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Hate The Game

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Manage episode 275488813 series 1591102
Content provided by Fulcrum Strategies and Informational podcasts by Fulcrum Strategies. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Fulcrum Strategies and Informational podcasts by Fulcrum Strategies or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.
It applies to so many situations, "don't hate the player, hate the game". Insurance companies are playing the game according to the rules they have and they're making record profits. Do we hate them? Or the game they're forced to play to maximize their shareholders' investments? The system we have now incentivizes payers to make life miserable for the 5% of health care consumers who account for 50% of all health care spending. They use tools like prior-authorization, pre-certification, fail-first pharmacy and more, all to try to make expensive members go somewhere else. What if we changed the system? Ron explores what we might be able to do to change the rules of the game and move payer's focus off shedding expensive members and onto efficiently caring for them.
  continue reading

35 episodes

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iconShare
 
Manage episode 275488813 series 1591102
Content provided by Fulcrum Strategies and Informational podcasts by Fulcrum Strategies. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Fulcrum Strategies and Informational podcasts by Fulcrum Strategies or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.
It applies to so many situations, "don't hate the player, hate the game". Insurance companies are playing the game according to the rules they have and they're making record profits. Do we hate them? Or the game they're forced to play to maximize their shareholders' investments? The system we have now incentivizes payers to make life miserable for the 5% of health care consumers who account for 50% of all health care spending. They use tools like prior-authorization, pre-certification, fail-first pharmacy and more, all to try to make expensive members go somewhere else. What if we changed the system? Ron explores what we might be able to do to change the rules of the game and move payer's focus off shedding expensive members and onto efficiently caring for them.
  continue reading

35 episodes

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