"Understanding how an underwriter thinks and how they manage risk allows you to create a solution that actually creates impact and change for the long term." - Bobby Stuart

This week on the show, I'm joined by Bobby Stuart, a benefits consultant with Hotchkiss Insurance, for a deep dive into the mindset of a modern, forward-thinking advisor. We discuss his journey into the industry and what it takes to guide employers through the complexities of self-funding.

Bobby also broke down his playbook for creating long-term value for his clients. We explore why learning to "think like an underwriter" is a crucial skill for managing risk, the importance of simplifying complex ideas for employers, and why mastering the industry's language is the first step to finding simple solutions.

We also discuss how these strategies translate into real-world results, including how Bobby's team uses direct contracts and early intervention to help members get high-cost cancer care for free, removing the financial burden so they can focus on their health.

Chapters:

(00:00:00) How To Think Like An Underwriter (And Why It’s A Game-Changer)

(00:04:03) Overcoming the Complexity of Self-Funding

(00:04:59) Learning to Speak the Language of Insurance

(00:08:49) The Power of Thinking Like an Underwriter

(00:18:48) How To Stay Optimistic As A Benefits Consultant

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"The balance bill came in, it was 37 grand for this member, and we were able to get that thing fully wiped." - Patrick Haig

My guest this week, Patrick Haig, Co-Founder of Goodbill, has built a company designed to find errors in medical bills and fix them. From upcoding to time-based discrepancies, these inaccuracies cost health plans and their members a fortune.

In this episode, Patrick breaks down the Goodbill model. We discuss how their technology integrates directly with health plans to audit claims for errors before they're paid, and why that “upstream” approach is so game-changing. We also dive into one of their most powerful tools: the underutilized 501(r) IRS rule that can wipe out bills entirely, even for six-figure income families.

This episode is personal for me, as Patrick's team fixed my own son's ER bill, saving almost $1,000. I hope you’ll tune in!

Chapters:

(00:10:22) How DPC inspired Goodbill

(00:23:03) The 501(r) Secret: Hospital Financial Assistance

(00:27:15) How Upcoding Inflates Your ER Bill

(00:38:29) The Art of Negotiating a Hospital Bill

(00:48:43) Why "Upstream" Claim Auditing is a Game-Changer

(00:59:29) Can a Six-Figure Family Qualify for Assistance?

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"I doubled my profit when I lost 70% of my customers, which is insane." - Brad Hart

My guest this week, Brad Hart, owner of Forest Park Pharmacy, came on the show to discuss how he moved his pharmacy from struggling to survive in a broken, insurance-based reimbursement model to thriving as an all-cash, "cost-plus" business.

Brad popped on my radar because of his very popular and informative Instagram profile, where he shows how everyday Americans are getting fleeced by PBMs. We break down the mechanics of his model and discuss the "low copay trap," why the term "specialty generic" is nonsense, and how his pharmacy's Price Checker tool brings radical transparency to a purposefully confusing industry.

We also dive into the exponential overpayments Brad has uncovered in the Medicare system, where a drug that costs his pharmacy $96 is reimbursed for over $3,400.

This is one you won't want to miss!

Chapters:

(00:00:00) This Pharmacy Went Cash-Only, Lost 70% Of Customers, & Doubled Profits

(00:07:28) The "Cost-Plus" Pharmacy Model, Explained

(00:08:49) How Brad Lost 70% of Customers & Doubled Profits

(00:10:45) The Deceptive "Low Copay Trap"

(00:13:29) The Pricing Breakdown: Cost + 15% + $10

(00:34:52) Why the Term "Specialty Generic" is Nonsense

(00:47:53) What is the Average Wholesale Price (AWP)?

(00:52:41) PBM Reform vs. Direct-to-Consumer

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/