If you got excited about the new patient potential outlined in last week’s podcast, you’ll be jumping out of your seat over what Doug has in store today.
Tune in right now and learn why IncentiCare® and kNew Health will be the driving forces that bring functional medicine to the masses, including:
- What IncentiCare® is, why it’s unlike any insurance product you’ve worked with before and why it’s a perfect match for the functional medicine operating system
- The role our community has to play in the evolution of insurance and “trend suppression”
- Why IncentiCare® is the ideal product for employers interested in cutting healthcare costs and incentivizing healthy lifestyle choices
- How IncentiCare is revolutionizing the insurance industry, by profiting when they save employers money, not the other way around
- What the new partnership between kNew Health and Benicomp means to you, your practice and the future of functional
- How, with your help, the kNew Vision tour and IncentiCare could make functional medicine accessible to millions more people this year
It’s time to act like we’re winning, because a whole new world is about open up for our ecosystem via IncentiCare.
If you would like to support our efforts to make FxMed accessible to millions, we’d love to hear from you about local employers or business owners who could be a good fit for IncentiCare®. Tell us about them by clicking here. You can see exactly why this is necessary below!
Please forward this to all your colleagues who could benefit.
Click on this link to join forces and please share: goevomed.com/Incenticare
Announcer: Welcome to the Functional Forum podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs in health technology as well as practical tools to help transform your practice and the health of your community. Now here’s your host, James Maskell.
James Maskell: Hello and welcome to the podcast! This week, we welcome back Doug Short. He is the CEO of Benicomp, an insurance company working with employers, and today we’re gonna talk about how we get functional medicine to the masses. How do we get functional medicine to every employee in a company and not just the executive team? It was a really incredible 40 minutes and inside this, what I really want you to take away from this, is that industries are changing. Industries are in flux and, ultimately, functional medicine can be the disrupting force in medicine and not be disrupted. And it’s gonna take us working together, and this is a structure by which it can happen. I would love to hear your thoughts. Please put your comments in the details below and enjoy.
So a warm welcome back to the podcast, Doug Short. Welcome back, Doug.
Doug Short: Thanks, James.
James Maskell: Well this is part two of a two part series that we’re talking about employer health, and we’re talking about functional medicine and new health. And I guess I just wanted to start by recapping. So last week, I shared with you and you shared your sort of story of finding out about functional medicine and why you’re interested in it. I guess the question … You know, we focused last week on this product Benicomp Select and we really reached out to the practitioners in our community to say, “Hey. If you’re getting paid cash right now for your services, this is a good opportunity for us to … It’s a sort of an opening to get functional medicine to the masses.” And maybe we could just start there. Why are people paying cash to functional medicine practitioners now the gateway to where we wanna go?
Doug Short: Yeah, actually, a lot of that changed with HIPAA and the ACA. So, it’s kind of an interesting collage. Back in the day, most employers had either a low deductible on their health policy or they even had, back in the day prior to HIPAA, and HIPAA’s 2007; prior to that, many of the big employers had two policies. One for the executive team and one for the rank and file. And the executive team had a low deductible and the rank and file, the factory workers, they all had a high deductible. Well, HIPAA made everything nondiscriminatory. So what happened is all those plans migrated: you could only have one plan. And the employer then opted for the cheaper of the two and everybody, even the executive, has the high deductible.
The second thing that you’d have to think about, James, is, back in the day, deductibles used to be 500 dollars. And then, all of a sudden, the world thought the highest deductible was gonna be 2000. And if any of those listeners remember, that was like a threshold for a HSA. You know, it was a number that was being thrown about.
Well, when the ACA came out, the deductible threshold was all of a sudden 6000. And it was a huge number and so all these employers then, they migrated their benefit plan because of HIPPA, that’s ’07, they migrated it to the single plan. Then in the ACA, that’s 2010 and that era … Then they discovered that the gap that they were creating was 6000 dollars or even 6000 times two if you’ve got a family. So it became-
James Maskell: Wow.
Doug Short: So it’s those people that are seeking out functional providers because they are … Those executives or the executives’ families, they have the means and they’re willing to pay cash. If you are just a normal traditional employee, many times they’ll take whatever the benefits of the company are. But in an executive’s case, they will migrate to, you know, “I want something greater. So I’m gonna pay cash.”
What Benicomp Select did is basically gave those people the way to have their cash payment pre-tax. And in order to accomplish that, it actually set up a data link between the employer and Benicomp. That becomes the key link, if you will, to the movement towards phase two, which is the Incenticare, which is how do we move the entire group into functional medicine?
And if I gave two over quick word analogies; the people that the functional providers see right now that pay cash, they are in most cases the executive or their family. But the other thing is, they are also leaders. And leaders … That’s one of the dynamics that is missing inside of health insurance, inside of groups, is they need a champion, they need a leader, they need a zelig. They need somebody at the top that is willing to lead by example and lead. And what has happened in the past is those leaders on health insurance have taken a hands-off approach and said, “We don’t care what happens, just let us know what you want done and we’ll pay the bill.”
Well, in today’s world, the bill is getting expensive and the leader now needs to find a solution and guide their lambs down a trail of solution: not added medication.
James Maskell: Absolutely, yeah. It makes total sense and so I just wanted to recontextualize this for everyone who’s listening is that, if you didn’t listen to last week, go back and listen to it. If you’re a functional medicine, integrative medicine, naturopathic medicine, if you’re one of those providers and you’re part of this ecosystem and you’re listening to this and you’re charging cash, or if you know that your patients are leaders within companies and you know that they’ve had good results with your medicine, so much so that they would advocate for this type of medicine within their organization, we need to be connected with them. Because that is the first starting point to be able to really understand, “Okay, if you’re ready to lead, we’ve got a value proposition up front for you, which is like all of the money that you’re spending at this clinic could be pre-tax and so ultimately your services are kinda becoming a third to a half cheaper,” that’s the first starting point.
But now we’re gonna get in to talk about what I’m super excited about, which is how do we bring functional medicine to the masses? That has been the question that has been on my mind for two years. Once we got the Functional Forum up and running and I could see that we were doing a good job of bringing new doctors across to functional medicine and we were sort of swelling the ranks, I then turned my attention towards: how do we get this for every American? How do we change the cost curve of American health at a population level? We need a lot more people getting healthy, staying healthy, getting off medication, and that’s what we’re looking to do now.
So, the product that we’re gonna talk about is a new product from Benicomp, and we’ll get into the details here, but it’s called IncentiCare and, straight away to me, the name just speaks to something that I’m really excited about, which is getting the right incentives for everyone to participate. Getting everyone the right incentives.
So, Doug, I know one of the cool things about IncentiCare is it actually has a really interesting story about how it started, why you came up with it, why you shelved it, and now why it’s back. So maybe we could just get into that.
Doug Short: Well the story is kind of interesting in the fact that this last year, in 2017, our company became 55 years old. So in that whole spectrum of time, of course, we saw PPOs launch. Where, prior to PPOs, there was Phifer Service, it was reasonable and customary; just go to any provider you want. And then, all of a sudden, there’s this restriction of PPOs and we’re going to point you a certain way.
Of course, the functional providers probably revolted, if you will, against all of this insurance mumbo-jumbo and how to fit inside of a plan. Well, back in the day, what we say is … I’m gonna use a word example of there … It’s like a good driver discount for car insurance. So, I’ll cast this word picture. There are really four types of insurance general categories. Life insurance, home insurance, car insurance, and health insurance. Now, there’s a lot of variance in between. Let’s say these four general categories.
Life insurance has forever given rate increases or rate decreases based on your lifestyle choice. I, personally, am a scuba diver. I always get rated for scuba diving. That’s a lifestyle choice. I could get rated for smoking, I could get rated for having a cancerous condition or even diabetes.
In home insurance, you get rated all the time for if you’ve got a brick home or fire retardant or a good roof for wind damage or a smoke detector. Or you live close to fire station or fire hydrant. All of those are underwriting factors.
In car insurance, clearly, if you have a DUI past your rates are gonna be different than mine. Also, your children will be rated differently if they get good grades or not. There’s a lot of factors that would grade based on lifestyle.
But health insurance, in sight of HIPAA, and then it really ratcheted down with the ACA; it was really socialistic, one size fits all, everybody’s in the same pool. And even personal choices, we cannot discriminate against. Again, HIPAA was an all encompassing nondiscrimination role. So it wasn’t that we won’t discriminate against somebody with cancer or heart disease, it’s now we won’t discriminate against anybody for any reason.
And that we had launched IncentiCare probably in ’04 or ’05 and we had made CBS news in ’07 … Oh, no, ’06. We made CBS news, nightly news, because we had proven that we could increase the number of visits that a person would have, but decrease the overall claims spend in a group. We had earned the award of the Best Business Practice of the Year from Sherm.
But then, the ACA came in and everybody’s moving to a single payer. It’s all government sponsored and it’s gonna be one size fits all. Well, at a certain point everybody thought that the pooling, the gathering of all these people was really going to drive the rates down and that has no impact. It’s pretty crazy to even think about that because it moves what’s called the delta point, James. And the delta point is the one year factor.
So, if you raise the deductible from 500 to 6000 you gotta premium discount, but from then on out your premium escalation is the same pace it always was. It’s just on a different delta point. So you didn’t change trend, you just eliminated one year of delta.
If I use another example, if you went to a car insurance company and they said, “We will give you a cheaper rate because we’ll eliminate the agent,” as an example. Well that might lower your rate by ten percent, but from there forward you’re escalating at the same pace as everybody else.
James Maskell: Yeah, nothing’s really changed, right?
Doug Short: Yeah. Nothing changed, you just changed the delta point. The only way you can change a health insurance plan, similar to car insurance or life insurance, the only way you can change it is by impacting the employee and having the employee get personally involved. That’s the next revolutionary drug, is employee engagement. Right?
James Maskell: Yeah, absolutely. You know, we had an incentive specialist on the Functional Forum once and he said that exact thing. He said that patient engagement was the next blockbuster drug. And one of the things that’s happening in functional medicine clinics all around the country is patients are getting engaged. I mean, typically, that’s one of the facets; participatory medicine is one of the big facets of a relationship between patient and provider that empowers the patient to participate in their care. That’s one of the tenets of functional medicine, integrative medicine, you know, whatever name you wanna call it, that’s happening. And so it fits very nicely with the IncentiCare ethos.
Doug Short: Yes, exactly. The other thing I think about as you just described that is the executive that comes in and is being seen by the functional provider now goes away with a feel of what’s going on. They look at that and say, “You know, I’ve figured out how to change my menu and improve my overall health. I’ve figured out how to increase my sleep and improve my overall health. I’ve figured out how to do these exercises and having a routine benefits my overall health.”
Well, now the ACA is kind of sun setting and it’s really on a spiral downhill right now. But inside of that going on, employers will be accountable for their health insurance. They no longer have the privilege of taking their hands off the steering wheel and saying, “It’s gonna be taken over by the government, I don’t care anymore.” It’s coming back to them. And thinking on a number of things in that circle, unemployment is terribly low right now. It is one of the lowest the country has had. And what’s that doing is it’s forcing the benefits into the employers because employers have for years used their benefits as a differentiating factor to recruiting and retaining people. So, benefits aren’t going away: they’re being ramped up. They’re trying to be used to motivate and recruit people. Oddly enough, when the ACA came in, the ACA thought, “If we mandate, we obligate, we shackle the employer and obligate them to provide benefits they’ll be more conscientious.”
And it’s actually the opposite. Employers are driven economically, I guess, and when unemployment goes low, the economy’s so strong and the unemployment’s low, benefits are a source of a differentiator to recruit and retain. And these employers see that, they want that, but they want not to have a double digit rate increase year upon year upon year.
James Maskell: Yeah, absolutely. So, one of the things that I’ve really appreciated about our relationship, Doug, is just really the schooling in where the ACA is going. Y’know, the first time that we met, which was back in the third quarter last year, I was not really aware of the sort of impact the Trump defunding was gonna have on future of the ACA. And then obviously the second time we met, when I came down to Tampa, was just at the moment when not only the defunding, but now the end of the mandate. And so just in this short amount of time, in the last six months, the trajectory of where health is going in this country has gone, in the last year, it’s gone 180 degrees.
I mean let’s talk about what would have Hillary done if she had won compared to what we see now?
Doug Short: You know, I was explaining to somebody the other day that of course Obama had two terms, and then Bush, but then you had the Clintons. The Clintons had two terms and Hillary, that would be 20 years ago, had a lot of movement towards … Back in that day, I don’t know if you remember, they called them the death panel. And what they were is trying to control the cost of healthcare by limiting or restricting access to care if in the last six months of life or if you were 85-years-old and, “I’m not gonna do that bypass surgery on you because the likelihood of you living greater than six months…”
Well that met enormous political challenge and it was just viewed as unconscionable. Well what was envisioned when Obama was leaving office, if Hillary would have been elected, there was a lot of business people that were looking backwards 20 years before at the path … She was actually on a stronger socialistic path than even the ACA. Well, as you know, when Trump magically got elected and even the night before the results came in I went to bed and all the pundits were saying Hillary was gonna win, and the next morning you woke up and Trump is actually in office.
Well he is 180 degrees of that. He is all about empowering the business, growing the economy, and then using the market forces to push the employers to providing more benefits. This is not a socialized program anymore, this is a program that is inspired by the employers wanting to retain and recruit employees.
And if I went down one other path, James, the movement of Trump has not been … He has not been able to repeal and replace. As the political discussions have been circled. But what he has been able to do is defund. So one of the critical things a couple years ago that really hit political problems was called the Cadillac tax. And the Cadillac tax was a penalty tax on health plans that got too rich. And that never came to pass. Even though it was talked about repeatedly, it never came to pass. At that time, the people in the insurance world felt that without that added tax, the Cadillac tax, without that tax the ACA would not be able to fund itself, would not keep the wheels on the bus.
Well then along that journey there was another tax that was vacated and was called the PCORI tax. People don’t realize that, but it was an internal tax that was levied against insurance companies. And that moved away. And then you move to the latest, which they removed at the beginning of the year they removed the federal mandate. Which will change the way people will come into the plan; they’re not obligated, they’re not penalized, they’re not taxed if they don’t come in.
So, you’ll see two other things that are changing. One of them that’s changing right now is the softening of the HIPAA discrimination rules. So as you look at that, James, I told you that that was one of the reasons we shelved this product: is because the HIPAA rules became so overwhelming and, in just the last month or so, they have begun to soften the HIPAA wellness rules, the HIPAA discrimination rules as they relate it to that.
And then the other one that you’re gonna start seeing, since Trump has not been successful repealing and replacing, the other one you’re gonna see is the subsidies for participants of the exchange. So, as it stands right now, the people that are in the exchange, they think they’re paying 200 dollars in premium and they’re not. They’re paying 1200 dollars, it’s just the government’s subsidizing 1000 of it. And if Trump were to remove the subsidy, if you see that subsidy going away, then that person will be met with the full force of that 1200 dollar premium and it’ll never float.
And then, on a social program, when the exchange came into place, the states: that’d be Florida, Indiana, Ohio, the states vacated their Medicaid programs. And they pushed all those people to the federal government. They all went on the exchange. And, as it stands right now, the federal government under Trump is trying to move all those people back to the states. That’s where they talk about block grants and things like that. But if they move that back to the states, the states will now have a hand in trying to get their arms around employee engagement, which is lifestyle, which is all of those things. In the absence of lifestyle, like I’m saying, in the absence of the employee being involved, there is no trend suppression that would come. It’s just a mathematical … Rate is nothing but math. It’s not trend, it’s just financing, it’s all that the rate is.
James Maskell: Yeah. So, absolutely. You know, so what I hear you saying is the functional medicine community has a lot of role to play in changing this and one of the things that I’d be thinking about is how do we scale up, right? We’ve got a certain number of doctors that are out there, we’ve tried to grow the doctor pool and when we were coming up with new health, the goal of new health is really how do we provide the functional medicine operating system for care at scale? And that means you can’t just have it with all doctors. We all love to have … If there are a million Jeff Gladds out there then we’d have no problem, but there isn’t. And also, Jeff Gladd and doctors cost a lot hour per hour as well compared to, let’s say, health coaches and other providers that can deliver a lot of the lifestyle pieces, which are really important for trend suppression.
And so, last year we started a sort of an experiment, if you will, to see could we get people well with mainly health coaches trained in functional medicine and then using the doctors to supervise those practitioners, but also to help with medication and more chronic types of things. And by October last year we had taken a couple hundred people through the process, the results were great, people were sticking in, but ultimately we always wanted to find a way to deliver this care platform which is made up of health coaches on the phone plus our practitioner network that we’ve been building for four years with the Functional Forum.
So all the doctors in all the states who are doing functional medicine, if we could combine all of them with this other layer of health coaching, could we provide function medicine to one hundred thousand, a million, ten million, one hundred million people over the next X number of years? And that’s the goal that we’re going for and last week on the podcast we talked about the fact that well over 150 million Americans get there healthcare from employers, and so this is the key thing that’s happening.
So, IncentiCare, and we’ll have more details about it on the site and the web, but why don’t you just share with us sort of for the audience what is special about IncentiCare and why employers would sign up for it even if they don’t care about functional medicine and why this is such an innovative product and why it matches so well with the functional medicine operating system?
Doug Short: Exactly. What we did a number of years ago is we talked to the Department of Labor, the IRS, we’ve talked to … We’ve gotten filing approvals from Departments of Insurance for a policy that is a health insurance policy that is driven to lifestyle. So, this has never been done before. Most policies are just universal policies to a deductible or a premium. Ours has the ability to leverage lifestyle.
There are really five lifestyle factors that the government sees: smoking, cholesterol, blood pressure, body mass, and glucose. Now the other things are considered health status factors and a health factor, you know, clef palate or heart disease or cancer, happened to you. Even a car wreck or plane crash happens to you. These five factors, the government has a definition out there that these five factors are driven by you.
It turns out, then, that Michigan State, Duke, some of these big universities have concluded that those five factors actually drive 80% of the claim costs. They are leading indicators, they are leading drivers of claim costs in the health plan. So by us having a plan that rewards or motivates people to control these things that they can control, their lifestyle, we can actually impact 80% of the employer’s health insurance spend. And what you’ll see through looking at the CBS news article, you’ll see that the rates actually can go down because the health plan is now paying what health insurance was intended to pay for: catastrophic … And what you’re avoiding is things that the employee can actually avoid.
I was thinking about … There was an article a number of years ago, James, with a union participant in a medical gown from his room, and this was in Forbes or one of these big magazines. And he’s pushing an IV cart just postsurgery and he’s got a cigarette in his hand. And the caption underneath it from the employee was that, “This heart cost me a ten dollar copay.” So his health plan was paying the bills, but it wasn’t helping him change what was causing the claim.
And what functional medicine does is it allows us as a … To link our two concepts together, I can provide the first economic reward system inside of a health insurance policy that is driven to employee engagement, but I need the providers that actually espouse employee engagement. Other conventional medicine providers tend to endorse diagnose and prescribe, diagnose and prescribe. And that has an unending escalation of cost to the plan. What we saw, then, years ago, was getting the employee involved in their own lifestyle care. Controlling what they can control. What we saw back then was that actually impacted the plan. CBS News did a story on that, Sherm gave us the Best Business Practice of the Year Award, and then they passed the ACA. And once they moved into Obamacare then everybody took their hands off the steering wheel and said, “I guess the government’s gonna take care of me for the rest of my life.”
And now it’s moving at a 180 degree shift. The employers will have the obligation, Medicaid will come back to the states, the shift will be that the employers will want to use their health plan as a retention and recruiting tool, and the employers will say, “We want this for our employees. We want a better benefit for our employees and we want to help our employees get better as opposed to paying for them to be sick.” Which is always ironic to me, James, that the health insurance system, the health insurance community, healthcare community is not healthcare, it’s sickness care. And it seems that the functional path is more about controlling health.
James Maskell: Absolutely, yeah. No, it’s really exciting and so, if I’m the HR manager or if I’m the CEO, I think that everyone who’s listening to this who’s a practitioner or maybe they’re someone who’s in the system or understands it can understand the value. Like, everyone, wouldn’t you love to have just a health coach on the phone? You could do telemedicine with, you can text, you can communicate with, it can help you execute the lifestyle stuff; all of that kind of stuff to have a functional medicine doctor if it’s needed.
I can see how practitioners would think that’s a good idea, obviously the employees in the company would say it’s a good idea. Just speak to a moment about the name IncentiCare because I know a part of it is that you and you as the insurance company make more money the more money that we save for the employer. And that, to me, is a really critical thing because I’m thinking, for the ten year trajectory of where functional medicine is going, what I wanna be doing with my time is going to other countries around the world and saying, “Hey, look, functional medicine can be the solution to solving the problems of noncommunicable disease!”
And ultimately I think that cost is so bloated the way they are now; one of the ways that we could get into these other systems is to be able to say, “Hey, look, we’ll just get paid on what we save you.” Because you know, the cost is so high now, there’s so much bloat, there’s a potential then. And I’d love to just sort of dive in a little bit to mean what does it mean to get paid on saving someone else money?
Doug Short: Yup. The first thing I would cast it is in favor of the functional provider. There are a lot of industries that we’ve seen in recent years that you would speak to that have been game changers. They have gone the opposite of what has been the way it has traditionally worked.
And I think about Amazon and how it’s just so dominant today, but there was a point where people were saying, “I don’t think we’ll ever buy things online and have them shipped to my house,” and now the Amazon delivery truck might come every day to your home. And they’ve made returns easier and …
The next one I think about is there was a … Somebody gave me a quiz question the other day and it was, “Who is the largest hotelier in the country and who is the largest taxi cab in the country?” And it really is Airbnb and Uber. What dynamic shifts. Those were industries ripe for change and somebody went in and actually changed it.
Well, medicine is the same way. Medicine has been diagnose and prescribe for years. It’s been beneficial to the conventional medicine platform for the nephrology unit to be filled. And what a dynamic shift to say, “We will control your trend, your expenses. We will help to manage that and control that by coaching, rewarding, IncentiCare, providing incentives to doing the right things. We will put that together and control your rates and we’ll add our revenue if your rates go down.” What a reversal of the entire space. We think that health insurance is the same space as taxis or hotels or retail shopping.
James Maskell: Absolutely, so, I hope what everyone’s taking away from this is that we have a champion in insurance that gets it and that understands the value of functional medicine. And we are working with Benicomp through IncentiCare. We are working to … essentially kNew Health is gonna be the protocol for IncentiCare. And what that means is that we’re gonna hire the health coaches and we’re gonna facilitate that delivery, but in every state, when we start signing employers …
And the big part of the tour this summer, the New Visions Tour, is too meet employers through what we talked about last week: getting them in touch with Benicomp, getting them set up on the Benicomp Select. That’s good for you because it’s gonna save money for you and for them, and then it’s also good for Benicomp and it’s obviously good for us too. And it’s good for the employer. Then we can start to sell them IncentiCare. And IncentiCare will have … If we were to sign, let’s say, an employer with 2000 employees in South Carolina, right? We would then need to provide enough health coaching for all those employees so they have, you know, everyone could have access. But ultimately, that’s gonna be maybe a hundred of those 2000 are gonna end up in the functional medicine office of a practitioner in that city if they’re in person or in that state if they are via telemedicine.
And we are gonna be launching in the next few weeks, you’re gonna be hearing about the new provider organization like the PPO for functional medicine. And that’s gonna be really facilitating getting all of these doctors together, getting all of our community together to be able to service this whole big new world that’s gonna open up through IncentiCare. Like our intention is to connect these companies to IncentiCare and then, as a result, when people are looking for trend suppression, when we’re looking to get people off drugs, when we’re looking to get people healthy, we can then tap into the countrywide practitioner network.
And so I just wanted to sort of share all of this at this moment because we feel like this is an inflection point for the industry. We feel like there’s, for everything that was said earlier, whether you’re a Trump fan or whether you’re a Hillary fan; at this moment it doesn’t matter. This is literally just the way it is. Right? This is the way that healthcare is today. And there’s no point sitting around wishing it was something else.
It’s about actually taking advantage of the moment that sits in front of us. And I think that the opportunity for the functional integrative medicine community is much stronger today than it’s ever been because we have the solution for chronic disease. That’s the first thing that I ever said on the Functional Forum, is that we’ve gotta start acting like we’re winning and stop acting like we’re losing. Because, as Doug is telling you, there is no other way to trend suppress apart from getting people to engage and participate in their care. And that is what is happening at your clinic and clinics all around the country.
And so I’m very, very excited to be sharing this with you. You know, if you have questions about this, feel free to put it in the comments below and we’ll be able to answer questions, but ultimately the reason why we’re putting this here is one: for you guys to get excited about the tour. Right? If we can sign five or ten employers in every stop around the tour, we’re gonna open functional medicine to a million more people this year. Like, that’s the plan, that’s what we’re looking to do. We wanna meet employers.
The best way to meet employers is to tell them about Benicomp Select, because it’s an easy starting point for them to basically save money on the money that they’re already spending in your clinics. And once Benicomp is connected to the executive team, who are already doing functional medicine, then we can talk to them about using IncentiCare. Companies by and large make their decisions about what they’re gonna use for their health plan in the summer. Right? July to October. Right, Doug?
Doug Short: Exactly.
James Maskell: Yeah. That’s what when we’re doing the tour. So on that part of the tour, when we’re going around city to city, we wanna meet the HR managers, we wanna meet the CEOs, we wanna meet those champions that already get functional medicine and show them there is a health insurance that you can get that is run by a 55-year-old company, that has proven to work and that is now giving everyone the incentive to get healthy, giving the company the incentive to keep everyone healthy and have people participate in the wellness program, and also to give everyone the opportunity to interact with the functional medicine operating system: initially via coach, and then with the doctors depending on the sickness or the relative sickness of the population.
But, ultimately, this is gonna bring massive demand to our ecosystem. And one of the things that we’ve been speaking about for a long time on the podcast is are we gonna be ready to meet this demand? Are we ready for the tsunami? And what I hear today is that the tsunami is coming. It is kNew Health to coordinate this in a way, to coordinate the practitioner organization, to coordinate the doctors and match them to employers. And so, if you’re listening to this, send this to a functional medicine doctor that you know. Another colleague, a friend, another health practitioner. If you want a job as a health coach we’re gonna need a lot of them. You can get in touch with us at knewhealth.com and we’re gonna coordinate it.
And one of the things that I know practitioners are scared of is interacting with insurance based on previous history. This is a very different game that we’re playing. Dr. Jeff Gladd, who’s our Chief Medical Officer, who’s the sort of connection point between Doug and I: Jeff left insurance too. He understands what it means to run an insurance practice and we are building it from our end to make it an enjoyable experience for the doctor to mean that our doctors will work less hours and make more money than the average primary care doctor, or certainly the average functional medicine doctor.
And that, ultimately, we can create a structure whereby which a million, ten million more people can have access to the functional medicine operating system or we can start to set a trend of trend suppression that echoes not just through the American medical system, but through every other country in the world that’s looking to America to say, “Hey! You guys invented chronic disease. You exported McDonald’s and Burger King and whatever all around the world. Have you got any solutions for it?”
And we do have the solution. The reason why functional medicine is way further ahead in America than it is anywhere else is one, because Jeff Gladd’s from here, and two, because we have this history of entrepreneurship, right? In no other country did doctors just hang their own shingle and do their own thing to the degree that they do here in America. And that works for us too. And here is an entrepreneurial opportunity coming through this health insurance, and, rather than hoping that all of our doctors are just gonna get it, we’re gonna step up through kNew Health and facilitate it and ultimately bring patients to you clinic, pay you a very competitive rate for your skills, and ultimately make it easy for all those doctors that I know want to do functional medicine, but just don’t want to be an entrepreneur. And, ultimately, that’s a huge group and that’s a big, big group that we’re looking to solve.
So, bit of a rant from me at the end of the podcast, Doug, but I had to do it and I really just want to appreciate you for having the vision and forethought to create this kind of thing, for making the mental connection between what you’re trying to do and why functional medicine as a community can do it, and yeah. Just any last thoughts before we end up here?
Doug Short: Yeah, I’ll make two. The first one is while this is economic for the functional provider and it is a dramatic change in the same light as Uber or Airbnb or Amazon would have been a dramatic change, this is for the social good. I was at a conference recently where one of the largest pension firms in America was describing that the number one delusion of pension assets is employee health. As the employee goes out into retirement and they take poor health practices with them, they eat up their pension, their retirement, their savings, with deductibles or unfunded claims. And you know that the Baby Boom is actually approaching retirement. So there will be an explosion of retirees and the Baby Boom.
The other thing, you had mentioned it there at the end, James, but entrepreneurship: this is being endorsed right now. Highly, by the Trump administration. They are looking for solutions as opposed to the mantra of this past, was everything’s going into a single bucket, so to speak. They’re endorsing that. They are not restricting us, they are actually opening the door. What makes IncentiCare and Benicomp unique is, oddly enough, we had this program built and its all in place. It meets all the federal, legal, local, state guidelines. And it has been approved, but was put on a shelf. It may never have seen the light of day had Trump not got elected. But with the reversal of the way the exchange is moving, the Medicaid people are now more interested in controlling this than ever.
And then, James, from an insurance company, the last thought I wanted your people to understand is there is a mathematical formula called Rule of 72. People have heard that phrase, but what is means is the rate of an increase divided into the number 72 will tell you the number of years from which that rate doubled. So if the rate increase currently is in the 14 percent range, it’s not a big mathematical formula to say that in just a half a decade away, we’re gonna be paying twice what we’re paying now because that’s the rate of increase of trend. The rule of 72 is just a mathematical formula. It just is what it is. So you must bring that number down or health insurance will become mortgage payments. It’ll surpass homes and other things.
James Maskell: Absolutely, yeah. That’s what we’re trying to do something about. So, Doug, I really wanna take this time to share my appreciation again for everything that you and your team are doing. I’ve had a chance to go down and meet the whole team there. Dr. Gladd, who’s the Chief Medical Officer and the hero of my book, and a guy that I’ve been in sort of collaboration with, ultimately, for six years, he really transformed the Functional Forum by talking about the micropractice revolution and how we could actually start to really grow the number of functional medicine doctors by advocating for this sort of low overhead practice model. So he’s been a constant thread all the way through the Functional Forum and, by making this connection, I think what we have is the opportunity now to be able to, in the next three years certainly and possibly in the next seven or eleven depending on what happens here, to be able to really have a seat at the table for what the future of medicine looks like and employers are providing health to the majority of Americans.
And my ask, if you’ve never bought anything from the Functional Forum before, if you’ve watched our forums, if you’ve listened to our podcasts and you’ve got value from it, but you’ve never given me any money or our company any money, you’ve just been sort of in our ecosystem; you’re welcome and thank you for being part of it. I will just ask this of you: if you know people who are in positions of authority in companies who care about functional medicine, we wanna meet them and we wanna introduce them to Benicomp. And we wanna find ways to be able to get their population healthy, to save people money and so, yeah, that’s my final thought.
So this has been the Functional Forum podcast, this is part two of a two part series called “Meet the Health Insurance CEO Who Loves Functional Medicine.” We’ve been with Doug Short from Benicomp. For more information about benicomp you can go to Benicomp.com or you can go to goevomed.com/incenticare. That’s goevomed.com/incenticare. And on there you will see all kinds of graphics. They’ve got incredible info graphics about why IncentiCare works and what it does. So check out those websites.
Thanks so much for listening, and we’ll see you next time.
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