Health Insurance As A Casino

David 0:00

What if the reason your health plan keeps getting more expensive isn't bad luck, but the fact that you're playing a game designed for you to lose? And what if you could finally flip the odds in your favor? We'll find out on this episode of Shift Shaper.

Announcer 0:16

Change either energizes or paralyzes. The choice is yours. This is the Shift Shapers Podcast, bringing the employee benefits industry interviews with individuals and companies who are shaping the industry's shifts. And now, here's your host, David Saltzman.

David 0:35

And to help us understand all of this, we've invited my friend Mark Gaunya, principal at Borislow Insurance, and more importantly, for today's conversation, founder of Captivated Health. Mark brings more than 30 years of experience in employee benefits and is a nationally recognized advocate for transparency, consumer-driven health care, and innovative health plan design. He's the author of the new book, Captivated Health: Take Control, Gain Transparency, Leverage Confidence", a guide for employers who are tired of taking that less bad renewal and want to turn their health plan from a volatile expense into a strategic asset. With that, welcome, Mark. Thanks for being here. Thank you, David. Always a pleasure to be with you. And congratulations on the new book. It's really awesome.

Speaker 2 1:19

By way of full disclosure, Mark and I worked together for a few years in the early, early days of Captivated Health. So I can tell you the book is a really good representation of the journey and the benefits for folks who are interested in that kind of relationship with their, with their um, with their health insurance. So you describe health insurance, Mark, as a casino where the house always wins. What do you mean by that?

Mark 1:40

So I was struck when I was there uh a couple years ago. Uh I got remarried in Las Vegas and I was sitting in one of the casinos, the wind casino, actually, and just taking all taking in the uh the experience that they create for everyone who co comes out to Vegas and and and gambling. And I marveled at all the opulent decoration everywhere and saying, you know, a house always wins. No matter how good you think you are at a particular game, I happen to like blackjack, um, but there are other games that you know you think you're winning, you're you're really not winning. Uh you're just learning how to play longer. So you go with money, you hopefully you can string out your uh, you know, your good time while you're there. And and I think when I think about the healthcare system, I I I just made that cross, that, that cross-reference because I feel like the healthcare system is not designed for the end consumer. I believe it's designed for the four rulemaking entities that created it.

Speaker 2 2:39

Yeah, you know, when when people say that the system is not working, answer is yeah, it's working great.

Speaker 3 2:44

It just wasn't designed for you, right? Correct. Exactly. I people say that to me all the time, Mark, healthcare is broken. I'm like, it's not broken. It works exactly the way it was designed. You have the federal government who controls Medicare and Medicaid, that's roughly half the population. And the other half of the population is covered on private health insurance. And the three rulemakers, in addition to the government, are big hospital systems, uh, the blue, the BUCAS, Blue Cross United, Cygna, Aetna, uh, in terms of uh the large health insurance companies in the country. And then you have PBMs who control the supply and and price of medications. So when you look at the four of them together, they created what we call the American healthcare system.

Speaker 2 3:27

So why is it that so many employers feel that though they're stuck in what you call the less bad renewal cycle year after year after year?

Speaker 3 3:34

The reason I frame it as the less bad renewal cycle is because you don't have any control. Or a plan sponsor is actually the insurance company when you buy an insurance plan from one of the BUCAs. And as a result of that control they have, they also don't share any claim information. And when you have no claim information, you have no way of understanding what you're paying for. I I've said for years, actually, as you know, at Zealot for transparency. And you can't see something, you can't measure it. If you can't measure it, you can't improve it. And so that's what I mean by the less bad renewal is every year your broker will come out to you, and your broker does the best job they can do for you finding the highest quality plant at the lowest possible price. But the the reality is you don't have the information. He or she does not have the information to actually do the analysis on is this a, you know, is this a favorable risk or not favorable risk? And what are some things that you can do to mitigate that rate increase? Instead, you're forced to change ID cards, moving from one of the BUCAs to the other. You're forced to water down plan design in the form of higher deductibles and co-pays and more cost share for the member. Or you have to take more money as an employer. You have to take more money out of people's paychecks, which in many cases they get a married increase of 3%, and their health insurance costs increases are 10 or 15%, and it eats up all their uh their wage increases. So it doesn't create a very good scenario for the employer or for the member covered by their plan.

Speaker 2 5:03

Before we get into the details, the nuts and bolts of how captivated health works and why it's been successful, what inspired you to write the book and who is it for?

Speaker 3 5:12

So inspiration for the book came as a way to tell the story a little bit easier. Find when you, first of all, if we're being honest, no one really wants to talk about insurance. It's boring. Unless you live in the environment like we do. Most employers and people I talk to just want it to work because they pay a lot of money for it. In fact, the average, what the average family plans, like $25,000, $27,000 a year. It's like buying a used car every single year. People just want it to work the way it's supposed to work. So I wanted to use the experience of our clients on this platform to tell the story. So it's not an insurance guy talking about insurance things. It's my clients, our clients talking about their experience on the platform and in their own words. There are 10 case studies in the book, and they're not my words, they're our clients' words about their experience. And I I think and I know you be a big believer in this, stories are help people really understand things. And my my entire mission with this book was to help people understand how they can take control and leverage scale through a captive insurance environment if they're a middle market employer, so that they can mitigate the risk of being self-insured, because the only way they're really going to change their less bad renewal is to get off that hamster wheel and become on some form of partial self-funding.

Captives Versus Self-Funding

Speaker 2 6:34

You know, I think for a lot of people, captives are either not understood or misunderstood. In a nutshell, what's the difference between a captive and a self-funded plan?

Speaker 3 6:46

So they are very similar. They're in the same family, right? They're in the partial self-funded family. Unlike traditional self-funding where an employer purchases stop loss coverage, both specific and aggregate stop loss coverage, specific for individual limit of liability and aggregate for the entire group's limit of liability, that still exists in a captive environment. But what also exists in a captive environment is a middle layer of risk sharing called a captive, which allows through a series of contracts, unrelated organizations to individually self-insure their own company's risk, but then share that risk with other like-minded employers to create scale and mitigate the volatility of what everybody worries about, which is large high-cost claimants that are unknown. But there's still stop loss insurance involved. Absolutely. So a portion of the stop loss premium that middle market companies pay when they enter into a captive is channeled into a middle sharing layer called the captive layer. So I'll explain it uh with a couple of examples. So the first is uh let's take a half a million dollar uh claim for a premature delivery of a baby. Not unusual in today's environment to see a half million dollar claim for that type of that type of event. So what a captive offers is the ability to share that large claim with other people who are also purchasing in that captive. So I'll use the example of a company who has, I don't know, 50 employees and they have a $50,000 specific deductible. So in the example I gave, that first $50,000 is covered by the employer. The next $300,000, because that's the captive layer, right? It's a shared risk layer. It's called a floating deductible. It doesn't sound really, you know, uh professionally scientific, but that's what it is. It sits on top of a specific deductible. And the next $300,000 is shared, right? It's paid by the captive layer, of which that organization's a member and has paid premium, in addition to the other members who are also members of the captive and also paid premium. And so that money, that $300,000 is pulled from that middle layer of sharing. And then the remaining $150,000 is carved off and paid by the reinsurer. So that's the example in a captive structure of how an individual claimant works. And just like traditional self-uh partial self-funding, there's an aggregate in place to protect the employer should they have a bad year. So in the example I gave you, let's say the employer was told they were going to have half a million dollars of claims in a particular year. There is an expected claim number, and then there's a maximum claim number. And typically the maximum is 120 or 125% of the expected number. So that aggregate acts as a cap of a limit of liability for the middle market employer. So when they enter into a traditional cell phone and they know what their worst case scenario is. And then the third and final component of risk transfer in a captive is the entire captive structure itself. So let's say we had 10 employers in a captive structure, and seven of them or eight of them had a really bad claim here. Chances are that middle layer of risk sharing premium is going to be uh going to be exhausted. And so the reinsurer steps in and protects everybody's limit of liability should should that happen. That's the magic of a captive structure, is the three risk transfer mechanisms that it includes, but that's not really the power of a captive. And we can get into that.

Speaker 2 10:12

Well, and that's that's where I'd like to go next. I mean, what differentiates captivated health? And I'd like to start with the four principles of self and self-governance.

Speaker 3 10:20

So that is what separates captivated health from other captives in the market. I would say first that Captivated Health platform was built to be like building a custom home. It's not like some of the big box store captives, I won't name their names, but there are others that operate. They say they're a captive, but they don't really operate like a captive, uh, at least not a custom-built captive. So our platform has been created to be customized for a particular industry or affinity group. Um, the four principles inside Captivated Health, the very first one, and I'm sure you won't be surprised to hear this, is members first. Uh, everything we do in the Captivated Health platform is about serving the end user. In fact, I often challenge our team. You may bring forward something that saves money, but if it's not something you or your family would take advantage of for whatever reason, I don't really want to entertain it as part of the as part of the community. We already have a system that tells you what to do. Telling you what to do, it's suggesting things that you should do to help um better take care of the member. So that's principle one. Principle two is consumerism. Um my big belief is, and the Kaiser Family Foundation backs this up, that our healthcare literacy rate in this country is abysmal. Uh 14%, which means roughly nine out of 10 people have no idea how to speak the language of healthcare. And if you've ever traveled internationally and you don't know the language, it's really hard to navigate places when you can't connect with people through through communication and language. So the second principle is about teaching members, but also teaching the employers who are sponsoring these plans the language of healthcare so that they can be um literate and then make better decisions. The third principle is creating a culture of health and well-being. And it's not just about physical well-being, it's physical, it's financial, it's community, it's um mind and body and spirit, and it's about the workplace, right? So physical, financial, workplace, community, and mind and spirit. Those five elements are really critical uh to build a culture of health and well-being, and ultimately create a culture that helps your business, your organization be more competitive because you're looking after the overall health and well-being of all of the people uh covered at your company. And then fourth and finally, and you alluded to it a little bit ago, uh, is our self-governance principle. Uh, when we constructed the captivated health platform, we were working with our existing clients. And one of the things that they were really passionate about is making sure their voices were always heard. And so I designed the bylaws. So each cell has a set of bylaws. And I designed the bylaws like our United States Senate, where everybody gets an equal vote regardless of size. And if we're going to pass any measure that affects the entire captive structure, in other words, it affects every member organization, then we need a two-thirds majority vote in order for that measure to pass. However, just like our United States, each entity has the ability and the control to do the things they think they need to do with guidance from us as their broker or consultant, the things in data-driven that they can do to actually help improve their planned performance. And then we have a structure, a governance structure that the members elect a chair and a vice chair that serve two-year consecutive terms. So you have consistency of leadership. And then there are, when the cell gets big enough, you have four um committees underneath. You have a governance committee, a finance committee, an engagement committee, and a membership committee. And those four committees are populated by HR and financial professionals who give back. In fact, the bylaws date, you need to serve two out of every four years of being a member. And the reason is it's a participatory community. You're participating in your own health insurance plan, but you're also participating in the greater good of the entire community.

Speaker 2 14:17

And that's made that's made a huge difference. I mean, I I can remember talking to some of the members early in the early going, and it was simultaneously exciting and very foreign to them because they were used to having either fully insured plans or self-insured plans where they rode the wave, but they really didn't have control of the steering wheel. And now you've given them the keys to the car and the steering wheel, and it's kind of made all the difference in the world. And that's that's kind of been responsible, I think, for a lot of the growth and the persistence of the groups in the captive. Just from, you know, from a broker standpoint, one of the things you want is persistence. And um I I I'm sure it's still going on since you and I parted ways, you know, professionally. Um, but a lot of the members of the captive will refer other members of the captive, refer other schools, which is kind of what you guys are are focusing on, to hey, you got you got to look at this, you got to try it. And they become your best salespeople, don't they?

Speaker 3 15:12

They do, actually. And and you're right about the stickiness from a broker perspective. Um, it's very sticky because you've given the members the control of their future, and all we are is the Intel chip inside. That's how I refer uh to what we are. Um we're we're there for navigation, we're there for analytical thinking, we're there for strategic thinking. It is uh it is very rewarding, I'll tell you. We have an annual meeting of the membership every year. And by the way, we're doing more than just schools now. We're doing uh other brokerage firms in our family of brokerage firms. We're getting ready to launch one for nonprofits. We have one that's going up for a franchise. I can't name the name of it, but um, so the Captivated ELF platform has been designed to be replicated by industry or affinity groups. So it's not a heterogeneous platform, it is a homogeneous platform. Um so what I was about to share with you is it's very rewarding to sit back in the annual meeting of the membership every year where they're all presenting things they did in the prior year to improve the value for their employees and improve the financial performance. And when we started this in 2014, to now listen to some of the CFOs have been in that room for over a decade, they speak the language as fluently as you and I do. They understand when I talk about uh a specific deductible and leverage trend and pharmacy and PBMs and rebates and all the things, all the technicalities that we live in, they actually understand it over time. And so you can have a much more meaningful dialogue and teach them you really have three areas that control the value of what you're providing and the cost of what you're providing. You have your summary plan description, your SPD, which basically lays out what you're gonna cover, what you're not gonna cover, limits of coverage, all the rest. You have your stop loss contract, which protects you uh when you have unforeseen liability, and there are levers you can pull in that to decrease or increase spend. And then you have your TPA services agreement, and the TPA services agreement is the agreement that that helps execute your summary plan description and your stop loss contract so that it's all tied together. And when employers understand that they have ultimate control over those three levers, it's fun to watch them play the game of healthcare. I'll just say it that way.

Results Schools And Employers See

Speaker 2 17:30

What are some of the results? Now now that you've got members who are thinking as owners, which is very different than any other part of the healthcare system, even to a large extent, a lot of plain old self-funded plans, they still don't feel as though they're the owner, even though they they are, but um, they're not as involved in all of the maffinations of how the plan runs, what's brought to the members and whatnot. There there have been some significant financial events that have also afforded these members of the captive to do some very interesting things. Can you talk about those things a little bit?

Real Stories Bundled Maternity And LASIK

Speaker 3 18:02

Sure. I'll say in our oldest cell, which is you mentioned our private schools, uh, we've helped these schools over almost 12 years put over $40 million on their balance sheet. Money that would have gone to the health insurance carriers, the PBMs, um, and the large hospital systems, the rulemakers that I talked about before. Instead of it sitting on their balance sheets, it sits on our clients' balance sheets. We've cut claim claim trend in half. The market's around 8.5% to 10%. Our claim trend hovers in the 4% to 5% range. We've taken control of pharmacy spend because we actually carved out our PBM contract. The entire captivated ELF platform has a PBM contract that exists for three years and then comes up for renewal and we go out to market again. We actually put our clients six years ago into a PBM contract that was with a transparent provider. Uh, it was no spread in the pricing. And then rebates that flow through, 100% of the rebates flow through back to the plan sponsors after they've been on the platform for six months. And so by taking control of that spend, instead of it growing at 20 to 25% a year, we're half that amount. Pharmacy costs are are still rising. In fact, for a period last year, we had negative pharmacy trend. We don't know, um, but we did have negative pharmacy trend for a period of time and distributed millions of dollars back to back to the planned participants in the form of in the form of rebates. The other area that we've taken control of is you price that captive layer that I mentioned before to break even. Um, that is the way it's priced every year because otherwise it'd be like getting taxed too much and then waiting for a refund check uh from the government. But some years you do perform better. And when you perform better than expected, it creates this thing called surplus. And when you have captive surplus, every member of the community gets a prorated distribution based on what they paid into the that shared layer. They get a pro rated distribution of captive surplus. So between pharmacy rebates and captive surplus, we've we've uh distributed close to $15, $16 million back to uh these organizations that would have otherwise been profit margin in the rulemakers that I talked about before. I'd like to give you a couple of stories, though, of how we've actually performed better. And I can give you a couple examples of organizations and their willingness to be innovative. So we have uh one school in your backyard in Nashville, Tennessee. Uh I'll leave the name of the of the school out for now. Um, but the uh school, we noticed it's an all-girls school, and uh they have a high maternity risk, as you might imagine, having a lot of women who are are childbearing age. Um, amazingly enough, in the in the area of Nashville, it costs $100,000 to have a baby. Um it's not what the member pays, but that's what the whole billing cycle shows. Absolutely insane. $100,000. So what we did is notice that that was a risk in their data. And we went to the CFO and said, we we are gonna point this out to you in terms of the insight we now have on what's driving your claim experience. And we're gonna negotiate a bundle contract, which we did with the Vanderbilt Health System that gave the expectant mother who decides to participate or not, because again, remember it's members first, you don't have to do it. Um, but ultimately gives that that expectant mom and a physician for 12 months, nine months during pregnancy, three months postpartum. And then uh the claim cost, instead of it being 100,000, was discounted to 50,000. So literally cut the unit cost in half. Because the platform is about members first. The CFO said, Well, I'm not gonna force anybody to do anything they don't want to do, but I'm gonna implement a shared savings model. And I'm gonna give any expectant mom who enrolls in this program free diapers and wipes for a year. That's four a four thousand dollar value to a young. Family. That's also very expensive. Diapers and wipes are very expensive. But what the CFO is able to say is I'm going to provide a better experience for you. It'll be a more pleasant experience for you. It's going to be less expensive for both of us. And I'm going to share some of the savings with you. So I saved a hundred, he had three people who signed up for it last year, and he cut his maternity claims from 300,000 to 150,000. And he shared 12,000 of that 50,000 with those three expectant, expectant moms. And so that's a way as an example of lowering your claim spend, improving the quality, improving the price, and include improving the experience for the member. I've had other uh organizations who've said, Mark, do you know that you know I'm only a hundred employees and I I have I am paying the same insurance costs now that I was six years ago? I'm like, yeah, I'm aware of that. And do you know that I actually have a million and a half dollars on my balance sheet? And like, yeah, I know that too. And then it got quiet. And then I'm like, okay, well, what's wrong? Oh, I've been getting ripped off for years. And that's not okay with me. I'm like, yeah, but you're in a better spot now. Yeah. He goes, and I get I could have I could stop my health insurance plan today and with the money on my balance sheet pay for the entire thing for a year. He goes, but I had my auditors leave and I have too much money in my health care reserve account. And I just started laughing. He's like, Why are you laughing? I'm like, because we've never had this conversation. You have too much money on your balance sheet, earmarked for health insurance. He's like, Yeah, but seriously, I got to do something about this. What do you suggest? I'm like, well, you could stop taking more contributions out of people's paychecks, right? Premium sharing. Now we did that two years ago, Mark. I don't want to touch that. I'm like, okay, well, you offer a health savings account and you fund roughly 30, you know, 33% of the deductible. Why don't you do a little bit more? He goes, actually, we do 50% now, Mark. We did that last year. He's like, you're not helping me. I'm like, okay. Um, through our health culture of health and well-being um algorithm that we've developed, we found out through a member survey that your people want access to LASIK eye surgery. Oh, well, I can't do that. That's not covered by health insurance. I'm like, it can be. It can be. I'm like, yeah, you can build it. Remember the three documents I talked about? You can build it into your summary plan description to have it be a covered benefit up to a specific dollar amount. I can? I'm like, yeah, so let's model it. So we came up with 500 bucks an eye or a thousand bucks a person. He was a hero uh to his employees because he listened, they listened, he listened to them. And then he built a plan design that gave them the benefit without costing him more money. Yeah, he was spending down surplus, but he needs to reinvest those dollars back into the value of the plan. Those are the kinds, I have many, many more stories. Those are two off the top of my head that I love to tell because that's the environment that the employer gets to once they transition off the hamster wheel into the self-funded. It doesn't happen all at all at once. It's a three to five year journey to get to that point. So never ever buy self and self-insurance if you're thinking about doing it for one year only. This is a multi-year strategy. And it's a multi-year strategy that gives you the control, gives you the data, and gives you an opportunity to actually change and improve your performance.

The Leadership Mindset Shift

Speaker 2 25:18

So, what mindset shift is required for leadership teams who who might want to think about doing this after years of being fully insured?

Speaker 3 25:27

What does Einstein say, David? The definition of insanity is doing the same thing over and over again and expecting a different result. If you don't get off the hamster wheel of a less bad renewal, you will continue to get the answer you don't like, which is your broker tells you, I think you're getting to 25, I'm gonna go 25% increase, I'm gonna go do my thing, I get you down to 12, and you're like, yeah, 12%. That's horrible. When everything else is going up by 3% in your life, right? That's CPI. First mindset shift is you want to take control. If you're looking for the easy button and press the easy button, you're not gonna get the answer that you want to get to. And I'm not saying this is like, you know, heavy lifting. It because if you have the right broker partner who can guide you through this and and knows how to walk you out of the hamster wheel into this type of environment, it doesn't have to be painful. But to answer a question specifically, it's a mindset shift of I want to be, I want to move from system decision to self-decision. That's that's step number one.

How Hard Is Implementation Really

Speaker 2 26:28

So if somebody wants to get started in this, in this process, what do they need to do? And and and is there more, I mean, obviously they're involved in a lot of decision making and there's some you know work up front to set it up and whatnot. Is it onerous or is it something that you can do without having to hire four more people in your HR staff?

Speaker 3 26:47

Yeah, nobody, that is the biggest misperception uh that I'm gonna have to hire an additional person to administer moving into something like this. And the the truth is, not one organization we've moved into this platform has had to hire somebody uh to do the work. What it does involve is change in the finance office and the way in which they account for things, right? Because you're now moving things from the uh operating statement, the PL, to the balance sheet. So there are some accounting tools you'll have to learn about how to, you know, how to account for that properly. You'll have a couple of bills a month as opposed to one big premium bill. You're gonna have your fixed costs, which include your stop loss coverage and your TPA service fees and your broker fees, all those types of fees. But but you're also gonna have claims costs that you have to cover, right? So instead of one bill a month, you're getting a couple of bills a month. Um, there is a bunch of paperwork on the front end uh that has to be filled out. And it sometimes it feels like buying a house. So I will say initially, like, oh my God, look at all these documents I have to review. That's the reality of getting into a captive structure where there are unrelated entities or sharing risk. There are things that have to be done from a contractual standpoint uh for that uh that dynamic to take place. So there's work on the front end to come into this type of design. But once you're in the design on the platform, the work actually becomes routine to you because you start to understand the flow of how things work. For HR, it's a godsend because now they're able to actually look at what am I doing to add value to people so they'll stay? And how do I attract people by offering certain things I know will be attractive? One of which is can you keep my premiums pretty consistent year to year? Because if you're taking more money out of my paycheck, every merit increase I get is disappearing in the form of higher health insurance premium contribution. So that's not really a winning notion. And we also provide on our platform access to a concierge. Our HR professionals love it because they now have a digital front door for members to go to. So an employee shows up on your doorstep, instead of you being the one who has to furnish the answers or do the research, you're now able to say, uh, you can go to the captivated health concierge uh service to get that question answered for you. Up front, there is work involved transitioning in. So I'm not going to diminish that. But once you transition in and you then are assigned a client consultant who who's working with you on your data, working with you on the connections, working with you on how you can actually improve the value of the plan, the work is far outstripped by the ROI you get in terms of the ability to take that control and to actually improve the experience and the performance for your people.

Why Transparency Stays Elusive

Speaker 2 29:33

We've got a couple of minutes left. I want to ask you a question that's kind of captive or even health plan adjacent. And I know it's a passion of yours. Why has transparency been so damned elusive in healthcare? I love that question.

Speaker 3 29:45

Uh well, fortunately, uh after 2020 in the Consolidated Appropriations Act, that was when transparency of price and quality actually uh was first uh cemented into law. And then now, most recently in the Consolidated Appropriations Act of 26, it's now taken the next step um in the level of transparency. So the good news is the laws now require um transparency of the players that we've been talking about. The bad news is and until we create poster children, that's what I call them, uh, people on the side of the road who are getting tickets by police officers, I'll use that metaphor, um, it it really won't work. Uh and when I say it won't work, the short answer to your question is people don't people don't want to disclose the things they're doing that are inflating the cost of health care and health insurance. That's the short answer. Um private equity is infiltrated. And look, I'm part of that private equity community too, uh, through our organization, um, Broadstreet, but we're we're not really traditional private equity. So it's not all about squeezing every last dollar out of the PL at the expense of the member, right? We're focused on really helping our employers and members have a better experience. But transparency isn't a thing, right? I often say this too, David. Transparency is a principle. You know, and people say transparency doesn't work. I'm like, well, what do you mean? It's a principle. Of course it works. What we do, the tools we create through that transparency, right? So when we have, that's why they said you got to have uh healthcare price and quality and disclosed in machine readable format. Why? Because then you have technologists develop tools that can read that machine readable format and then ultimately create tools that help people get access to price and quality. And that's really all I want to do is I want to have people be informed like they are about everything else they buy in their life. What is the quality of the service I'm going to get and what's the price that I'm going to have to pay? That is not unreasonable. We do it in everything else in life, but we don't, not until recently. Um, and I think the this administration and every other that follows it has to create examples of people not conforming to that law so that we get more compliance with the law. And then we can truly change the way people interact in healthcare because they can actually see the quality and they can see the price of the healthcare service or product that they're about to buy, which they are entitled to in my view.

Closing Thoughts And Where To Buy

Speaker 2 32:13

I know it's a passion of yours. I wanted to end with that. I mean, you and I have been talking about this since we were both working, different companies. We were both working with companies that were at the bleeding edge of consumer-directed healthcare. And it it's been a long time. It's nice to finally start seeing some change.

Speaker 3 32:27

Yeah, Danny, actually, it's interesting that you raise, if I could just raise one more thing. I think when you look at the captivated health model, what makes it unique, and you just triggered a memory for me, is we Jennifer Borslow and I are my business partner, authored a book called Ben the Healthcare Trend in 2009. Um and it was the advent, right? The beginning of the journey on health savings accounts and consumerism. So when you pair the Ben the Healthcare trend with Captivated Health, Ben the Healthcare trend is focused on getting the employee and their family engaged and being in control. And then captivated health is about helping the employer actually take control. And when you pair those two things together, an educated and informed consumer and an educated and informed employer, you get the types of stories that you and I were talking about. So thank you for allowing me to mention that part as well.

Speaker 2 33:14

It's our pleasure. The book is called Captivated Help, Take Control, Gain Transparency, Leverage Confidence. It's available wherever you get books. Please get it. If you're an employer and you're struggling with these kinds of issues, and most of you are, um, or if you're a broker and you have clients who are struggling with these issues, get in touch with Mark and let him help you because it I've been I've been privy to it right up close and personal. And it it's a it's a really, really neat thing to behold once you get hold of it and you work. Mark, thanks for a great conversation.

Speaker 3 33:44

Always, David, thank you. I appreciate uh your treasure and your talent. Thank you.

Speaker 33:48

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