Episode 111: Why You Should Unbundle Your Health Insurance with Katy Talento

The most obvious statement we can make about the US health care system is that it's a mess. It's complicated, expensive, and rarely delivers what patients expect. A large part of the problem is because we use employer based insurance products where there is little incentive to control costs or provide the kind of care the patient wants. It's all about incentives and they are placed a long ways from those receiving the care - the patients.

The unserious answer to how you fix the health care system is to blow it up and start over. As the largest sector of the economy that hires the most people, there are far too many interests in keeping the system just as it is. Although there might be a sizable electoral will to change things - there isn't any genuine appetite within the industry or politicians to truly start from scratch or honestly address the problems. The solution will have to come from entrepreneurs, employers, and patients.

How Can Employers Fix Health Care?

Katy Talento is a health care consultant at Allbetter.health and KFT Consulting with an extensive career in federal health care policy. She worked for 5 US senators and early with the Trump administration serving as the head of the domestic health care policy team. Simply put, she understands the US health care system. She knows the players and the hurdles faced by those looking to reform it. Through this extensive experience, Ms. Talento brings a lot of innovative ways to save money for employers and create a better experience for their employees.

We all know that people have to pick their insurance either on the marketplace or through an employer. We've discussed the right way to pick insurance options before on the show. But Talento brings a way for employers to specifically save money by unbundling all of the components of the traditional insurance plans offered by carriers.

What is Unbundling?

Talento allows businesses of various sizes to self fund the insurance care for their employees by bidding out all of the aspects of a traditional plan. This means she acquires a company for processing the claims, a pharmacy benefit manager (that doesn't take kickbacks), deals with hospitals, specialists, imaging centers, and finds a cadre of direct primary care physicians to provide the bedrock for coordinating care.

Savings from this technique usually save at least 20% for employers and often provides much better coordinated and personalized care. Also, the care can happen with much more reasonable deductibles and other incentives which will make the employees much happier.

How Can You Protect Yourself?

Finally, Talento says if you go to the hospital or emergency room, it is important to protect yourself from hidden or unexpected charges. Few people know that when you sign the release form entering the ER that it also includes a provision where you agree to pay your bills at whatever the hospital and their agents charge. She recommends that you fill out a battlefield agreement with the hospital or emergency room. Essentially, you agree to pay no more than 1.5 times the Medicare rate for any services you receive in while getting treated. An example emergency consent form can be found here.