium when we were doing that slide. We had the survey up and people were filing in the blank about what they felt was the number one thing we needed to improve. Replace Brady came up in big letters and obviously everyone jumped on the bandwagon. Thought it was hysterical. At that moment, Adam, a tour was passing at the next level, over the balcony. They were looking down at this group of professionals wearing suits at Gillette Stadium with a big slide that says “Next Step: Replace Brady.” And you have these tour people taking pictures with their phones sending it to Barstool and ESPN thinking they just stumbled upon…. (Adam: are you serious) I kid you not, the children were crying up on the balcony, I kid you not there was a tour going around the stadium at that moment. ADAM: Replace Brady was definitely there. Who knows maybe they will take us up on it. That would be Ron’s worst nightmare. Anything else you want to add? (No) So listen folks as we said in a couple weeks we will have all the information about the forum. If you want any information about our services, or even want the slides please feel free to contact Brady, Ron, or myself. On behalf of Ron Peck, Pat Santos, Brady Bizarro, and myself thank you so much for empowering your plans with the Phia Group. Have a great day.

Empowering Plans: P38 - A Labor of Love?

On April 24, 2018
In this episode, Adam, Ron, and Brady interview in-house specialist, VP of Consulting Attorney Jennifer McCormick, and discuss the many complicated issues surrounding surrogacy, and the costs for which benefit plans may be responsible. What can be denied? What must be paid? Why is this a threat? What can we do to avoid it, or at least minimize the risks? Listen and find out!

Empowering Plans: P35 - Direct Primary Care – The Pot of Gold You’re Looking For

On April 4, 2018
In this episode, part of our Partners in Empowerment series, we interview Doctor Jeff Gold of Gold Direct Care (golddirectcare.com). Join us as we ask the questions you want answered regarding this innovative and interesting approach to “real” medical care.

Empowering Plans: P32 - Red Cross Blood Drive Special Episode

On March 1, 2018
Today The Phia Group in partnership with the Red Cross hosted an on-site blood drive. Join Ron Peck as he interviews members of The Phia Group staff and Red Cross leadership as we discuss the event, personal experiences, and the ever present need for donors. This moving and important episode will hopefully drive you to action!

Empowering Plans Segment 04 - Attack of the Killer Savings

On March 13, 2017
Join The Phia Group's CEO, Adam V. Russo, and Sr. VP, Ron E. Peck, as they describe how The Phia Group identifies facilities that provide the best outcomes for the least cost, and encourage plan participants to visit those facilities.

The First 100 Days: President-elect Donald Trump, Healthcare, and Self-Funding

On November 21, 2016
The election is behind us, and no matter who you supported, it was one of the most divisive in recent history. Regarding the contentious topic of healthcare, President-elect Donald Trump has promised to repeal the Affordable Care Act and replace it with a better, more efficient system. The future of our industry is sure to change.