Valuable Finance Insights from Tier 1 Capital

Tim: Today, it’s our honor to have John St. Pierre, author of The $100M Journey. John is a coach to entrepreneurs. He also has a podcast called Entrepreneurs United, which can be found on all your, favorite podcast channels. John, welcome to the Control Your Cash Podcast.

John: Thanks, Tim. Thanks for having me.

Tim: John, in the pre-call, we talked about your journey. And so let’s start with your entrepreneurial journey, and you had shared with us that you know you were an entrepreneur in college. So tell us about like what you did while you were in college, because that was something that it sort of appealed to me when I was in college. And I never pulled the trigger. So tell us about what you did to make money in college.

John: Yeah, I love that. Well, I didn’t have a choice and you’ll learn why in a second, to become an entrepreneur, but I grew up in Canada, came to the U. S. to go to school and studying accounting. And, in terms of a student coming to the U. S. you really don’t have a work visa. You have a student visa. So my first summer in college, I went back home to Canada and went planting trees. Six hours north of civilization, getting paid 10 cents a tree, wearing all netting for the black flies and not to be able to get you, and spent my summer up in the wilderness. And at the end of that summer, I said, I’m never doing that again. What do I do next year to stay down south? And you know, a little small, little loophole, but you know, you don’t have to be a U. S. resident to own your own limited liability corporation. And so I, basically saw a poster on my dorm room wall, which was own your own College Pro painting franchise. I’m like, what is this? I don’t like painting. I don’t know anything about painting, but I would like to own my own business so I can stay down here. Cause my only other option was to go work for free for some public accounting firms, right. And doing an internship. Right. So. Got that poster, apply for the job. And next thing you know, I’m running my own painting company, uh, in the summertime, hiring all my friends to paint for me, going out and doing sales and estimating, and really got hooked to this like concept of entrepreneurship and, you know, yeah, I’m studying accounting, but I didn’t see myself as an accountant. I saw myself that from that point forward, as an entrepreneur, spent two summers doing that as a college pro painting franchise, and learned a lot about business and had a lot of fun, but a lot of hard work too.

Tim: Well, it always is hard work. And just as an aside, the question, as you were explaining, you know, hiring your friends, tell me how that went when you’re hiring your friends. That you need to depend on them, you know, to paint some house or some, some business. So tell us about a little bit about how that worked out.

John: Yeah, I’m happy you picked up on it. My first summer running my own business was a complete and utter disaster, partly because, I couldn’t count on my crew to show up on time. Why? Because I was partying with them every night. And then the next morning I’m like, guys, let’s go. You got to go, you got to go paint some homes. The most undependable crew, right? The sec…, by the time my second year came around, I learned so much through disastrous, you know, this road as an entrepreneur of ups and downs and challenges. And you’re a new entrepreneur in college trying to figure this all out. I learned a lot of valuable lessons and that was probably one of the biggest ones was don’t hire your friends to work for you. It doesn’t quite work the way you want it to. In the second summer, I built my crews right. I trained them right. I paid them right. And I had a much more enjoyable summer. That first summer I ended up painting a lot of houses myself because my crew didn’t show up on time.

Tim: Naturally, right? And that’s the key as a business owner. The buck stops with you. So, and it’s certainly something, it’s a lesson that we all learn, but so now you have this entrepreneurial bug, so to speak, right? You’re sort of hooked on being in control of your own destiny. Which we know you’re not in complete control, but at least you do have say over certain issues. So tell us a little bit about, you know, after you graduated college, you have this degree in accounting. Where did that take you? What did you do with it? And how did that lead you back, if you will, to this entrepreneurial bug?

John: Yeah, for sure. So immediately following graduation, the parent company of College Pro, which is also the parent company of CertaPro Painters and California Closets and a whole bunch of contracting businesses, were willing to sponsor my visa to stay in the U. S. and work full time for them. So I moved out to Chicago and my job was to actually go. Hire and train college students to do what I had just done. So I was uniquely qualified to show them how to do, how to run your own painting business. So I was training college students on how to be an entrepreneur. Really did that for a couple of years. And this was 1998, Tim, you can probably imagine what’s going on in 1998. And you’re like, okay, do I want to be in a contracting business or do I want to be in a .com business? It was kind of the evaluation and everybody was jumping ship, right from corporate environments to, .com, web businesses. And so. I did that along with a bunch of other colleagues. We were part of a company called handymanonline.com, which was a venture funded startup that basically helped connect homeowners with contractors. That business ultimately was supposed to get another round of funding completely collapsed in the crash. So we lost everything that we were building and the assets of that were sold to ServiceMagic, which was rebranded HomeAdvisor.com, which just merged with Angie, that was that business way before it’s time. That’s the one that didn’t survive, right? But that was the brand well before those others. And so I did that for a few years, learned a little bit about that whole VC environment and .com startups. But then I found myself in the early 2000s saying, okay, now what am I going to do? And it was offered a couple of opportunities to go work in corporate environments, get a nice salary, stabilize everything. But I had this bug. I really wanted to figure out how I could build my own business. And, I started two companies, uh, in 2003. One was a contracting project management company because I had experience in contracting by that phase. And we were doing projects in commercial environments. So we started up a small business for that. And then I started up a little hobby business. I was, I played hockey growing up and all of a sudden, so me and a couple of friends started a hockey hobby business where we were taking teams, youth teams over to Europe to play in hockey tournaments. And that was just a lot of fun, but these two companies started growing. And I’ll fast forward all the way to the end. But 15 years later in 2018, the sports company was a global north of 50 million dollar sports business that we had incubated and grown, massively. And I was the CEO and president of that business full time. And, I got fired. From the very company that we founded, in the boardroom of that business. And I can explain all the reasons why in a few minutes, but yeah, that was a devastating moment for me, 15 years of building this business. And in the aftermath of that, I looked back over at the project management company that I still had over there. It was grown 15 years as well, but it was kind of like. The tortoise, you know, just going a little slowly, hadn’t really grown as much, you know, as around, you know, sub 5 million dollars at some point around then. And I said, you know what, I want to learn some lessons from this massive failure. I’m going to apply it to this other company and prove that I can actually do this right. And we successfully in 2022 grew that company to north of a 100 million dollars the right way. So those were my entrepreneurial journeys in past. And since then I’ve been coaching entrepreneurs and, building our holding company, subsidiaries accordingly.

Tim: Wow, that’s amazing. So, you know, not to dwell on it, but take us through, right? So you really get knocked on your butt when you get fired from your own company.

John: Yes.

Tim: So if you don’t mind, take us through how that went down and like literally what you were thinking, did you see it coming? You know, so explain how that, that whole thing unfolded.

John: Yeah, Tim, it was 25 years of running really hard, feeling invincible. Oh, I got this thing called business all figured out to a big smack. And you know, when you look back, it’s so easy to see how you made yourself so vulnerable. But in the moment, you know, you’ve grown a company from zero to north of 50 million dollars in global revenues. I, all a ton of, really great people worked at that business. The culture of the business was amazing. We were in industry. I have a ton of passion about in sports. I mean, this was my dream come true to build this very large sports business. But over time, you know, I made myself so vulnerable and I felt so invincible that I didn’t quite see it coming until it was too late. I could see the train coming, but that’s within, you know, a couple of months of it actually happening. And, you know, we had raised 20 million dollars of private equity money. To take us, take us from 50 million to a hundred. That was kind of the goal. But it was within six months of raising that capital that I was fired from my own company. And, you know, I know you talk a lot about cash and building your own cash as an entrepreneur. And that’s one of the biggest lessons that I learned is over time. As that company grew, I was more consumed with growing the company than I was with protecting my own equity and control of my business. And so, you know, maybe I started the business as a 33 percent partner. The day I was fired, I owned 8 percent of the company. And I lost the confidence of the private equity firm and said, Hey, we can put somebody else in here to do something better with this business. And, yeah, it was, it was devastating. I had to take some time off. After that, I woke up for the first time ever, not having emails or calendars or calls to be on. I lost my identity. That was my identity. My kids had the logo of this company tattooed on their arms, not literally, but you know, in a, in a way that kids all their t shirts all have this company’s logo on it. I, it was a very devastating moment for me and my family. And, you know, it took a lot of introspection and a lot of perspective to realize, okay, what am I going to make? Yeah, I gotta make some lemonade out of these lemons. What are my learnings? How do I crystallize these and apply them?

Tim: Yeah, so that’s something and that’s I think this is part of the entrepreneurial journey as well. Everything’s a lesson, right? So you get smacked in the face and then the question becomes, what’s the lesson in this? What can I learn from this to make sure it never happens again? What can I learn from this? To teach other people not to be able to be subject to this again, right?

John: Yes.

Tim: And that’s, that’s the whole thing. And you know, when our kids were younger, when anything would happen to them, whether good, bad, or indifferent, I would go over it with them and explain like, okay. And, and try to find out if, sort, sort of pull out from them what was the lesson that they learned from this. And one day my wife said to me. You know, everything doesn’t have to be a lesson. And I disagreed. I said, no, honey, everything is a lesson. That’s what our evolution in life is all about. Learning from the successes, as well as from the failures and being able to apply the wisdom that we got from those experiences so that we either build upon them or avoid them going forward. And so that was, I’m glad you brought that up because there was a lesson in there. So let’s talk about the lesson you learned and how you applied it to grow your other company.

John: Yeah, I love the way you put that, Tim. And it’s just recently the CEO of NVIDIA was talking to, I think it was Stanford College and talking about how important sometimes failure and suffering is in your development as a person, but you have to take it in good light. You have, you know, You have to have perspective. You have to really view your hardship is not the end of the world. Your hardship is here to teach you something. And what is that? And so I had never journaled before, Tim. I had always told about the power of journaling. I never really stopped to think about what my purpose was in life. I just thought I had it all figured out. I don’t need a purpose. I can just kind of build things and have fun. Like, so this moment of reflection, deep self reflection is something I had never done before, but I was forced almost in doing it. So for the first time in my life, I had to sit down and go, okay, what am I going to do with this information? This embarrassment, this, this business that I tried to build and it’s now gone. How am I going to, make this, you know, the most beautiful thing in the world because right now it does not look beautiful. And I don’t wish any suffering or failure to anybody in the world. It’s very difficult when you’re in the moment of going through it, but you are right. The learnings you can take from all of those successes and failures are so important. The first lesson I learned was almost exactly that. You know, when do entrepreneurs take time for deep self reflection on what their life plan is relative to their business plan? And I had those completely separated. I was living a life this way and a business this way, and they were not connected in any way, shape or form. So one of the things I work with a lot of entrepreneurs on is what’s your 30 year life plan? What are you as an entrepreneur trying to achieve in life and all segments of your life? Let’s start there and let’s build a business that can help you achieve that, not create a business that achieves this when really in life you want that, right? How do you connect those two pieces? That was a number one lesson for me that I had never stopped and created a life plan. I had never, you know, take the moment to journal every day and put my thoughts on paper what was important to me in life. And so that was critical lesson number one. And then critical lesson number two applied more to some fundamentals of blocking and tackling with entrepreneurship. And in my book, The $100M Journey. I talk about seven principles of entrepreneurial success, and I can certainly rattle those off, but I know exactly where you would go with it. You know, principle two for of the seven principles was you got to build your own capital. You cannot go hat in hand to financiers and investors or you will lose control of your business and you will not be protecting your equity, which is principle one. So I learned a lot of principles, seven principles to be exact, that I would never do again. If I’m going to grow a business and I, and I really, you know, crystallize those in my mind and formulated a plan around those.

Tim: Well, that’s, that’s tremendous. So, what sort of spurred you on to write the book, you know, and, and obviously a lot of lessons there, but, and I’m sure writing the book was not an easy task.

John: No, no, not at all. Have you written a book yet, Tim?

Tim: We’re in the process and I’ll tell you it, it is, it’s easier said than done for sure. Right, John?

John: Yeah, no question. I mean, I had always thought someday I’m going to write a book. Someday I’m going to write a book. And then I’d have a friend asked me, well, what would you write about? I’m like, I don’t know. I just got a lot of experience and learnings, but someday I’ll write a book. I didn’t really have a story. And, you know, in the midst of this failure, I’m documenting a lot of things. I’m journaling, I’m thinking through what I did wrong, what I would do differently. And then I started applying those principles to this other business. And that business starts growing and I start realizing, Oh, this is what I messed up over here that I’m not now doing here. And we successfully grew that company to north of a hundred million dollars, which was my goal with the sports company. And in the midst of growing that business, when I could see that we were about to hit that target It dawned on me. I got to tell this story. I got to tell this story because a lot of entrepreneurs try and grow their businesses from a lifestyle business to a high performance business and get caught in this messy middle where they feel like they got to go raise capital. They feel like they got to put more debt on their business to grow and put themselves in a little bit over leveraged position. They put themselves in these positions that really suffocate them and they end up losing control of this business. They poured their heart and soul into. So my mission that I discovered in my purpose, I discovered during, during my time off was I really want to help entrepreneurs build the business of their dreams without ever falling off the cliff like I did. It’s good to learn lessons. It’s good to have some failures, but it doesn’t have to be that drastic. You can protect yourself and do things the right way. So I, you know, I combined my mission and purpose. I really want to help entrepreneurs build the business of their dreams. And the failure and success of trying to grow a company to a hundred million dollars and the learnings within that, it really became, okay, I now know what I need to share with the world. And that’s my story.

Tim: You know, that is such a great point because think of it this way, John. And again, going back to, you know, being a business owner, there’s so many similarities to being a parent and right. And, and think of it, think of it this way. One of the things that, again, we used to preach to our children was, the best lessons that you could learn are lessons that other people had to pay the price for. Learn from other people’s experiences because, first of all, there’s no direct cost to you for that learning. Somebody else had to pay the price to make that mistake so that you don’t have to make that mistake. If you’re able to do that and then just take those experiences as a kid, and then even apply experiences from other business owners, if you’re an entrepreneur, Oh my gosh, your learning curve. It’s going to just going to be like, well, no, no pun intended, like a hockey stick. Right, John?

John: Exactly.

Tim: But, you know, it’s, it’s so important to understand that. And, you know, one of the things, you know, you talk about having cash or, you know, sort of giving away your equity, or a lot of times we don’t realize that when we’re dependent on banks for raising capital, the banks own us. Because we always have the saying that whoever controls your cash flow controls your life. And one of the things that I found, and we do a lot with, with data, we had a research report and they found that 61 percent, according to Intuit, 61 percent of small business owners around the world struggle. With chronic or cyclical cashflow issues, and 69 percent of small business owners either lose sleep or sleep less due to cash concerns. Now, sleep deprivation is linked to a 200 percent increase in the incidence of cancer, 20 percent increase in premature death, and the lifespan, the life expectancy of a small business owner is a full five years less than the average American. So obviously, these sleepless nights are creating issues. And this all starts with cash flow. Here’s what I’ve learned in 38 years. Working with small business owners, all of these cash flow issues categorically are self-inflicted. It’s all due to how we’re using our cash, our cash flow. And if we, we call that the financial golf swing. And if we’re able to change that financial golf swing on how we’re using our money, the outcomes for us and our business are dramatic. It is a lifestyle changing exercise. So I’m glad you brought that up because obviously learning from somebody else’s experiences. Is the, is the cheapest lesson in the world.

John: Yeah, no doubt. I subscribed to everything you just said. You know, my sleepless nights, if I go back in time was when I was gonna make payroll. It’s the time where you’re not sure how you’re going to pay your vendors and they’re all calling and screaming at you. Those are, those are really tough times as entrepreneurs. And, and when you get through them, you look back and go, you know, what could I have done differently? In my case, the situation of failure was. We were growing faster than we can actually afford to grow. And I was like, let’s go to a hundred million. Let’s let’s go build this business. Let’s go, let’s go, let’s go. And, and we were reinvesting reinvesting. And Oh, we don’t need cash. Let’s go to the bank again. Okay. Let’s get some more money in here. Okay. Now we need some investors. Okay. Now my equity is going down. It was all for what, for what purpose I’d rather own a 100 percent of a 10 million company than 10 percent of 100 million company. It’s the same math. What was I trying to do? What was I trying to create? And I’ll tell you, Tim, that one of the biggest aha moments for me, and it happened after this whole failure as I was researching is I realized that, you know, your net operating cashflow that you’re generating from your business and how you manage the net operating cashflow is much more important than your profit and loss statement or, or your balance sheet, even to a certain degree, like is your business generating cash? That you can then reinvest to generate more cash. And that’s just really an important metric. And I think a lot of entrepreneurs glamorize raising capital. I did, Oh, he just raised 20 million dollars. Look how cool we are. When in reality, I needed those monies to go reinvest and scatter and, and, and try and build things when in reality, the things I already had weren’t generating enough cashflow to begin with, right? And so there’s a lot of things like that, that I’ve learned. There’s a fantastic article that, is a Harvard business review article that also made a dent for me, which was how fast can your company afford to grow? And what I found was I was trying to grow my company 30, 40, 50 percent a year. But based on my cashflow, I could probably afford to grow 5 percent a year. Well, where does that difference come from? Where’s that 45 percent difference come from and how fast your company can afford to grow and how fast you want to grow. It has to come from investors or banks or other people’s money, meaning the cashflow you’re supposed to pay Peter, you pay Paul, and then you get caught in this whole situation that ultimately ends up, you know, with the, with a bad situation happening. So, you know, as I work with entrepreneurs now, I was working with a group, last couple of weeks. And based on their, their cash flows, if they just make a few tweaks to their AR and AP and working capital days, it could be an a hundred thousand dollars of difference in cashflow in the given year. And think about the relief that that would provide just by some small tweaks of looking at that. And now you don’t need bank money. You don’t need investor money. You got this in your own little business. You just got to do it the right way.

Tim: Yeah, exactly. And, you know, John, I want to share a, an example of that. So we, we work with small business owners, showing them how to create a succession plan, how to attract, retain and reward key people and how to set up an exit strategy. So we worked with a company about eight or nine years ago and we set up their succession plan. And we told them, listen, by doing this, by setting this up, you’re actually going to be building a sinking fund that you can borrow against. And their response was, you know, we’re not interested in that. And I, you know, I didn’t push it at the time, but think about where we were. Okay. Interest rates. So when they went to a bank, Interest rates were two and three quarter percent to borrow on a credit line again. This is going back eight or nine years ago So fast forward to last summer and I get a call from this guy It’s July. It’s August of 2023 And he said hey Tim remember that succession plan we set up? I said, yeah. He said, we, we funded life insurance policies. I said, yep. He said, you said we could take a loan. What does it cost to take a loan now? And I said, well, before I answer that, can I ask you a question? He said, what? I said, what changed? So he goes, I bought a truck, which I always do by taking a draw on my credit line. And I usually pay it off over a two to three year period. Well, do you know that they want nine and a half percent to borrow on a credit line? He said, what does it cost to borrow on a life insurance policy loan? And I said, at the time it was five and five and a half percent. He said, well, I want one of those. And I said, well, you’re, you’re in, you’re in luck because it’s that option is available to you. And so I said, but here’s what I’m going to do. Normally I said to him, Chris, we’ll help you get the loan, but I want you to go through this process. So you understand how easy it is. So here’s what I want you to do. I gave him all the information he needed, call the company. And when the money hits your account, call me. He said, well, what’s it going to take about two, three weeks? I said, no, it shouldn’t take more than four or five days. Three days later, I get a phone call. He said, Hey, I just checked my business checking account and there’s $325,000 in there. And I said, well, you sound surprised. He goes, I can’t believe how easy this was. And I said, well, Chris, this is what I’m telling you about. But the point is this, when you have access to capital, opportunities will find you. And that’s really what we try to impress upon our clients is, listen, you may not have a need for this today, but we don’t know what the economic and, you know, situations are political situations are going to be in our country, you know, in the future. And if we’re able to position you to absorb whatever crap gets thrown at us, man, that’s going to position you and your business for opportunities in the future.

John: Yeah, Tim, similarly, you know, one of the things I talked to the entrepreneurs a lot about, I’m sure you would subscribe to this or even talk to them as well. It’s like, you know, Vern Harnish in his book, Scaling Up, talks about core capital target. Hit your core capital target, right? Which is have your six months to a year of operating expenses, you’re debt free. And you’re generating strong net operating cash when I like to say a million dollars a year when you when you get to a point where you’re generating a million dollars a year of net operating cash flow from your business and your debt free, and you’ve got the kind of reserve account of operating expenses, your position of power to grow your business is so much stronger. What ends up happening is businesses start making, you know, 200k, 300k, or 400k. And then they go hire a VP of sales. And then they go hire this person and they try and grow a little too fast. And then, and the cycle just kind of repeats itself over and over and over again, you know, try and get to that core capital target. And then the whole world opens up for you to grow your business.

Tim: Right. So John, you have such a such an incredible message to share. I mean, just the fact that you, you know, you got fired from your own company and to a lot of our, our listeners out there. That’s almost incomprehensible, right? But you also realize how and why it happened. And you learn from it and now you’re out there teaching other people how to prevent that from happening to them, so how John how could people get in touch with you and where could they buy your book etc?

John: Yeah, so the books on amazon The $100M Journey, the website is 100 M as in million. So 100mjourney.com and people can find me on any social platform. John St. Pierre 100. But yeah, feel free to reach out. I do schedule 30 minute free consultations. People want to talk through the book or the business, and I also have a free workbook that goes along with the book at 100mjourney.com. If people want to download that as well with a lot of templates and tools.

Tim: Yeah, and we’ll put that in, in the, the, episode notes so people could contact you, John. It was such a pleasure. They have you on our show. Is there any parting shots you have for us?

John: Yeah, I think the parting shot I would have Tim based on this conversation. It’s something I didn’t have, but when it comes to cash and protecting your business and growing your business, have patient ambition, it’s good to be ambitious, it’s good to have big goals and go get them, but have patient ambition because that patience will really serve you as you build your business the right way.

Tim: Such a great lesson. Thanks so much, John St. Pierre, The $100M Journey. John, thanks so much.

John: Thanks, Tim.

Tim: Welcome to the control your cash podcast. I’m Tim Yurek 

Olivia: and I’m Olivia Kirk. Today we welcome Harlon Pickett of Eagle Care Health Solutions. Harlon, thank you so much for joining us on this episode today. 

Harlon: Absolutely. Olivia, Tim, it is a pleasure and my honor to be here. 

Olivia: Yes. And Harlon, you’re calling in from San Antonio, Texas, but we understand you work with all 50 states and I know that we have a great episode in store for our listeners today, um, with some unique solutions to health type insurance and health care for small businesses as well as individuals.

So I’m excited to get into that. 

Harlon: Yeah, absolutely. Whenever I had an opportunity to talk to Tim previously, I think It fits right in with the model that you guys use in control your cash. The thought process around health insurance, what we call the big lie, is that you cannot control your health care cost.

And business owners in particular have been fed this line. I’ll just stop right there for years and years that they had no control over it. It’s just a you know what? Next year the rates gonna go up and the next year the rates gonna go up and there’s nothing you can do about that. And as I said, it is the big lie.

There are ways that you can actually take control of your health care costs, therefore controlling your cash. 

Olivia: Yeah, absolutely. So Harlon and I had the chance to speak a little bit before, before the recording and, you know, he was talking as you were, as you were talking, Harlon, there were so many parallels, you know, between what Tim and I do and in our work is with financial planning, um, that were direct parallels with what you do and how you help people break the chains to what is normal and what is the conventional wisdom and what is presented to us that so often.

could take advantage of the business owner as well as the individual. So, um, you’re doing great work over there. So tell us a little bit about how you got started in this space. 

Harlon: Yeah, the story is, you know, the same old for many people. And that is I’ve been in this industry for almost 20 years. I was brought up to believe that insurance was awesome.

It was necessary for everybody. You know, the definition of insurance, if you’re out there and you have no idea what insurance actually really means, it isn’t someone just to pay your bills. It is the sharing of risk. The actual definition of insurance is the sharing of risk. Now, what happens whenever there is no sharing of risk anymore is you’re going to see, uh, rates really climb the way we have seen since.

The ACA, Affordable Care Act, Obamacare, has been put into place. When there’s no underwriting to be done and everyone must be considered as the same, then in essence everyone must be considered sick. So everyone has to be considered, at basically the worst case scenario, because even though it’s still called insurance, it really isn’t by definition anymore.

Because once you have, uh, now really what you’re doing is you’re paying somebody else to pay your bill. Uh, that is not a sharing of risk anymore. The insurance company takes on the full blunt of that because they have no choice but to accept you, no matter what your conditions are. Of course, this is also the reason why people have to pay the same thing, whatever your age is, whatever your zip code is.

You’re paying the same thing as everyone else is in that age group and in that zip code. The, the reason for that is, is because once again, everyone must be considered the same. So even if you are 32 years old and perfectly healthy, never been sick in years and years, and you go and you have your annual physicals done and everything is wonderful, Or you’re 32 years old, and you’ve got autoimmune diseases, and you have thyroid problems, and you are a cancer survivor, or in cancer treatment.

All of those prices are exactly the same for each of those two people. Uh, therefore, everyone is sick. It doesn’t matter if you’re the well person or the sick person. Everyone is taught, everyone is looked at exactly the same. I didn’t understand this, as many of us didn’t, whenever this change happened. So, we watch these prices increase, and then we watch the insurance companies start taking dramatic action and denial of services and deciding when people really should have something or not.

There’s a difference between pre authorization and just denying service. Pre authorization is actually necessary in many cases to make sure you’re not getting something done that can hurt you or harm you. Uh, that’s also called medical utilization management. But what we’ve really run into now is so much that is just automatically denied.

You know, there’s that old joke out there that there’s the person that their only job is to rubber stamp deny it on everything that comes across their table without them even looking at it, right? Just, they just, it just comes through there and they just hit the red thing on it and then we’ll see who appeals and then we’ll think about whether we’re going to pay anything.

And it feels that way sometimes to folks because they don’t understand. Why I just got an x ray denied when clearly I have something wrong. Why would you say I can’t have an x ray to figure out what it is? So all of these things kind of bundled together, Olivia, as I was going through my career and I realized I’m not helping the people that I thought I was helping.

People are getting denied life changing services. And people are not able to afford their insurance anymore. They’re, they’re really just putting it away. And if they do have insurance, they’re deductible so high now that they can’t afford to get their health care anymore. And I used to believe, like many people do, that health insurance and health care were the same thing.

But they are not. They are two very different things. And you do not have to have health insurance to get health care. I had to learn that lesson. And once I did, then I realized there had to be a better way. And so that’s what sent us down this pathway of what we call alternative funded health solutions that in some cases use insurance and in some cases do not, but in every case provide access to high quality health care.

Olivia: Is that the real insurance, Harlon? The sharing of risk or the fake insurance?

Harlon: You know, it’s interesting because when we go through with one of these plans, typically your group is going to be underwritten as your group, not what everyone else is in your area. And so that then is actual insurance. It is based on the health of your population, your employees. That means that, hey, a younger, healthier group is going to get better rates than that middle or older group that may have some health issues.

Is it fair? Well, absolutely, it’s fair. One provides a lesser risk than the other. That’s the way, in my opinion, it should be because now we’re using insurance again. Do you want the lower rates? Well, let me tell you, this is something very interesting. There are a number of things that we can institute into a health plan to help your group get healthier.

We can’t get them any younger. We haven’t figured that one out yet, Lydia. We haven’t figured that one out yet, Tim. We can’t get them any younger. 

Olivia: You had my attention for a second, Harlon. 

Tim: Well, Harlon, I just want to hold that thought because I got the solution for getting younger because a few weeks ago, I was up in St.

Augustine, Florida, and they have the Fountain of Youth. So, you know, we haven’t given up on that, so just keep that in mind. Mastermind 

Olivia: Sessions, St. Augustine, Florida, the Fountain of Youth.

Harlon: When you said St. Augustine, I knew where you were going there, Tim. That’s uh, that’s clearly their claim to fame there. I, I don’t know. Maybe that’s why so many people retire to Florida is everyone’s actually trying to matriculate that way down towards St. Augustine so they can get them a little drink and see what happens, right?

Tim: That’s right. Well, you know, a couple other things that you had alluded to earlier on in this conversation is that, What passes for health insurance today is really not insurance. It’s really just basically you’re hiring somebody to pay your bills and, and they’re not doing a good job at that anyhow. And you know, the other thing, you know, you had mentioned the affordable care act, which every government program that comes out with a name sounds like this great thing for the consumer or for the Average person, right?

The Affordable Care Act. It’s neither affordable and they don’t care. They don’t give a crap, you know? And it’s funny. And you talk about the lies, right? So I’ll, I’ll just, I’ll take over here. I’ll carry the ball for you here, Harlon. If you like your doctor, you could keep them. Obama. That was it. That was the truth.

Or how about. If you like your health plan, you could keep it. Well, none of that turned out to be true, but I guess we have to also accept that 81 million people voted for a guy who stayed in his basement.

Harlon: Well, I’m not going down that pathway with you, Tim, but I hear what you’re saying, you know, the thing about that act and you missed one key part of that whole thing. We can’t read it until we pass it. Then we’ll take a look and see actually what’s inside of it. That was just one of the most famous things ever to me.

It’s so, first of all, you’re just too dumb to understand it, people. You don’t realize how much we’re helping you. Y’all read it later. It’s like, really? What could go wrong? It’s the old saying, right? I’m from the government and I’m here to help. Run for the damn hills when you hear that, folks. Run for the damn hills.

Olivia: Yeah, absolutely. So, Harlon, let’s pivot back. Tell me, how, so, as far as, from an employer’s perspective, let’s say someone has a small business and they have normal health health insurance from, you know, wherever they get it. Um, how could your solutions help them to, you know, get their people better care, healthier and lower the cost as well?

Because that’s a huge burden. I know it’s a huge burden on the on the business owners to the point where some business owners aren’t offering Uh, insurance to their employees. Even 

Harlon: Yeah, that’s something that we ran into a number of times. And once again, it’s one of the things that opened my eyes as well.

So some of the clients that I had some of the small group clients that I had within two or three years of the passage of Obamacare, they were out of that business, right? They were out of that. I’m giving I’m providing health insurance to my employees business, not out of business, out of business, but out of that particular business.

Because Transcribed If you have less than 50 employees, you are not required to provide health insurance. And that number, that less than 50, that makes them about 90 percent of the businesses in the United States. So that means that the majority of businesses are not required to provide insurance. They do it because they want their folks to have, you know, access to health care.

They care about their people. And the unfortunate part is when they do offer it, it eventually becomes such a burden or becomes, uh, the plans change to where there’s very high deductibles, very low usage, and it ends up becoming a burden to the employer and the employee at the end of the day. So now the employee is wishing they didn’t have anything offered because they may actually qualify for a nice tax credit and be able to get that.

Another crappy plan, a different crappy plan, we get a crappy plan on the marketplace instead of a crappy plan from work. And, so, that just, it changes the dynamic of it. So, the answer, of course, is to look at what is going on with that company and asking them a very interesting question. I’m sure y’all never ask your clients this, because it doesn’t appear anyone in health insurance does anyway.

Well, what do you want? What do you want your health plan to do? What do you want it to look like? What are the benefits that you believe your employees would like to have? Would you like us to talk to them and find out what’s important to them? What’s their overall health? What type of care do they need?

When you ask those questions and then the employer realizes that they can actually have input on what their plan looks like and the benefits that are built into it, it changes the game dramatically. And here’s the other part. Most health plans, and I talked to you a little bit about this before we started.

Health insurance and health care are two different things, but we’ve been brainwashed in this country to believe that health insurance equals health care, and especially for small employers. But what is not built into any of your traditional health insurance plans is health care. Now think about that for a minute.

There’s nothing in there. that there is actual access to health care built in. Even if there’s a copay, you’re like, oh no, no, but there is. See, I have this copay where I get to go see a doctor. Okay, how’s that working out for you? When you finally get to see that doctor, how long do you spend in the waiting room?

When you finally get out of the waiting room and into the room, how long do you wait before the doctor shows up? When the doctor finally shows up, how much time do you actually have with that doctor? When that consultation of five to seven minutes is done, what are the next steps? Well, I can promise you it’s typically going to be one of two things.

Hey, it’s time for a new medication, or I’m going to refer you to a specialist for that. Even if it’s within the scope of what that practitioner can do, they typically don’t have the time to treat you and the inclination, because They know that they’re going to actually receive bonuses by pushing you up that chain.

The more they push you, it’s not about writing medication scripts anymore that give them bonuses. It’s about feeding up that chain. healthcare system change. They need you to see a specialist, and then another specialist, and you know what the best possible outcome could be? Surgery. Oh my god, I wouldn’t believe how much money they’re going to pour down on me if I can get someone to have some surgery.

That’s a beautiful thing right there. It is. Talk about a conflict of interest. Well, of course it is, but imagine that every single year you could guarantee one thing, and that is the compensation you received was going down. Would you like that? Olivia, would you be happy if every year you knew the one thing that you could guarantee is that your, your job was going to guarantee you a lesser income?

Well, that is primary care in our country. Primary care every year gets anywhere from a three to five percent decrease in how much they’re getting paid by Medicaid, Medicare, and in many case health plans. However, their expenses go up every single year. So, they’re being treated, as the old saying would go, as a red headed stepchild, when they are actually the primary person, primary care, primary person, that determines what your health is going to look like.

What is your journey going to look like? Well, let’s take that health system out. How do we switch things up, right? How do we make it better? Let’s take that health system out there. Let’s get back to that patient doctor relationship. where we have what’s called direct primary care or advanced primary care or even direct specialty care where you have, in essence, your own corporate doctor, your own company doctor for your employees, where they can even text with a doctor 24 7, where they can, they can know they can be, I mean, when’s the last time you were able to text to your doctor and actually get a response?

Right? I mean, you can’t even talk to him. You call the office and you’ll never get a call back from the doctor. I’m lucky I could get to the nurse. Maybe, you might eventually get to the nurse, right? 

Tim: Maybe, maybe. 

Harlon: Maybe, right? This is, when we get these relationships in there, when we bring back that doctor patient relationship, now we’ve actually put health care back in the health plan.

But notice what I didn’t say there, health insurance. I We’re building a health plan that actually is what’s called the health care supply chain. So we bring in all the different parts of what a health plan or a health insurance plan would look like, but we build it in a very, very unique way so that it benefits the employee and the employer, not an insurance company.

Tim: Well, Harlon, it also, it appears to me that it also benefits the physician. 

Harlon: Absolutely. 

Tim: Right. So, I mean, there’s three stakeholders in this deal and they’re certainly the patient or the employee. There’s certainly the employer who’s paying the lion’s share, if not all of the cost. Right. And then there’s the physician.

And so the physician is paying is is getting paid. To do what he loves to do the reason why he went to medical school or she I’m sorry right because they want to take care of patients and that’s one of the things that I’ve seen in this corporate world of what is now and I hate to use the term health care because it’s really not health care but in this you know big corporate health care conglomerates that have taken over what you’re seeing is the care is just not there because, you know, doctors don’t have the time and they’re really not compensated to do what their patients expect them to do, which is to care for them, right?

Harlon: That’s exactly right. And it’s interesting. We talk about it, you know, still the number one, I’m sure you guys know this very, very well with the business you’re in. The number one reason people file bankruptcy in this country still to this day is medical debt. And for the first time ever, the numbers prove out that more people that have medical debt also have health insurance than those that don’t.

So we’ve seen that this thing is, it’s not, it’s not about not having insurance. In other words, the people who have health insurance, more of them now, there’s more of them that are having bankruptcy due to medical debt than those that don’t have it. So it’s, it’s not about insurance. It’s about access to health care.

And it’s about how you get that access. And just knowledge. And that’s the problem is the other part of it. People simply don’t know. And, and that’s the, that’s the difficult part. But the other side of that is what you just talked about with doctors. And that is the moral bankruptcy that happens to physicians when they’re not allowed to practice medicine.

And the way that they truly want to. They truly have a desire to do what’s in the best interest. But they simply. are not allowed to because of the machine that they have found theirself in. Um, we see record numbers stepping away, retiring earlier, completely getting out of medicine in a time when we can.

We cannot afford to lose any more primary care physicians. They’re just leaving in droves. and the folks coming out. Remember what I talked about. Hey, here it is. You’re going to be the lowest paid coming out and every year your pay is going to go down. And by the way, Mr. Med School student, can we get you to be a primary care doctor?

Yeah, good luck with that. I think I’ll be a podiatrist. Or whatever, right? I certainly don’t want to be one of those guys who has a high workload and a low pay. But this is the beauty of what has happened. There’s always the balances, right? The beauty of what has happened is it has caused a remarkable number to step away and say direct primary care is the answer.

This, this base where I’m not, I don’t accept insurance, I don’t accept Medicaid, I don’t accept Medicare. It is simply a relationship between me and my clients. And I’ll only take so many because you’re going to be guaranteed same day or next day appointments. and you’re going to be guaranteed the care that you truly deserve.

And the, the primary care physicians we see that are using this direct primary care model, they’re taking care of anywhere from 85 to 90 percent of all of your health care needs. A primary care doctor can take care of so many more things than what you believe they can, Before they ever have to send you to a specialist.

Whenever they have time to treat you. So in direct primary care, you’re getting 30, 45, even an hour to spend with your physician. Not in the waiting room, but with your physician. They don’t stop you and they say, Well, you know, uh, Olivia, I see you came in for four things today. But you know, we have a limit of three.

So, we’re going to talk about which ones are the most important to you. And then you can set another appointment for four months now to talk about that fourth one. I’m not allowed to really talk about four things. I don’t, I can’t put that in my code thing. If we did that, I wouldn’t get paid. And I can’t afford to not get paid.

You don’t want the, you don’t want the office to close, do you? Come on, help me out. And that’s real case stuff. That’s ridiculous it should be that way. But it’s not that way. Whenever you have that relationship with a primary care doctor in the direct primary care or advanced primary care setting. in a membership base where we’re taking care of your employees and we’re taking care of your business and we’re making sure they get healthier, not sicker, and we’re making sure they can afford care and there’s not any barriers to care.

It changes things dramatically. 

Tim: So Harlon, that that is so such a such great, uh, insight on, you know, the problem that is faced by the employer, the physician. And the employee. So how did you see, or how did you have the foresight to see the solution? And what have you seen as the result of implementing this plan?

Harlon: Yeah. So I would love to take credit for all of this and it was all my idea. And, but it’s simply, it’s not the case. I did something kind of crazy. I went to places and I listened. I listened to others that had these great ideas. I listened to others that were fighting the good fight. Other rebels, as we like to say.

Other disruptors. Other folks that were seeing the problem and looking for solutions. I listened, and some of it I agreed with, some of it I didn’t. Some of it was just even too crazy for me. And I know that’s nuts, right? I mean, because I do some crazy stuff. But some of it also I didn’t feel like went far enough.

So what you get with eagle care is you kind of get what I believe is a bit of a balance, a balance between, you know, the old ways and some of the new ways. While I am not a huge fan of traditional insurance models now, I still believe they have a very, very important place. There are times there are groups that simply because of health issues are ongoing health use.

In particular, they have to stay with a fully insured health plan. Or we have to do some type of hybrid where some of the people are on a fully insured health plan and some people are not. It’s all about the group themselves and building something that’s custom for them. If you don’t ask the right questions, there’s no way you’ll get the answers that help you determine that.

But this journey has, is not easy. It’s still, it’s still not easy, Tim. Still not easy, Olivia, because Employers have been told this big lie that I talked about earlier. It’s been, it’s been talked about for so long. They just don’t want to hear there’s something different. They just don’t believe that there’s a chance that they could control their health care cost.

And when you start talking about something that’s not one of the big ones, if it’s not a blue, if it’s not a United Healthcare, if it’s not a Humana, if it’s not an Aetna, if it’s not one of those, then it just must not be any good. I mean, why would you even talk to me about something like that? That just doesn’t even, I mean, my employees have to have that blue cross blue shield on their card.

If they don’t have that on their card, they’re gonna, they’re gonna hang me, man. I can’t have that. Why? Why? Why is that? What about some education? What about we really asked him how well this plan is treating them and what is happening on this plan? I think you’ll be surprised. I think they’ll be surprised because even people who believe they have to have something like that once.

You really ask them the questions on how they’re being treated, and on what their experience has been, sometimes that film is lifted from their eyes, and they’re like, you know what? I’ve had all those things happen to me. Why do I need this card exactly? 

Tim: You know, Harlon, it’s, it’s not as much film lifted from their eyes, but the scales are lifted from their eyes.

Harlon: Yeah, no, I mean, you’re right. It’s, it really depends on how blinded they are. What’s, what’s interesting, it Is we have some that there is no conversation. They have had such bad experiences that it’s like, I don’t really care what you’re doing as long as it ain’t the same ol same ol right? All the, the only thing I don’t want is status quo.

You just tell me whatever we’re gonna do and I’m in. And then you’ve got the other ones that they’re just not ready. And that’s okay. It really is okay. We’re gonna show you the other way. We, maybe we just put small little steps in there. Maybe the first thing that we’re going to do is we’re going to address what you’re spending on your prescription drugs, because that’s one of the number one things that kills health plans is the high cost of prescription drugs.

Maybe we put something in there where now you’re going to start getting some of those overseas. Or now you’re going to start doing a little bit of different thing for specialty. Putting just a few little things in there can have the impact of saving tens of thousands of lives. Depending on the size of the group, hundreds of thousands or even millions of dollars from your health plan.

And once an employer gets a taste of that, Ooh baby, here we go. They’re ready. They’re ready for at least another step. Another step, another step, and Uh, you know, we’ve seen turnarounds as long as, you know, three years before groups were ready to really start making that dramatic change. You just work at whatever pace they’re going to because the number one thing that we’re looking to do is meet that group where they are.

And help them negotiate this incredibly difficult system so they can do the best thing for their employees and for their company. 

Tim: So Harlon, your solution is not an all or nothing. So it seems, it appears to me, if I understood you correctly, it’s the kind of thing where you could sort of ease into this and transition away from the conventional wisdom traditional health care plan.

Harlon: Yeah, absolutely. And you can even have a traditional plan at the same time you’re doing this. You can have a traditional plan and once again, we can ease in, uh, different solutions, different point solutions, different ideas and concepts into it with your, even your traditional plan so that you can start getting a taste and a feel of what it looks like.

You know, one of the main things that we have a difficult time with when someone is fully insured is they have no claims data. The insurance company will not provide us anything to let us know what the overall health of that group is. So as we can start putting a few little things in there, even if we keep them with a major insurance company, but we move them to what we call self funded.

It’s not as scary as it sounds, but once we put that in there, it’s just a, just a way the thing’s funded, folks. It’s not really. You’re self funding already. Who’s paying the premiums, right? Whose money is it? It’s your money already. So, just because it says fully insured, it doesn’t make any difference whether it’s fully insured or self funded.

It’s still your money, okay? It’s just the way the buckets are set up. But even if we do that, that means that now that data is yours. You are allowed to look at that data, so we’re better able to make the adjustments where those adjustments need to be. When you’re fully insured, we have no idea where all your costs came from.

We have no idea if you really should have got that rate increase or not. There’s no data. The insurance company just tells us, Oh man, y’all had a really bad year. We’re going to have to kick up your rates. Based on what? Well, we can’t share that with you. That’s proprietary. What? I just spent my money and now you’re telling me you can’t tell me why you want more of my money.

Where else does anyone do that? Really guys? Think about that. Where else does anyone have that same thing happen to them except for in the crazy world of healthcare and health insurance? 

Tim: Yeah, that’s that’s a great point. And you know, Harlon, you made a good point earlier a few minutes ago about it’s your money because a lot of times the employee Because the employee may not be paying directly or paying the lion’s share of the cost, they think that, okay, my employer’s paying, paying this.

But what they fail to realize is in the absence of the healthcare, they would get a higher wage. And 

Harlon: it is, you know, so one of the number one things that people miss out on is realizing that these, the cost of healthcare. is keeping money out of their own pockets because whenever you a recent survey came out and the question was asked with the cost of health care continue to increase and even outpace and outpace inflation right now of 172 employers that were surveyed across groups of less than a thousand to over 5, 000 across every industry you could imagine.

91% said that in one way or another, we’re going to have to push those costs off onto the employee as they continue to go up 91%. Well, that can be done in various ways, right? It can be done by your premiums go up. It can be done by that three, five, 6 percent raise you were going to get. You don’t get it.

Okay. Believe me folks, that is pushing the cost onto you. Trust me. If you’re not getting a raise Blue Cross is Aetna is Okay? Your insurance broker is. Ask him. He’s a heavy guy, man. He plays, uh, he plays golf with the director of HR, uh, every couple of months. And, uh, he, he takes him out to dinner so he can stay on that health plan so he can enjoy your raises that you’re not getting.

Okay? That’s the reality of what’s happening out there right now. But that is, that’s directly, uh, to, to your point. It’s taking money out of employees pockets because of the increased cost of healthcare. 

Tim: Yeah, so thanks for making that clarification. So the other thing is, what are you seeing as far as, and I know you had alluded to it earlier about, you know, your physician under, under this plan, your, that your physician is now allowed to spend more time with you and actually maybe carve or craft a, uh, an actual health care plan for you to improve your health.

Get better, what have you. What other positives are you seeing or results are you seeing from this type of care? 

Harlon: So one of the big issues that we have in this country is, uh, about 61 percent of folks don’t go to the doctor unless they’re sick. So that means they’re not getting the preventative things done that they should be getting done.

And there is not a focus in United States on primary care like there is in most other first world countries as it were. For And because of that, we have seen chronic illnesses. I mean, look at what’s happened with diabetes and look at what is what happened with thyroid issues. I mean, they’re in chronic, terrible levels.

I mean, it’s epidemic like with what’s going on with some of these chronic diseases because they’re not being controlled properly. So we’re seeing a workforce that is not as healthy as it should be. But with these health plans It’s not just the access to the doctor, but it’s the it’s the removal of the barriers to get to see the doctors.

The removal of barriers to get to have access to a nutrition without having to spend a bunch of extra money because it’s included as part of your plan so that you can now get that taken care of. It’s I’m not having to deal with this chronic back pain anymore because now I have access, in many cases, to zero out of pocket to find out what’s going on with my back.

I can get my imaging for zero out of pocket. I can have that imaging looked at and read and diagnosed for zero out of pocket. And now if I need to have other things done, it’s going to be affordable or it’s going to in some cases, when we put plans together, zero out of pocket. all the way up through surgery if necessary.

Last thing we want to do, if we don’t have to, we don’t want you to go through surgery. But why are you dealing with this chronic pain in your back, in your knee, in your shoulder, and wherever? So it’s access. It’s true access and removal of barriers to health care, not just at the primary care level, but all the way up that chain of what of the different things you may really need.

And in a lot of plans that we’re doing now, too, people want to look at more holistic. They want some of these natural solutions. Maybe they want to look at chiropractic or even acupuncture or acupressure. Some of these other things. We can build that into a plan now. If that’s something that your group wants to have, we can do that.

There’s just so many things that are out there now that will help remove the barriers to access to health care. And that’s, that’s the big deal, Tim. To answer your question, that’s the big part. Remove whatever barriers there are to health care. 

Olivia: Yeah, Harlon, I was, I was actually going to ask about the holistic because I feel like so much of our country and so many in our country faith in the conventional care, um, because they’re not getting what they need and getting actual help and results from their doctors, regardless of how many times they go to see them.

You know, it’s always like, Oh, I have this chronic condition, this chronic symptom, and there’s nothing wrong with me. So finding, you know, alternative care solutions, um, is something that I see very commonly now, you know, especially as the younger generation, I feel like, you know, the millennials, the Gen Z is I’m sure older people as well, but I see it in our marketplace very much looking for other solutions.

Harlon: Yeah, they absolutely are. And many folks are much more open minded than others on those type things. And there’s nothing wrong with that whatsoever. But your traditional plans, they’re not going to include those things because This is the way it’s always been. I mean, that’s, that’s one of the scariest terms you’ll ever hear, but that’s, this is the way it’s always been.

We don’t do that because this is the way it’s always been. Um, most of our options now, uh, we include some version depending on the plan and what the employer wants. We even include some version of stem cell therapy. 

Olivia: Wow. 

Harlon: And we’ve seen stem cell therapy, especially in the MSK, the musculoskeletal. Uh, we’ve seen that have dramatic effects where there’s a lot of folks that may have had some kind of invasive surgery that haven’t had to have any.

They, they had the stem cell and they’re, I mean, fully 100 percent good to go and have not had to have the surgery at all. So imagine that cost savings for an employer when he didn’t have to pay those tens of thousands of dollars for some surgery, a knee replacement maybe. Uh, and instead he was able to, to get, you know, spend a couple thousand bucks on a, a treatment regimen for stem cells and the individual is good to go and super happy with everything that happened.

Olivia: Yeah. There’s, 

Harlon: there’s great answers out there. 

Olivia: And the other thing I was thinking about Harlon is, you know, we talk about saving money and, you know, saving money is great, but if you don’t have your health and your employees don’t have your health, like you don’t have anything at the end of the day. You know, you can have.

millions of dollars and feel like crap and have no solution and you don’t have it. You don’t have anything. You’re at the mercy of the system at that point, the system and God. Um, so having solutions that are accessible, affordable, and are actually going to give the employees and the patients results is something that’s very powerful and certainly worth looking into.

Harlon: Yeah, I mean, as a, as a paraphrase here from, from Vir, from Virgil, uh, the greatest wealth is health. 

Tim: Mm hmm. Yeah. Exactly. You know, in Harlon, so I would imagine because there’s a, I won’t say a greater focus, but I guess the reality is there is a greater focus on preventative care under this model. Yes. And there’s certainly, uh, so I would imagine that the overall costs.

to the plan or to the company are probably significant or the group. Let’s say the, the, the employer group, I would say the savings have to be significant. Is that a fair estimate? 

Harlon: It’s, it’s somewhat fair. So let’s remember, we have to meet a group where they are and what we see is typically a very dramatic savings, but sometimes it’s over three years.

If we walk into a group that has a number of health concerns that can be corrected through better engagement with primary care, with better engagement and you know, the really working through those chronic conditions to get them under control. Then they may not see a savings in that first year. In fact, they may see a slight increase in cost that first year as we get their group healthier as we implement all the different pieces of this because I promise you It’s never just as easy as everyone in your company says yay a new health plan.

Let’s all do new stuff It’s gonna be awesome. They say they’re gonna make us healthy So we’re gonna do all the new things that they want us to do from day one 

Olivia: because health insurance 

Harlon: Exactly, right? I mean, they’re so excited whenever they do in the insurance guy comes in and talks to him about all the new stuff And oh, look, we have a new app.

I’m gonna play on it every single day and keep track of all my stuff It’s gonna be awesome No, you’re not going to have that. Um, it’s going to take a little time. There’s going to be some engagement issues we have to overcome, depending on your group. Some groups are easier than others, but there still has to be some buy in.

And typically, your second year is better than your first year, and your third year is where you’re knocking it, starting to knock it out of the park. If you don’t knock it out of the park that year, you’re usually hitting a triple. And here’s why. Because especially if it’s designed To benefit, to give greater financial benefits to the people that fall in line, okay, I’ll say that.

But the people that actually follow and go through, get their, get their annual physicals done, uh, work with the, uh, the medical utilization management to make sure they’re getting the proper care at the proper time at the proper place, getting quality health care, and they follow this pathway. Once the other folks that are not doing that see the results of these folks, They want to come over here.

They say, wait a second, I had a knee replacement, and John over here had a knee replacement, and it didn’t cost him anything, and he was back to work in eight weeks. Mine was not messed up, but I got an infection. I got an infection, and then I had to be readmitted to the hospital. They had to clean that out, and I had to be on antibiotics for two weeks, and then because of that, I ended up having to have another knee replacement.

And it was 8 months before I was back, and my total out of pocket was 28, 000. What the heck happened? How did he get his for free, and everything went great? And mine went horribly awry. I thought I went to a good doctor. Based on what? Honest question. Olivia, Tim, right now. How would you decide, if, if you had to have a major surgery, how would you decide that the doctor you were going to see was a good doctor?

Olivia: Referrals? 

Tim: I would probably look at referrals or do some research. 

Harlon: Where would you research at, Tim? That’s a good, where would you research at?

Tim: Probably at, at the doctor’s website or the hospital website.

Harlon: You know what’s interesting about the doctor’s website, Tim, is everything on there shows five star Google reviews. He’s a great doctor, just ask him.

Olivia, what are your thoughts on that? Where would you, if you had to, if you had to check on a doctor, where would you do that at? 

Olivia: Well, I was also thinking, so, I mean, I don’t know what I would do because there’s nothing on the websites. There’s, you know, the doctor’s picture. So he’s a person, um, where he went to school, his address, his phone number, how to get in touch with him.

So, but I mean. I think another option would be, you know, the referral from your doctor, but I was thinking that at the end of the day, I think the, I would imagine the surgery, the success of the surgery would have to do with your, your overall health and your body. So, you know, individual results may vary.

Well, 

Harlon: okay. So here’s another question then. If, if there’s two surgeons working at a Same exact hospital, same exact operating room. One does this surgery anywhere from 20 to 25 times a week, and the other one does this surgery anywhere from 2 to 8 times a month. Which one of those surgeons would you want to go see?

A. 

Olivia: The first 

Harlon: one. 

Tim: So, so where do you find that information? 

Harlon: This is the interesting thing, right? You have to know what the quality scores are for surgeons and there are resources out there, but typically it’s not easy to find as an individual. Uh, we have that information in our health plans and we have nurse navigators that help provide you that information.

Uh, we also have the difference in facilities. Here’s another thing. We know where a surgeon can that maybe a surgeon has a score of 93 at one facility and 60, 70 at another facility. Why would that be? It tells you that one facility is doing a better overall job of cleanliness and the team at this one is a better overall team than what they have at the other facility.

Those type numbers are very important because you’re still getting to see the same doctor. But would you rather go to the place with the better outcomes? Same doctor. It’s not the, in other words, in this case, the doctor score reflects everything guys. It reflects the outcome. It, uh, it, uh, reflects this, uh, readmittance.

It affects the infection rate. So even things that are outside of that particular surgeon’s purview, as it were, all fall into that score. That’s important information, in my opinion, but there are multiple places where you can get this. Typically what we do is we have ways to aggregate all of that information so that then you get a real true score of what that looks like for that particular surgeon.

We have seen wildly different scores for the same exact person. And then also wildly different scores even at the same facility. For more information visit www. FEMA. gov Because sometimes some of these physicians will not work with anybody but their own team. And when that happens, when you have that specialist that only works with their, that one team, you’ll see very consistent scores at different locations where it may be different for other doctors.

It’s kind of an interesting little thing, but if you don’t know, you don’t know. I wouldn’t have known any of this stuff until I started listening, right? I started listening and hearing like, whoa, wait a second. I was, I heard a great story one time where the guy said, I was referred to this doctor for this, for a neurological, uh, situation that I had.

I was referred to this doctor, and he was great. He was, he was the head of the department at this hospital, so that means he’s got to be a great doctor. And I went through the whole process, and I was getting ready for my surgery, and then I talked to my buddy, a friend of mine is who we talked to, and he said, he said, would you like me to see what that doctor’s score is?

He said, yes, I’d love to know what that score is. I mean, I’m certain that he’s a great doctor. Once again, he’s the head of the department here. But yeah, just to make me get that warm and fuzzy, give me that, give me that score. Called him back a couple days later. He said, you know, I got some good news and some bad news for you.

He’s like, well, tell me the bad news. He goes, well, your, your doctor, your doctor score was 8. 64. Like, that’s not terrible. Out of a hundred.

What? Out of a hundred? He said, how’s the guy even still practicing? He said, well that’s the problem. He’s not really. He does just enough to keep up his certification to be able to do this surgery. He’s so busy administrating as the head of that particular department, he doesn’t have time for surgery. So, you’re kind of out of practice when that happens, right?

It’s not fair to the surgeon, and it’s damn sure not fair to the guy that’s affixing to go under the knife. He says, well, what the hell could be the good news? He says, well, two of the guys that work under him both have scores over 95, so I’d highly recommend maybe talking to one of them. So, that’s what he did.

He changed doctors to one of the guys, uh, the guy actually had an over 97, a 97. 2 rating, and everything went wonderfully for him. But you don’t know what you don’t know. Once again, this guy’s the head of the department. He’s got to be the best there. Unless he’s not. But how do you know? 

Olivia: You don’t. You don’t.

And hopefully you find out before it’s too late, right? 

Harlon: You’re going to find out one way or the other, Olivia.

Tim: Yeah, and And it could very well be that he became the head of that department because his best friend was the guy who was hiring or appointing the heads of the various departments. Right, 

Harlon: or he could have been, he really could have been great at administration, right? It could have had nothing to do with his skills, but he was really good.

And maybe he was a really good leader and a really good administrator and he found his niche. And that’s where it was. But at the same time, I don’t know how hospitals work. Clearly, this one worked where he still had to maintain that certification and obviously his licensing to be able to be the head of that department.

But he was, in my opinion, he was doing no one a favor by doing that, but they didn’t ask me for some reason.

Olivia: Okay, Harlon, well, how could our listeners get in touch with you if they have any questions, you know, as an employer, um, looking for services for their, for their business as far as healthcare is concerned? 

Harlon: Yeah, absolutely. Uh, obviously they can reach out to me directly at my email at hpickett at EagleCareHealth.

com. But if you want to learn more about EagleCare itself, you can go out to EagleCare. com You can also find me on LinkedIn I have lots and lots and lots of content for you on LinkedIn Go out love to connect with anybody and everybody on LinkedIn. We do monthly audio rooms live audio rooms on LinkedIn called why does health care suck and Every month we talk about different subjects.

We are right now on a three part series of What’s going on with employers. So the why does health care sucks series has talked about all kinds of things, including some of the barriers to health care. But in this particular part of the employer point of view, it has been what is keeping employers from making that change.

So if you go out, you can find recordings of that as well. But go out to linked in and Find me there. And then, of course, as I had met Tim originally, he was on my podcast, the Health and Well Power Hour. You can find the Health and Well Power Hour at hwpowerhour. com or at any of the typical places where you digest your podcast.

And then on March 4th, we kicked off our once again series that we were doing for a lot last year and kicked off in a new format this year across multiple platforms. And this is called the kickstart. So each week, 10 a. m. Central time, we will do a broadcast about trends and news in the health insurance and health care world that really kind of keeps you up to date with what’s going on.

So follow all of these different things. Reach out to me personally. Love to talk to you about what’s going on with your company and how we can help you If you don’t want to work with us, I promise we have got tons and tons of other folks around the country that are doing some of the same point solutions and some of the same concepts that we are.

Uh, we even have a good buddy in Puerto Rico that is doing this as well. So he can help you out there if you’re in that area. 

Olivia: Awesome. Well, so much for all of the wealth of knowledge and the energy that you brought to the show today. We greatly appreciate you taking time out of your day to You know, inform everyone about what’s going on out there and about the alternative solutions that are available, um, for health care, um, for their employees and, you know, bringing that to the forefront for a healthier country and healthier individuals that were around every day.

Tim: Yes, Harlon. This is such valuable information. And you know, when we’re talking about helping people or companies control their cash, one of their major expenses other than salaries is health care.

So if there’s an opportunity for people to save on health care, but also improve the quality of life. of health care that their employees are receiving. That all translates to the bottom line of the business as well. 

Harlon: It has been my pleasure. Thank you guys very, very much for having me.