Jeff Hogan has spent 42 years in employer benefits, three decades of it on the distribution side, and he has been a purchaser himself as a town council chair in Farmington, Connecticut. In January 2026 he co-founded the Judi Group, which runs forensic-level reviews across every vendor and contract sitting inside an employer health plan and carries the work through renegotiation to contract terms.
The conversation starts with why employer healthcare has never really been a market. Jeff explains how the second largest expense after wages got handed off and why CFOs concluded they could not change the trajectory, then walks through what CAA 2021 changed, what emancipating your data involves, and what a contract review turns up when nobody has looked in fifteen years. He is specific about the new disclosure obligation on every vendor paid more than $1,000, candid about why the hardest part is often internal rather than contractual, and clear that carriers are now conceding things at the finalist table he never expected to see. Listeners walk away with the sequence, the leverage points, and the first three moves.
In this episode
- Why Jeff compares American healthcare to pre-revolutionary France, and what enlightenment would look like here
- How the second largest expense after wages got handed off, and why CFOs concluded nothing could be done about the trend
- What CAA 2021 required, starting with the gag clause attestation most employers never completed
- Emancipating the data: claims going backward, prospective risk, the contracts themselves, and the point solutions feeding nothing
- The disclosure obligation on every vendor paid more than $1,000, and the three things a plan sponsor has to be able to prove
- What a forensic review turns up: rebates traded for a small admin credit, undisclosed broker compensation, spread on medical and pharmacy claims
- Why carriers are conceding data rights, carve-outs, episodes of care and caps on shared savings at the finalist table
- Health systems waking up to share of wallet, what direct contracting looks like for the middle market, and the first three moves for an employer starting from zero
Figures cited in this episode
Jeff and Andrew cite a handful of numbers on tape. Here they are checked against the primary sources.
Jeff cites a Vizient report putting the average health system at about 51% share of wallet in its catchment area. The Vizient 2025 Trends Report states that a typical health system captures less than 50% of its patients’ total healthcare spend, and puts the figure for chronic patients at 51%.
Jeff says 73% of self-funded employers carry stop loss. KFF’s 2025 Employer Health Benefits Survey puts it at 75% of covered workers in self-funded plans at firms with 200 or more workers.
On healthcare’s share of the economy, Jeff says we are almost at 20%. CMS national health expenditure data puts 2024 spending at $5.3 trillion, or 18.0% of GDP, and projects 20.3% by 2033. Andrew’s $5 trillion figure is correct.
Jeff says Indiana passed legislation telling health systems they have to direct contract. House Enrolled Act 1004, signed in 2025, requires the state’s largest nonprofit hospital systems to offer direct-to-employer arrangements at or below 260% of Medicare, effective September 1, 2025, with standalone hospitals following September 1, 2026.
Transcript
Andrew Gordon: Welcome to The Price of Healthcare. I’m your host, Andrew Gordon. On this show, we sit down with the executives, influencers, and people working to build a functional healthcare market. Every episode, we’re unpacking what’s broken, what’s working, and what it takes to buy healthcare with informed choice. Today, we’re talking about the self-insured employer as a purchaser and what it takes for proactive procurement of health services.
Andrew Gordon: For most companies, the health plan is the second largest line item after wages, and for decades it’s been bought without anyone asking what things cost or what they should cost. That’s changing fast, driven by fiduciary law, better data, and purchasers finally making demands this market has never heard from them. My guest today is Jeff Hogan. Jeff is the managing director and co-founder of the Judi Group, an independent healthcare advisory firm spun out of Judi Health in January 2026. The Judi Group was built to help fundamentally reshape employer-sponsored health benefits, replacing opaque, fragmented, vendor-driven arrangements with transparent, accountable, sustainable programs that serve plan sponsors and members, not simply to lower short-term costs, but to build a benefits system in which employers can exercise real fiduciary control and make well-informed decisions.
Andrew Gordon: The way they get there is a forensic-level review of an employer’s entire vendor ecosystem. This includes medical, pharmacy, and all supportive services to surface hidden costs, conflicts buried in contracts, and compliance gaps. And they don’t stop at the reporting stage. They carry their work through redesign and renegotiation all the way to contract terms. The firm does this work for employers, health systems, provider groups, unions, states, and municipalities, essentially anybody sitting in a fiduciary seat.
Andrew Gordon: Jeff is also the president of Upside Health Advisors, the national consultancy he’s run for 25 years, working with payers, health systems, large employers, and provider groups moving into risk. Before that, Jeff spent his career serving the Northeast for a national benefits consultancy. So he sat on the distribution side of this business — knows how it is built. I had the pleasure of meeting Jeff early in my healthcare journey, and he’s become a good friend. What I admire most about his perspective and his work is that he does not treat the self-insured employer as a passenger.
Andrew Gordon: He treats them as the purchaser with the leverage, the legal duty, and the data to act like one. Jeff, welcome.
Jeff Hogan: Thank you very much. I’m excited to be here. It’s actually exciting to see your evolution in this business as well. You’re a very curious person. I’m surprised by the feedback loops that you’ve gone after and created, and I’m excited to have this conversation with you today.
Andrew Gordon: Appreciate that. Thanks so much, Jeff. So most conversations about employer healthcare start with a solution. I wanted to start a little bit earlier than that with your point that we don’t really have a marketplace here yet. The supply side of the industry connects with purchasers through a small number of stakeholders.
Andrew Gordon: The demand side has historically never put its own needs in writing, and money has moved in between with little accountability and oversight. You’ve watched this for more than 40 years and you’ve been a purchaser yourself, so I figured we should start there. Set the problem up for us. What level of engagement have employer CFOs historically had with how their healthcare services are purchased?
Jeff Hogan: Yeah, it’s a really interesting question. We could probably spend the whole hour on it, but we won’t. So my undergraduate degree, I was a European history and economics major. So I like to refer to the American healthcare system as pre-French Revolution France, a comparison to pre-French Revolution France with the landed gentry who owns pretty much every aspect of the healthcare system profits from it while the rest of the country and the world pays for it. And we called that era the Ancien Régime.
Jeff Hogan: And it wasn’t until, ready? The Enlightenment that things changed. And I think we’re, after 42 years in this business, that we’re finally seeing some enlightenment. We’ll get into that today as well. So to answer your question simply, think about it.
Jeff Hogan: US healthcare, particularly employer-sponsored healthcare, occurred after World War II as a way for employers to attract and keep employees. Originally, it was just master medical, catastrophic type coverage, and then it kind of grew as an accoutrement benefit for employers coming out of World War II to where we are today. And unfortunately, now for decades, the BUCAHs and others who really control the entire health system, they’re the big supermarkets that control both supply and demand, have become almost impenetrable, or had up until this point. And employers, if you speak with CFOs of big companies, even public sector organizations and what have you, simply have become conditioned to not being able to do anything around their costs. There’s this trajectory of cost increases, often double the cost of living, sometimes triple or quadruple that trend factor.
Jeff Hogan: And the answer is pretty simple, that we have become conditioned to not being able to do anything and this whole benefit spend thing was kicked over to, for the most part, HR folks to manage, whatever that means. And management and conditioning means sameness. And we continue just to be treated poorly. So that, I mean, that’s the best answer, I think, having talked to many CFOs and C-suite that they didn’t feel that they could do anything about that trajectory.
Andrew Gordon: Fascinating. Yeah, it does seem like to that conditioning and then to your point on enlightenment and how there’s a lot of things that are coming forward in terms of being able to be more proactive there. As we were warming up for this conversation, you had mentioned that there was an example of an employer that it had been about 10 or 15 years since they put their contract out to bid. Just wanted to learn a little bit more about what you’re seeing and what you learned when you went through that process.
Jeff Hogan: Yeah, so it’s a really good point. And I think what follows from your first question is, well, what has changed? What does the opportunity look like? And much of the work that we’re doing in our new organization is focused on that change. How do we get employers, purchasers to think differently about this second largest expenditure that they’ve just been putting up with, they’ve been putting up with it, but more importantly, their members contribute 20 or 30, 40% of the premium on these things.
Jeff Hogan: They’re the ones who suffer the most. They’re the beneficiaries to the plan. So what has changed to want to cause that purchaser or the members to be involved in change to make things better? And that was, you know, really the Consolidated Appropriations Act of 2021, was a piece of legislation that basically said, hey, look, you know, not unlike what happened back in 2012 with the retirement industry, employers, you get this opportunity to offer a benefit to your employees and you get tax benefits for doing so. Now you must act differently.
Jeff Hogan: You’re gonna act only in the best interest of your members. You have this fiduciary responsibility. And now it’s occurring in healthcare. In addition to the fiduciary responsibility, we expect you to do things differently. So that opened the conversation.
Jeff Hogan: And, you know, one of the key aspects of this CA 2021 was an obligation that employers must attest. So small group, middle market, large group, fully insured, self-funded, doesn’t matter if you’re an ERISA plan or even some non-ERISA plans as well, you must attest, ready, that you’ve removed gag clauses from your contract. There are very few employers who had any idea what a gag clause was or is even to this day too. Many didn’t do that attestation even though they have to and responsible for doing it. Basically, the law said you’re going to act in a fiduciary capacity, and you’re going to go out and you’re going to actually look at the contracts.
Jeff Hogan: Imagine that — the contracts that you have with your vendors, your service providers, your TPA, your PBM, your broker, the point solutions that you hire — and you’re going to make decisions responsibly here, and you’re going to negotiate the removal of gag clauses that keep you from getting data around your group that will help you to understand the needs of your members. What kind of data? What do things cost? What is bad quality? What about clinical integration?
Jeff Hogan: What about the amount or a lack of primary care that’s attributed? How about bad quality readmissions and infections? And how about the prevalence and acuity of disease process in your population? So it basically said that your group is unique and has unique needs and they go to unique providers. And it’s your responsibility to understand the unique needs of those members that you have and to get that data and to make decisions based on that data.
Jeff Hogan: Whoa. You know, think of that. So suddenly we’ve gone from, you know, a system where HR folks hire a broker and the broker goes out and they, you know, run an RFP process with the BUCAHs and say, hope this works, to now, no, you must make sure that you remove these gag clauses so that you could get your data, number one. And going back to your actual question, most of these groups don’t even have their contracts. They don’t have their administrative services agreement.
Jeff Hogan: They don’t have their PBM agreement. They don’t have their provider agreement. They don’t have their stop-loss agreements for the most part. I will tell you, this is true even with some of the Fortune 500 companies that we’ve looked at as well. And often when we go back out and say, well, go to your broker and get them.
Jeff Hogan: The broker hasn’t seen them either. Can you imagine a world in a company where your second largest expenditure, you have no contracts and you don’t even know what they say, what the provisions are, you know, what is being taken or extruded from your system? So this is the starting point and the example that you’ve described is a company that just hadn’t gone to bid in 15 years and didn’t have any of their contracts. And, you know, what was discovered internally is really kind of shocking in terms of what they were being charged for administrative costs, the broker adding per-script costs, the TPA taking a third of their rebates for an admin credit. Spread on medical claims, spread on pharmacy claims.
Jeff Hogan: So it’s just a mess. Why? Because nobody’s watching.
Andrew Gordon: Nobody’s watching. It seems like there’s no visibility. Going back to your conditioning comments before, seems like there’s been a mentality for so many decades, Jeff, where folks are thinking, it’s a done-for-me service, it’s going to be taken care of. I’m trusting certain folks. I mean, when you were describing as well the contracts and not even being held by and owned by and screened by the employers.
Andrew Gordon: But instead, I was thinking it would sit with the consultant or the broker. Even then, there’s limited visibility or some challenges there. I find that quite fascinating. And the thought that I’m also having, and a question I want to cycle over your way, speaks to when it comes to this data. Because when we think about fiduciary, we also think about there needs to be a certain level of visibility, as you mentioned, into those costs and into what’s going on.
Andrew Gordon: What have you seen in terms of where the claims data sits? I feel like there’s a lot of our audience where, of course, they’ve known for a long time that healthcare pricing has been off the forefront. It’s something that’s hidden, relatively hard to even comprehend for a lot of Americans. Talk to us around the visibility that you’re seeing in some of this pricing or how that plays into the CAA and fiduciary duty, and then a little bit about where the claims data is living and sitting and some of the additional visibility that’s coming through in those departments.
Jeff Hogan: Yeah, great question, by the way. And the answer is, for most employers, the data still sits with their BUCAH payer. For some, their brokers are holding data, very specific data, and they hold it specifically and they interpret it specifically back to the employers as well. So data, means, you know, let’s talk about what data actually means. Retrospective data is claims data going backwards.
Jeff Hogan: And it’s really important that we have that data because it gives us insight into the providers people are going to, clinical integrative issues, things like DRGs and acuity, all kinds of really interesting stuff that most employers immediately when you start discussing, I use this term all the time, so I’m just going to use it here again. Look like my labrador retriever when I’m talking to him. You know, no clueless into any of this stuff. So we can, we can go and get the data. I call it emancipating the data from the payers.
Jeff Hogan: And that, that’s a big deal, by the way, negotiating appropriate data rights and what it looks like and the frequency of that data. So that we can get that employer to understand how important it is to them not only to do their fiduciary duty, but to take care of their employees. That’s why they — that’s why they got this plan, to attract and keep employees and to be competitive in the marketplace and what have you. So most employers don’t even know what data is. So certainly claims data is part of what we want to emancipate.
Jeff Hogan: We also want the contracts in a data warehouse as well. So we don’t see that anywhere right now. Where are the contracts? I have no idea where the contracts are. And think about it, during the year these contracts can get amended.
Jeff Hogan: Are you looking at them? What does that amendment mean to us? How is it going to affect our pricing or our costs or whatever the case might be. What about prospective data? That, I put it this way, the bug that’s hitting you in the windshield, how are you going to act on that big risk that’s hitting you unless you know about it?
Jeff Hogan: Most don’t. So prospective data, how do we get it and how do we act upon it as well? And then there is another big one, the 15, 20, 30, 40-point solutions that an employer has that is not feeding into your data. You have no idea how to prove ROI on any of these things. And then I’m going to add one other item that becomes critical now as we have this new legislation and the converging anti-competitive stuff and disclosure is disclosure.
Jeff Hogan: You know, basically any vendor that you’re paying more than $1,000 a year or two is considered a prohibited transaction. And you need direct and indirect compensation for 408b disclosure. You have to be able to show why that vendor is even relevant to your population. Again, using your data, why do we have it? And third, you have to be able to demonstrate fee reasonableness, that you’re paying reasonable fees for that service on behalf of your members.
Jeff Hogan: This is now table stakes. You have to have it. You must be able to prove those things because if you don’t, that is a fiduciary breach. So the onus is now on you as the employer via the Cornell decision. This is the JPMorgan remaining claim that states.
Jeff Hogan: So this is why it’s so important that you, the employer, own your data and have it so that you can apply analytics and appropriate decision-making to your data to be sure you’re purchasing properly and that you have accountability for those vendors as well. This is the place that we’re moving into. This is the exciting opportunity for transformation in healthcare. This is the area that we’re focusing on the most right now. So data emancipation, negotiating data rights into your administrative services agreement, you know, that they are literally institutionalized in your contract.
Jeff Hogan: So there’s no debate about it. We’re negotiating those things on your behalf. As well as a whole bunch of other stuff as well.
Andrew Gordon: There was a lot packed into that.
Jeff Hogan: Sorry. Yeah.
Andrew Gordon: That’s awesome. It’s great. So you have claims, which is also a great way to say, am I paying a rate that’s reasonable here too? You’ve got contracts, which helps to understand what are the different slices and payments or things that are being taken in terms of fees or on a per volume level. There’s certain things that are a higher level in the contracts.
Andrew Gordon: And then as you mentioned, disclosure, We have emancipation of the data and the information visibility into that. Walk us through just from an ownership standpoint as well. You know, we have employers that they’re running a business that may or may not sit in healthcare. Some of them are obviously healthcare companies. There’s companies that do completely different things, but we often say you have two businesses.
Andrew Gordon: You have your healthcare business to take care of your people, which are some of your most important assets and aspects of your operations. And so walk us through a little bit around when we talk about that ownership, when we talk about being able to really understand and get engaged and involved in the operation. What does that look like? How much is the employer expected to manage as part of that? And obviously there’s firms such as the Judi Group coming in, being able to really help guide that. But then what is that level of engagement that is expected and required of them in order to be proactive and to make sure that they’re taking these things seriously?
Jeff Hogan: Yeah, it’s a really important question. You know, clearly for jumbo groups, this is a big deal. You know, that named fiduciary has personal liability, and often the liability also extends to their boards of directors as well. So some take it, you know, a lot more seriously than others, particularly if you’re a publicly traded company. We also see that same level of attention for Taft-Hartley groups.
Jeff Hogan: Why? It’s the members’ money. All of it. All of it. They’re really deeply involved in this.
Jeff Hogan: So let me just back up to answer this question a little bit. It’s really critical to understand that most employers, even the biggest and the best, that have huge HR departments and — or big HR departments may not be huge — are generally ill-equipped to go through this process. And what does that mean? You have to start with governance. What does that mean?
Jeff Hogan: Do we have the right resources? Can we put together a fiduciary committee that contains the right owned and non-owned resources to help us make these decisions, to look at our data, to use the analytics appropriately. So for many of the biggest companies and organizations out there, they are putting together fiduciary processes, which are really critical. I’m talking about Jamie Greenleaf’s, what she does in setting up governance. We even do governance training ourselves as part of it.
Jeff Hogan: But if you simply start these new processes where we’ve gotten data and there’s analytics and you have to prioritize, we have to think about accountability, and we’re using the same rails that we have over time, doesn’t work. You can’t do stuff with it. You can go out and hire analytics vendors who can tell you, hey, this is really important. Your, you know, your people are going to really terrible hospitals with bad quality and you’re paying more for infections and complications than you are for the underlying procedures as well. So the governance thing is critical out of the gate that employers make a decision.
Jeff Hogan: Yeah, this is really important. We have to make sure we have the right resources. You can even hire fiduciaries to help you with the process internally, which includes this whole data thing, how we’re going to own it, what layers of analytics we’re going to do to prioritize the things that are inside of our plan. So for example, many employers right out of the rip immediately start to look at pharmacy and PBM. Why?
Jeff Hogan: It has outsized value to the plan in terms of catastrophic claims and specialty drugs and double or triple the trend factor. So they say, well, this is a big thing, we have to focus on that first. Others will start in simple places like MSK. Hey, it’s the second largest expenditure we have. And we have too much variation in cost and quality on arthroplasties.
Jeff Hogan: Let’s focus on that in getting predictability there. Others will look at medical pharmacy, you’re in New Jersey, one of the worst states for J and Q codes for three, four or 500% of Medicare plus facility charges, focusing on things that immediately change it up. So while this may sound like a daunting task for many employers, simply getting your data and starting to use it more responsibly is what we’re looking for. The fiduciary responsibility is to focus on things that matter most. So it’s not necessarily as big a thing as employers think, but they get immediate value from getting insights into the needs of their own population that they haven’t gotten before.
Jeff Hogan: Why? Because the ancien régime, the BUCAH world, has been here’s the network. Hope it works on your population. I hope it works. That’s our procurement.
Jeff Hogan: And we know that it doesn’t. Each population, each group, each employer’s group has unique features. Their demographic, where they go, what they do and what they don’t do, the point solutions and things like this. And this creates, if you will, the rubric for being able to convey demand, your unique demand, into the supply side of healthcare that has also used the BUCAH in the past to convey its wares into the demand side. So this gives us the next part of our conversation, I know, the elementary aspects of a functional marketplace, which we certainly haven’t had ever in healthcare at all.
Jeff Hogan: So I went all around that question, but my answer is you don’t have to boil the ocean once you secure your data. You just have to use it to start making decisions in an appropriate way.
Andrew Gordon: For sure. And I absolutely want to get to the functional healthcare market and have us start to map out what those major frameworks look like. Before we get there, I’d be curious to, in your experience, Jeff, thinking about these employers as they get activated and more engaged, would love to understand. Of course, we have the regulation, we have the CAA, we have some things that are making this ever so pressing and important for them to address. Just curious, as you’ve gone about your engagements, what things have worked really well in terms of unlocking that psychological viewpoint of this is something that we have to address.
Andrew Gordon: We cannot put this off. We need to move on this today. You know, this sense of urgency is something that I feel like a lot of folks, irrespective of what they’re selling, hope to invoke in their prospects. What does that look like today in this market as you are interacting with these different employers?
Jeff Hogan: It’s almost entirely dependent on the employer group. So for example, what we’ve described here is start from A and end up at D, where we’re, you know, for some reason the CFO has decided, hey, we better do something here, and so let’s get the contracts and do the contract analysis and get intuition around the features or aspects of our plans that aren’t competitive, and how value is being extruded from us by middlemen or taking of rebates and things like that. So so that’s one story. Typically, if we start there on the diagnosis, the inspiring thing, the kind of punch in the nose thing that inspires them to do more is what we discover, you know, that, hey, we, you’re giving up $7 million a year for a $2 admin credit.
Jeff Hogan: Hey, the broker is making twice as much as what you think he or she has been making or has been disclosed, you know, indirect compensation for bonuses, the $1.50 a script, the point solution, the voluntary benefit compensation. So that’s surprising. And that’s the thing I will tell you that has activated most of the employers who are starting at kind of A is this is what’s happening to you. Why are you letting that happened to you? You know, that’s insulting.
Jeff Hogan: And typically these folks have trusted people along the way too. And that, you know, that’s a, that’s a very different thing to deal with. Other organizations are at a different point, meaning they’ve gone out with a traditional RFP process and they’ve gotten to finalists and we’re getting called to help them at that finalist negotiation and discussion to negotiate their terms. So that’s a really exciting place. And we’re doing that a lot, by the way, right now, where, all right, here we are we’ve got the incumbent and two or three other organizations that are finalists.
Jeff Hogan: That’s where the employer has leverage. You used the word before. It’s a critical word. This is where they can really make things happen. Why?
Jeff Hogan: Because an incumbent doesn’t want to lose the group and others want that group in this marketplace. And honestly, that’s the most exciting thing for me to see right now are BUCAHs that are coming to the table and are allowing us to negotiate really robust data rights, number one. Two, for 408b disclosure, using our disclosure terminology as an aspect of negotiated terms, carve-outs, uh, for primary care, for episodes of care, for providers that are not in their network that we need, like behavioral health, that where there is a blind spot in there, even caps on things like shared services. Shared savings, which is a big area too, even on out-of-network type arrangements too. So we are securing those things on behalf of employers.
Jeff Hogan: 42 years in the business, I never thought we would see the BUCAH payers move in this space, and we’re getting those things. In addition, ready? And this is really critical from going through this diagnostic process on hundreds of groups at this point. We can see the pattern of behavior for the carriers in terms of their administrative costs and fees by provision. Okay.
Jeff Hogan: And where there’s variation in that, and then use that data for benchmarking to come in and negotiate the terms, not just the contractual terms, but also the financial terms as well. This is a big, big deal. And I’ll tell you, it’s not just because CAA came and we have, you know, CAA 2026 and FTC settlements and the DOL reg that’s coming out. Those really, really help a lot. But what’s different now is technology.
Jeff Hogan: We’re able to use technology to help us not only on contract analysis, but on data analysis as well. And it really moves things up. It really speeds up processes. It also makes it less expensive for employers to get insights that they’re looking for in the marketplace, even on things like point solutions. You know, what is the priority of the point solutions for my population, you know, and we’re able now to show employers how important their metabolic health point solutions are to their risk profile as well. So this is the new kind of taxonomy, if you will, using, using data, using analytics and getting the employer excited by giving them agency to be able to convey their unique needs into the marketplace, negotiate those terms into their contracts to allow them to do the things that they need on behalf of their members.
Andrew Gordon: Lots to unpack there. Love the comments on the patterns, the benchmarking of those patterns. I think it takes a lot of exposure to really be able to pinpoint those things. So incredible to hear that you guys have been able to do that and then distill that into actionable items to continue to serve folks in a really meaningful way. And then as technology is coming in, I’m also hearing there’s a lot of concessions that are starting to be made inside contracts.
Andrew Gordon: Would you say it’s a fair statement that a lot of the leverage and the effort for folks looking to get activated on this is within those contracts? As I think about disclosures and claims data and where a lot of this language lives that really governs the ability for somebody to effectively manage their plan. and their spend, would you say that the starting point and the foundation for a lot of it is in the contract and that kind of helps to set the tone for all of these other aspects we’ve been talking about? I’m just trying to distill for our audience where that core area is and it seems like with the work that you guys are doing, you’re coming in and you’re helping with those term negotiations, spotting those gag clauses, finding certain things in there. Seems like that’s definitely a core focus area for those who are listening.
Jeff Hogan: Yeah, most definitely. The contract is a big starting point. I think, though, as we move forward, even those that aren’t necessarily going through and doing their contract analysis can skip to 2.0, which is disclosure. Having a process, a very simple process, and we’ve devised that simple process where groups can enter this without, oh my God, data emancipation, and we don’t have the RFP coming up till whatever. Well, what can you do in the meantime?
Jeff Hogan: You can now, by the way, you have to, and if you don’t, you’re in trouble. You must have a simple process, a system for doing disclosure on every vendor that’s in the plan, direct and indirect. If they refuse to answer it, then you can’t enter into that contract. It’s really as simple as that. And once you get that direct and indirect compensation disclosure and understand it, there’s a benchmarking thing that has to occur there.
Jeff Hogan: Am I paying two or three or 10 times as much as I should be here? This is, this kind of is an eye-opener. How’s that? It’s a mind blow for most people. What?
Jeff Hogan: You know, on these type of things. What is the compensation? What is that compensation? Oh my God. You know, and it is inspiring to them to do more.
Jeff Hogan: So yes, the contract is really important. We like to do that analysis. It’s not that hard to do it and to show them the landmines and things that can be changed and cured, that’s the word that we use, and go back and fix that. All right, and fix it. But this big new disclosure thing, and you’ll see in the DOL regulation that’s coming how important that is, by the end of this year, you have to have a process.
Jeff Hogan: So you can enter this only through that disclosure process as your starting point. And it’s going to inspire you to do more and to do different, to negotiate better in the process as well. So one, two, or three, if you’re close to that finalist thing, you can now engage and you have leverage in that system to get things they wouldn’t and then kind of learn backwards, if you will, as you get your data and stuff like that. So it’s not this linear, you have to do this and you have to have this huge engagement. What happened?
Jeff Hogan: No, no, no, no, no, no. This is, this is the wake-up call. And once people do any of these things, it gets them going, you know. So I will tell you, so let’s, let’s give the — what it, you know, here’s your next question. Sorry.
Jeff Hogan: Uh, the next question is, well, what’s the impediment? Uh, what is the biggest impediment that we run into in many groups. So think about it. Really nice people in every firm are the HR people, CHROs, and people officers. They’re great people.
Jeff Hogan: You know, they’re there to make sure employees are taken care of and they know their rights and they do this and that and the other thing. Most HR people have not been trained, ready, in risk, finance, accountability, procurement, or any of these types of things, although they’ve been asked to do that, many for decades. So here, you know, we come in or someone else comes in and starts on this process. It’s kind of a threat to what they’ve been doing for a long time, and this is a big deal. Okay, and and we recognize this.
Jeff Hogan: CFO says, I don’t care. You know, we have fiduciary responsibility. We have to do this. We go blah, blah, blah, blah, blah. But you don’t just change the minds of people overnight.
Jeff Hogan: You know, often once we get into it and show what’s inside these contracts, it kind of changes behavior. But HR people tend to be very protective about what has been done in the past. So we’re very cognizant of that. I’ll tell you that inside of Judi Group, we actually have a law firm so that we can engage with groups, via privilege so that we’re, you know, in our own world, we can engage with privilege and have these conversations without, you know, shaming people for what’s occurred in the past. And so this is something to be recognized.
Jeff Hogan: It’s really hard. And even with the governance, once we start to talk about what governance should look like, that often is a sore subject for HR people who have owned this whole thing for a long time. So, I want to make sure I mention that because that is something that we have to be concerned about. And I’ll tell you, there’s some really brilliant, innovative chief people officers and CHROs out there who embrace it and say, look, I’ve been running this thing myself for a long time. I’ve been relying on that broker, we did the disclosure and discovered this, or I ran an independent RFP process for PBM and I can’t believe, you know, what we’re discovering. But this is, this is something, you know, to be aware of.
Andrew Gordon: And as you were talking too, Jeff, I was thinking about essentially bridging the gap between the CFO of the firm, the CHRO. There’s a lot of training, knowledge, and education that both of those roles have that absolutely can help when it comes to accelerating this more thoughtful procurement of services. So it is interesting, and I do feel like relative to renewals and folks thinking, well, hey, it’s coming up, we should probably start taking a hold of this. As I hear you talk about governance and evaluation and the potential need to set up data warehouses or other components, I mean, it’s one thing to be aware of, here are the areas that we need to be critical of, here are the areas that we need to scrutinize.
Andrew Gordon: It’s another thing to then act on that, to be able to put in those partnerships, to be able to put in that plumbing. to make those moves. And so for people who are thinking about this and when they should get activated or engaged, I would imagine the answer is year-round, is that you could get involved anytime. You don’t need to be waiting until —
Jeff Hogan: You don’t. And in fact, off of renewal is often a good time. I told you, you know, the renewal and the finalist negotiation is when you have maximized leverage, but people can enter this process you know, the diagnostic process at any particular time when they have time to do it as well, which is really quite helpful. I’ll tell you, for — go back to the CHROs and chief people officers. Often they identify as their biggest problem the 20 or 30 or 40 or 50-point solutions that they’re trying to manage, and are not integrated in their data.
Jeff Hogan: They have no ROI on it. Why did that happen? So just think about it. Show some empathy here. Coming out of COVID think about what HR people had to deal with during COVID, you know, the remoteness, still hiring people, dealing with all kinds of situations.
Jeff Hogan: And we, you know, we discovered coming out of COVID an epidemic of behavioral health demand. The average BUCAH network maybe, maybe takes care of half of the demand for behavioral health needs on a population. So what do the HR folks do? What have they been trying to do? Where they see a need that’s unfulfilled by the network, they’ve been trying to go out and get point solutions, you know, to fit that need.
Jeff Hogan: You know, that’s a big deal. And then they have the burden of managing all of those things that aren’t integrated. So, so part of this is recognizing their priorities as well, looking at disruption analyses, looking at blind spots in the BUCAH networks. I’ll tell you right now, one of the greatest impetus drivers for the carriers making concessions is that their networks don’t cover all of the things that are needed on specific populations. And that employer wants to direct contract for those things on DRGs or behavioral health and supplement them and have them integrated into their data in an intelligent fashion.
Jeff Hogan: That’s kind of where we’re going. And finally, we haven’t talked about it yet, the care delivery, the supply side of healthcare, is waking up and saying, wow, we could actually be relevant to these unique populations too.
Andrew Gordon: I think it’s a beautiful segue to actually get into the functioning healthcare market, which we’ve been delaying for a little bit. So let’s talk about that. We do think about demand and supply. We think about the fact that there is a lot of point solutions, which shows that there is certainly unmet needs. There is room for competition.
Andrew Gordon: There is room for being able to come forward with a lot of value and then specialized value because we know healthcare can be complicated. So you have firms that are doing certain areas and slices of the industry incredibly well. What does that functioning market of the future look like? And perhaps, Jeff, before we go there, maybe we should talk about a little bit of why we’ve seen some historical dysfunction and why there hasn’t been as much oversight, accountability, responsibility, even pre-CAA, just understanding that there’s been a lot of things behind the scenes, whether it’s contracts that haven’t been scrutinized, prices that haven’t been disclosed, folks coming in with things that they just aren’t exactly sure how it kind of plays into that informed choice dynamic that’s happening. So, so walk us through where we were and then where we’re headed and sort of the future of what you’re seeing in a functioning healthcare market as you talk about direct contracting and these other aspects that you’ve been able to see momentum grow dramatically in?
Jeff Hogan: Yeah. So, I mean, we’ve been conditioned to apathy almost that, hey, look, there’s not much we could do. We talked about that at the first part of this conversation, and people just assumed that they couldn’t beat the system because of its complexity and what have you. And for a variety of reasons, as we said, the convergence of health policy, and by the way, it’s bipartisan, having spent a lot of time in DC in the last year. This is a bipartisan thing, anti-competitive provisions in healthcare.
Jeff Hogan: Look at the most recent Kaiser polls relative to midterms. People are talking about healthcare and the cost of care and the lack of adequacy and appropriateness of care in the system. People don’t like this system. It’s not good. So, you know, the politicians suddenly are creating public policy initiatives targeting these anti-competitive provisions and things like this, which I never thought I would see that, you know, especially looking at, you know, all the pharma lobbyists that are in DC.
Jeff Hogan: We get CAA 2026, which basically says this is the new PBM fiduciary model. No spread. Give the rebates back. What? You know, that’s astonishing.
Jeff Hogan: Look at the FTC settlements as well. This is astonishing. So this is a wake-up call to say, hey, look, we’ve — we’re almost at 20% of the GDP with healthcare. Let’s put the brakes on. We have all kinds of tax breaks going to employers to do this.
Jeff Hogan: You have to act differently. The system has to act differently. And we need to activate a system that’s competitive and has transparency and accountability as well. So, so what has changed, you know, since CAA 2021? People are starting to get their data.
Jeff Hogan: And I will tell you that I have not seen a group that we can’t get data for at this point. I would not have said that a year ago. I will say it now. You can get your data. So don’t say you can’t.
Jeff Hogan: And by the way, all the new legislative things are pointing to, okay, well, if we’re not going to give it to you, report it to us, and we’re going to help in this process because we expect you to do that. There’s also been a tremendous focus, I think, on the BUCAHs and the adequacy and appropriateness of their networks, the inadequacy of that as well. And then let’s look at one more public policy thing that occurred, which was this strange thing, the Medicaid contraction, that the extension of Medicaid is going to now get limited. And so now the health systems have to start thinking about losing revenue in some of the areas that they were looking at before. There’s a really cool report that came out last year, published by Vizient on health systems, and you’ll see where I’m going with this in a second.
Jeff Hogan: And basically what the report said is that the average health system nationally, substantial health system nationally, only has about 51% of share of wallet in the catchment area that they’re in. That’s surprising. You know, even though we have only a few health systems in certain areas. It’s really surprising, 51%. And then I’m going to lose this Medicaid expansion and what have you.
Jeff Hogan: So the health system suddenly realized the need to become more relevant in the marketplace. And maybe those BUCAHs are limiting our ability to do more in specific marketplaces. Look at your own market, New Jersey, one of the most expensive markets in the country. I’ll tell you, having worked on the state of New Jersey analytics project on episodes of care, I’ve never seen more variation in cost and quality in episodes of care. And the reaction to that from many of the health systems was, we could fix that and design direct-to-employer products and strategies because that is a market signal that there is demand for predictable access, cost, quality outcomes, and patient experience for big things, big, high-volume episodes of care.
Jeff Hogan: Maybe that can be treated in an ambulatory surgical center and warrantied as well. So suddenly we’re seeing the supply side of healthcare wake up. The state of Indiana, the state of Indiana basically passed legislation, brilliant, one of the most expensive states in the union for healthcare that tells the health systems you have to direct contract. Okay. And they’re starting, that whole thing is now bubbling up.
Jeff Hogan: So so what does that say? The health system who has also relied on the BUCAH to convey in the supermarket its wares into the demand side of healthcare, saying, maybe we could do it better. Maybe we can do it by, you know, creating warranties and a better experience and what have you. This is the sign of a marketplace being created. Okay.
Jeff Hogan: And not being walled off. Like the ancien régime and the entrenchment and what have you. And we’re seeing it, we’re seeing it everywhere, okay, on both the supply and the demand side as well. And the cool thing is that technology is certainly playing a role in what that looks like. An employer has to have a data warehouse because how do you convey your unique demand and improve it retrospectively to the supply side and have them bid on it or take risk on things unless you have the facility to be able to manage it yourself without it being manipulated by a third party who doesn’t have your same interests in mind.
Andrew Gordon: Access, quality, cost, outcomes, patient experience. Those things that I heard you say, Jeff, curious to get your take on how prices have been set in healthcare, how they’re being set, and how many of those factors play into how folks on the supply side are thinking about and setting their pricing. Really interesting as I hear you kind of go through that and step through, we’re having a lot where there’s the supply side, the demand side, the consumers, the buyers, and then the folks who are actually delivering that care, being able to come together and say, we want to create more seamless arrangements, engagements that are transparent, upfront, visible, verifiable. What has healthcare pricing looked like? And as you see these direct contracts come into play, how many of those variables that we just talked about are playing into the discussion on the pricing that is set?
Andrew Gordon: Because as you talk about the massive industry that we have, the $5 trillion industry, as Americans think about the fact that the price of care has been outpacing their outcomes and their quality, and that we don’t stack as well as other countries do, respective to our per capita spending and the quality and the outcomes that we’re receiving as a result. Just curious to kind of dive into this with you a little bit on the financial side and pricing and its correlation or lack of correlation into quality and how you see this future functioning healthcare market addressing that gap.
Jeff Hogan: Yeah, it’s a really interesting question. Again, we could spend an hour on this. You know, it’s something of a rigged system. I mean, if you think about it, the AMA builds the CPT code system, you know, which creates the valuing of certain types of providers and procedures. And number one, this is, you know, it’s a rigged system too because they are also determining how many residency spots for each type of provider, specialist, and what have you.
Jeff Hogan: So there’s, you know, that’s a big deal. And then what do we get inside of primary care and clinically integrated networks and specialty organizations? RVUs, these very artificial relative value things that providers are expected to do to generate revenue. And then we have the BUCAH carriers who basically know what they’re making on administration, by provision, claim edit, and shared savings and subrogation, and even on out-of-network claims right now, audit, you know, all of these things are financialized and not in the interests of the employer, in their interests. Rev cycle management.
Jeff Hogan: We have EMRs and EHRs that perpetuate rev cycle management. Let’s make sure we get the right mix and things like this. My point is that suddenly, and you mentioned the consumer, the ultimate oxymoron is in the US is to say healthcare consumer doesn’t exist, never has before. Why? We could care less about the member or healthcare consumer, or we have in the past really not cared about that person.
Jeff Hogan: Look at the net promoter scores for the BUCAH carriers, single digits, sometimes zero as well. We don’t care. The purchaser is the employer. So, so suddenly, suddenly, the employer, the purchaser, the fiduciary must act only in the best interest of the members. Whoa.
Jeff Hogan: Okay. That’s pretty interesting. What are the best interests of the members? All the things that I was telling you about a few minutes ago. I say now value equals predictable access, cost, quality outcomes, and patient experience.
Jeff Hogan: And curiously, those health systems nationally, even clinically integrated networks that are setting up direct employer things. This is how they’re thinking about these things as well. We can give a better experience. We can give a more predictable and warrantied experience, particularly for the largest volume of repeatable services that employers have — their hips and knees and babies and shoulders and CABGs and infusion. Let’s get rid of that variation and show you that we can do all of these things just on those.
Jeff Hogan: And it takes care of a big part of an employer’s cost. Number one. Number one. And number two, for the 73% of self-funded employers who carry stop loss, that’s the largest fixed cost that they have. It has an oversized effect on the cost or the cost increases on stop loss because you have predictability around those episodes as well.
Jeff Hogan: So that was kind of an all over the place answer to your question. But the answer is health systems are businesses too, and they’re constrained in their catchment zone. And if they can increase their share of wallet by 4 or 8 or 10% that’s a big deal. That’s them acting in their best interests, not having a BUCAH through the network, you know, pretend to be acting in their best interests as well. So these are, these become, think about it, aligned interests.
Jeff Hogan: That’s what a functional marketplace does. It creates aligned interests.
Andrew Gordon: I love what you shared there too, because as you were talking, a part of me is thinking as well that we’ve historically had, as you mentioned, folks that were not interested in serving the purchaser, not interested in prioritizing this consumer that you mentioned, a very important term and a term that transcends multiple industries that people can easily wrap their head around. It is perplexing, I’m sure, to many, this whole notion that the system has grown to the value that it has with the supply side and the supply chain in large, not necessarily prioritizing the end user. If you think about any other company that exists to please and to serve the people who are consuming and receiving the services, it starts to get pretty perplexing to think that we’ve even reached this point.
Andrew Gordon: But it’s amazing to hear as you’re talking about this alignment to say people are activating, people are realizing that it’s important to bring parties together to be able to serve and to increase the value that’s being delivered. I want to actually parlay off that, Jeff, to get your take on a little bit more of the mechanics of the direct contracting that we’re seeing coming, coming into play. There’s a lot of larger health systems, as you mentioned, that are doing this. You’ve got a lot of independent, smaller direct primary care groups and other specialty groups that are starting to do direct contracting. They’re leveraging things like the price transparency data to understand the markets and what makes for a really competitive rate, which is exciting news.
Andrew Gordon: How long do these agreements take to stand up? Who are the people that are involved in at the table putting these agreements in place? And does the employer have a large role in the actual standing up and integration and creation of these direct contracts?
Jeff Hogan: Yeah, this is another, it depends. So there are all kinds of opportunities to direct contract. Nationally and with different organizations. So for, for example, right now, even as part of finalist discussions, BUCAH carriers will help to facilitate direct contracting for you. You know, that’s part of the negotiated thing, which is kind of a shocking thing, but they do.
Jeff Hogan: I did direct contracting with a BUCAH carrier four and a half years ago. I think it was one of their first in the nation and worked out great. It’s totally integrated and we know what the terms are or what have you. So it certainly depends on the size of the organization. If you’re Walmart and you have 1.1 million employees, it’s a lot easier to do direct contracting and your terms and even get better terms.
Jeff Hogan: If you have 10,000 of these getting done a year, you’re going to get a really good price and you have market power and what have you. In specific regional areas, obviously, we have episodes of care that get negotiated for. Like I was saying before, there are third-party vendors who will do episodes of care and already have them, and you can get prices and just go to them and contract with them directly. We’ve got primary care organizations, big ones. The Premises and the Marathons actually do direct primary care almost in a capitated way and carve out services.
Jeff Hogan: That’s a big deal. Works really well. Many of them even do the workers’ comp for the employers as well. And specific health systems now are usually starting small. Maybe they’ll do infusion or other types of things.
Jeff Hogan: We will do the direct contracting with these organizations. It’s easy to do. It really is. You’ve got organizations like Mark Cuban doing it. I know Rachel Means and Sage is doing a lot of it as well.
Jeff Hogan: So it depends on the region. It depends on the size of the group. The question you haven’t asked me yet, so I’m going to answer it anyway. What about the middle market group that, you know, says, oh my God, contracts and procurement and accountability and, you know, risk and all of these types of things. This is a big deal right now.
Jeff Hogan: In fact, I’m having conversations. There’s a lot of captives out there, unfortunately, that have perpetuated the same problems that we have with networks that are doing the arbitrage, that don’t do the 408b disclosure. But we’re starting to see captive organizations coming in to say, hey, we’re going to bring together, you know, 50, 100, 200, 500 of these groups, and we will help you with the data and warehousing and the analytics and the procurement of whatever, uh, the services, direct contracting, but also the risk layer, which is a big, big deal there as well, that we can help with this. So I’m starting to see that occur. I’ve been a little bit cautious because of the lack of disclosure of many of these organizations over the years as well.
Jeff Hogan: But think about that becomes a target for a health system. Hey, you got 500 groups in our catchment zone. We’re going to give you these services at a warrantied price. That’s pretty cool. It creates the predictability that an employer fiduciary absolutely needs.
Jeff Hogan: And, you know, people say, well, why is this so important? Because that fiduciary decides what the premium’s going to be and what the employer’s — employee’s share of that cost is going to be. And if you have elements in your plan like GLPs that you can’t get predictability around, well, how do we do that? How do we get it so that it’s tighter? How do we deal with our IDR problem, which suddenly has just exploded?
Jeff Hogan: You know, how do we tighten those things up? That’s a big part of the work that we’re doing as well, focusing on the unpredictable elements of your total cost of care to make them predictable so that you can act in the best interests of your members.
Andrew Gordon: You were one step ahead of me because I was going to ask about the small and mid-market so thank you for coming forward with that. It does sound like it is about being able to have a pool of folks or people that come together. I also think a lot about internal champions and people that sit inside employers who may be listening to this podcast or coming to these events that are starting to help people understand how these alignments, engagements, and activations are taking place. There certainly is a lot to be said for even a single employer within a captive that says that they want to take more proactive moves toward doing this, and then collectively figuring out how do we take a whole group or somebody inside an employer saying, how do we get this moving and what can we do here?
Andrew Gordon: So there’s been a lot of exciting developments there. In terms of three things, Jeff, to round us out for what people can do if they haven’t touched any of this, employers, people sitting inside captives, whatever the deployments may be, as they think about this enlightenment that we’ve talked about, as they think about the aligning of incentives and interests and priorities, what should their first few moves be here? The first three moves?
Jeff Hogan: Yeah, I think the easiest first move is to get your contracts and to have them looked at. You know, it’s a, it’s a simple process. It’s also enlightening for most employers to see what their contracts look like and to get some insight into what they can do to give themselves agency. Once they do that, you know, step two becomes the cure, which is an RFP process that includes your demands. Okay, it’s no longer, hey, I’m calling up my broker and they push a button on their computer with a standard RFP that doesn’t give them their data rights or carve-outs or caps or, you know, any of the things that would be in the intro.
Jeff Hogan: So the diagnostic and obviously the cure, I would say maybe 1.5, how’s that, is the disclosure. I think even if you you don’t want to start with your contracts, getting this disclosure process down, having it, you know, having a system internally, and it’s not a terribly expensive process, but this is table stakes right now, you know, for your fiduciary responsibilities is to have that disclosure, have some sense of, you know, what you’re being charged for the services and whether they’re relevant or not. Those, those would be the top ones. And the last one we really didn’t get into that much would be around point solutions. This also becomes part of your RFP process.
Jeff Hogan: You have to demand that any point solution that’s going to work inside of your organization not just be like really good and everybody says that they’re good, they have to be relevant to you. So if they’re diabetes or MSK or whatever the case might be, how will you, point solution, show the prevalence and acuity of disease process for what you’re supposed to be treating? Create that baseline. Nobody’s doing that right now. Create the baseline, one.
Jeff Hogan: And two, how are you going to show us how you’re managing that risk and gauging with our population so that it’s helping us to understand the population and how it feeds our claims and our catastrophic risk and what have you. Each point solution must be able to show its relevance to your population and how they are engaging and demonstrating ROI on your changing population as well. So nobody has been thinking this way. And as this evolves, it’s a critical aspect of what you’re doing.
Andrew Gordon: I did want to double-click, and thank you so much for that stair-step summary of these action items that people can take. I did want to double-click into the point solutions, and I know we haven’t talked too deeply about them, but I really appreciate you laying out that relevancy, the ROI, the importance for anybody that wants to be extraordinary that’s building or operating companies in that space. How do you see — you had mentioned before, Jeff, that from a claims warehousing perspective and being able to sync these feeds, to have it come together, when we think about an ideal deployment for an employer, for somebody that’s managing a health plan, you want everything in one spot if possible. You want to make sure systems are talking to each other.
Andrew Gordon: Are there examples? Have there been? Do you see more instances where point solutions, quite frankly, they’re playing together? They’re starting to say, hey, we need to be able to feed into this. We need to be able to standardize on these things.
Andrew Gordon: What does that look like? And then I would imagine that that’s probably helped them to increase their adoption because they’re able to reach and get into more areas with those standards set, similar to the governance that we talked about. They play hand in hand of setting forward these frameworks that are really going to transcend organizations and growth.
Jeff Hogan: Yeah, a couple different ways these are merchandised. One, is through the, what I call the supermarket, the BUCAH supermarket. This is, they have them basically integrated into their offering and, you know, they’re making money on that process. That’s one. 2, brokers have their own point-of-solutions that they’re putting out there and they’re making money on those as well.
Jeff Hogan: And oftentimes there are significant bonuses and incentives to sell these things at a, you know, PMPM and whatever the case might be. And then there are independent point solutions that are out there selling directly into employers as well. We even — last category, it’s a smaller category, but provider groups that have their own point solutions that they’re selling as part of their service too. So those are all the different categories. How do you figure out, you know, what they’re making and, you know, evaluate from the financial perspective?
Jeff Hogan: That 408b disclosure that you have to do is designed to do that. You’re going to pay them more than $1,000. They need a disclosure and they have to be able to show this. And if they don’t, you don’t engage with them. So it covers all of those things.
Jeff Hogan: I mean, that is the — I used the term before, this is the emancipating opportunity for employers to say, wow, I didn’t realize that they were making $1 million on me and that I was losing that and that I can get that back, you know, that I have the power to control these things. That is the thing that’s most exciting right now, is to see that awakening, the enlightenment that I described before, and it’s causing people to behave and act differently.
Andrew Gordon: Enlightenment, emancipation, the pursuit of excellence. Well said. Anything I neglected to ask you today that you’d like to share with the audience as we close out, Jeff?
Jeff Hogan: We covered a lot of ground today. You know, obviously, this sounds complicated. It doesn’t have to be. You can start small. We’ve seen many employers who started at one piece and it begins to feed on itself.
Jeff Hogan: We have had big employers now where we were able to negotiate great terms in their finalist agreements now that are digging deeper, they’re looking at how they’ve procured their stop loss and how it hasn’t been in their interest. And, you know, I describe what’s occurred to many employers as boiling the frog. The carriers over time realize that nobody’s looking at their contracts, that they can actually change and crank up costs and provisions and elements on these things. And you know what happens to the frog in the end, you know, it’s not good. And we’re seeing a change.
Jeff Hogan: For the first time in my entire career, we’re seeing evidence of changes where the employer is getting what they want and need for their employees. And on the care delivery side, this sudden thought process change, even with leadership that’s completely obsessed with rev cycle management and all of this other stuff. Hey, maybe we do have a better role or a more strategic role with purchasers in the marketplace where we can decide our destiny rather than a third-party institution, carrier, or BUCAH.
Andrew Gordon: I love that so much. Now, for those who are interested in reaching out to you after this episode, where would you direct them?
Jeff Hogan: Yeah, certainly they can email me, jeff@judigroup.com. I’m active on LinkedIn, you can message me there as well.
Andrew Gordon: Amazing. Jeff, it’s been a pleasure. Thanks so much for coming on.
Jeff Hogan: Thanks for having me.
Andrew Gordon: And that’s a wrap for this episode of The Price of Healthcare. We’ll see you on the next one. Thanks so much for listening.