EP309: FFS Providers Getting Locked Out of Referral Flows, Right Now, As We Speak, With Jeff Hogan
Episode Description
In Episode 309, Stacey Richter talks with Jeff Hogan, northeast regional manager for Rogers Benefit Group and president of Upside Health Advisors, about how fee-for-service providers are getting locked out of referral flows right now, as self-insured employers steer their plan members toward accountability and financial predictability.
WHAT YOU'LL LEARN
✅ What self-insured employers are doing right now to actively steer referral flows
✅ Why fee-for-service providers fear the informed health care consumer
✅ What employers actually mean by "value" coming out of COVID: accountability and predictability
✅ Why brick-and-mortar providers are realizing they need to up their game
✅ Why data has become critical to how employers manage their health care spend
WHY THIS MATTERS
Armed with claims databases and reports like RAND 3.0, employers can now see clearly which providers deliver accountability and financial predictability — and they're using that data to steer plan members accordingly. Slower-moving, FFS-centric providers, whether a large health system, urgent care center, or hospital-owned PCP, risk getting shut out of referral flows entirely. As Jeff Hogan puts it after 35 years in the business, this finally feels like an inflection point where health care can't go back to the fragmentation of fee-for-service.
=== LINKS ===
🔗 Show Notes with all mentioned links: Episode Page
🔗 Healthcare Industry Acronyms and Terms
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00:00 Introduction.
01:43 What are self-insured employers doing right now to impact referral flows?
03:29 Are any virtual tech companies moving in on the local provider space?
07:46 "What we're trying to do … is to help the member have the best outcome."
10:32 "It's a continuum, if you will."
10:44 "There is a fairly significant gulf between providers … and, say, a COE [Center of Excellence]."
11:13 "What is value for employers coming out of COVID? Accountability and predictability."
13:40 What are second-order effects?
14:29 "People like and want better access."
14:46 "Fee-for-service providers fear the informed health care consumer."
22:19 "Many of the brick-and-mortar providers are realizing that they have to up their game."
24:52 "Things will change."
25:07 "People not only want convenience, but they want safety, they want data."
26:11 "We are at an inflection point … After 35 years in the business, I really finally feel like we've broken through."
27:31 "This requires people to really think; it requires employers to actually know what their biggest problems are."
29:53 "We can't go back to the fragmentation of fee for service."
30:25 "Data is critical."
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