EP275: Will Self-insured Employer Costs Ultimately Go Up? The Why and How to Protect Your Company From Predatory Health Care Pricing, With Brian Scott, From Point6 Healthcare

In this Episode 275, Part 1, Stacey Richter talks with Brian Scott of Point6 Healthcare about whether self-insured employer costs will ultimately go up, and how to protect a company from predatory health care pricing. WHAT YOU'LL LEARN ✅ How to think about the "additions" and "subtractions" that determine whether an employer's health costs rise or fall post-COVID ✅ Why telemedicine is likely to be the point of care most utilized after the pandemic ✅ What a health care model without a traditional PBM might look like ✅ Why COVID could be a flash point for real structural change in employer health costs ✅ Why digging into individual plan concerns, not just macro trends, is where real savings live WHY THIS MATTERS Brian Scott breaks down the equation self-insured employers are wrestling with: added costs from COVID-19 treatment weighed against reduced costs from deferred elective care, with doctor visits down 35% to 80% depending on specialty. Whether that nets out to higher or lower total costs depends heavily on how care-seeking behavior shifts long term, especially around telemedicine, and how PBM and formulary dynamics evolve. Scott sees COVID as a genuine flash point — a moment that could either normalize predatory pricing further or finally force the structural changes self-insured employers have needed for years. MENTIONED IN THIS EPISODE 🔗 EP273, with Jonathan Thierman, MD, PhD 🔗 EP274, with Jonathan Thierman, MD, PhD 🔗 EP264, with Ron Wince === LINKS === 🔗 Show Notes with all mentioned links: Episode Page 🔗 Healthcare Industry Acronyms and Terms ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 00:00 Introduction 03:27 Contemplating the additional costs an average employer might incur relative to employees and COVID-19. 04:34 "People want to interact differently with the health care system moving forward than they have in the past." 06:55 "It's not necessarily intuitive." 07:03 The biggest point of care that's probably going to be utilized post-COVID: telemedicine. 09:19 EP273 and EP274 with Jonathan Thierman, MD, PhD. 09:34 The health care shifts we're likely to see moving forward. 13:00 Some of the negative consequences of COVID-19. 15:25 What a health care model without a pharmacy benefits manager (PBM) might look like moving forward. 17:22 "Their solution might be, 'Change the formulary.'" 19:39 EP264 with Ron Wince. 21:02 "Finding ways to really dig into … these individual concerns … are not necessarily top of mind." 22:37 COVID creating a flash point for change. 23:04 "I don't know if it's best to call it an opportunity." 24:52 The different health model changes being discussed. 27:28 The incentive carriers have to make this COVID analysis. 28:51 "Costs have to come down."