In this episode, host Joe Pantozzi teams up with healthcare strategist Troy Reichert to shine a light on the true costs of employee benefits and health insurance. Troy talks about jaw-dropping differences in procedure costs just a few miles apart and exposes the lack of transparency that keeps businesses and employees in the dark.

They’ll discuss practical ways to become a more informed consumer, spot the hidden money leaks, and pay fair, not inflated, prices for healthcare. 

If you care about protecting your wealth and making smarter decisions for your business or family, this episode is a must-listen.

Show Highlights

• How are rising health care costs affecting business owners? [02:33]
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• Here is how you can access health care differently [03:05]
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• Discover the book that will teach you all about self-funding [04:04]
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• Do you know why insurance premiums keep soaring? [05:19]
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• Discover how financial experts pinpoint where your money leaks [07:19]
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• Learn why employers need to look for better alternatives [08:33]
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• Here is Troy’s win-win solution for all parties involved [13:20]

joe@alphaomegawealth.com

https://www.linkedin.com/in/joe-pantozzi-941a073/

AlphaOmegaWealth.com

Welcome to make youe Wealth Work, the podcast where wealth becomes your greatest ally in achieving your dreams.

Hey, everyone, this is Joe Pantozzi, and this is make youe Wealth Work, our podcast with Alpha Omega Wealth. And I'm here today with my good friend and trusted advisor, Troy Reichert. Hey, Troy, how you doing?

Good morning, Joe. How are you?

I'm really good. Good to see you. Good to be with you.

Good to see you.

So Troy is with Troy Reichert, and he's got several different companies and several different areas of expertise and counseling that he provides to clients. He's in Tulsa, Oklahoma, and I'm going to have him share a little bit about what he does.

So this is going to be a little bit different conversation because I'm primarily concerned with the financial integrity of our clients and financial progress and helping them become better stewards of their money, helping them understand the economic influence in their life that helps them achieve their goals, helps them create legacy, create generational wealth, et cetera, et cetera. And one of the biggest expenditures that any family or business has after payroll is medical insurance or medical care or health insurance.

And Troy is an expert in that field from several different levels. So Healthcare Reimagined is one of his companies, TR Strategies and Prime Healthcare, three different efforts.

So I'd like to spend a little bit of time, Troy, with your outlining what you do, why you do it this way, who you do it for, how it works, etc.

Absolutely. Absolutely. Well, thank you, Joe, for the introduction, and I look forward to this conversation. You know, you talk about wealth for individuals.

So many of those individuals that you're working with are business owners. And you're exactly right. Their largest expenditure beyond payroll is their employee benefits, their health care.

And they're just seeing their prices go up and up and up every year without any checks and balances. And at some point it's going to break. They're just. They can't afford it. You know, there's already been studies.

JAMA came out with a study about a year ago that said basically that documented that employers are not able to give raises to their people because of the rising health care cost. So it's affecting everybody.

You know, when your employee benefit costs are going up faster than inflation, are going up faster than your own growth in your company, something's wrong.

And so I work every day to help people, from the CEO of the company to the secretary at the front desk, to help them afford healthcare, to help them think differently, to reimagine how they can do and access Care and that's what I get up every day and do.

So that's cool. That's a great overview.

I'd like to ask you about some specifics and I don't know if the couple of books that you've written are commercially available, so you might want to plug those books as well. So tell us about that.

Yeah, so you know, I grew up in the employee benefits space and have done it literally from coast to coast. And I Met Joe about 12 years ago when I was living in Los Angeles.

And it's all about for me helping businesses find a way to afford their health care. And so I moved back to Tulsa about eight years ago to run a tpa.

A TPA is a third party administrator who basically manages the claims for a self funded medical plan. And in that process I was educating brokers and I was educating prospects about what is self funding, what does that mean?

You know, most people when they hear self funding, it's sort of a big boogeyman. Oh my word. And their brokers are scared of it too because they don't know about it. And so I wrote a book called Benefits Reimagined.

It's basically the Self Funding 101. I wrote it in such a way that the guy on the line out in the manufacturing company or the CFO could read it and get something out of it.

It's a very short book but it's very well documented and it helps explain. It removes that boogeyman aspect of it. It helps them understand that, hey, there's only two buckets of money when you pay your premiums.

I don't care whether you're with Blue Cross or United Healthcare or self funded medical plan. There's only two buckets where your premium dollars go. And that's the admin bucket, administrative costs, and then there's the claims bucket.

And guess what? The claims bucket is twice as big in normal places as the admin bucket. So where are we going to focus our attention?

We're going to focus it on the claims. Well, it's not that we want to prevent people from having medical claims. We want to pay a fair and a nice price for those services.

You know, when I'm paying 900% of Medicare, that's not a fair price. You know, I want the doctors to make money. I want the facilities to be in business next year. We all need that.

But it's not, it's egregious when they're paying, when they're charging 900% of Medicare, it's egregious when they're not showing the price.

I mean, this whole price transparency thing that you hear and read about all the time, it is the biggest fear of two, two people, the hospital administrators and the big Alphabet houses. In terms of the insurance agencies, they don't want transparency because there's so much money in health care and they're taking advantage of it.

Who's paying it? The companies, the business owners and the employees that you work with every day. That's who's paying it, who's taking it?

It's the big, what I call Buca, Blue Cross, United Aetna, Cigna Humana, they're taking it.

It's the big insurance agencies, the big Alphabet houses, national Alphabet houses that are getting retention bonuses from Blue Cross that in the millions of dollars, it's even in Gallagher's annual report a couple years ago, that they were, they were relying on the retention bonuses that no one knows about, that they don't disclose. They were relying on those retention bonuses for their profit and their growth. Who's paying that?

The CEO of your company, the CFO of your company and the guy out in the warehouse. Those are the people that are doing it. Those are the people that are actually paying it and they don't know it.

And that's what I again, I want to expose that. I want to help people understand, hey, you can make a decision to be with Blue Cross, that's fine.

If you understand the cost, if you understand what's going on behind the scenes and you make that decision, that's okay. I want you to be a well informed business owner, a well informed CFO to make those decisions. And if you make that decision, that's fine.

I don't want to, you know, make, make you make a different decision just because you, you listen to me. I want you to make a better decision because it's good for you and for your people.

Wow, that was a mouthful. And no, and it's important because, you know, I'm, I'm a financial quote unquote professional, right.

On the financial side, on helping clients to find out where their money's going.

In many cases, find out where the leaks are, where the hemorrhaging is, if they're overspending, if they're using the wrong types of credit, toxic credit and so forth and so on. But like I said earlier, health care is a huge expense.

And I'd like you to repeat for me something that you shared a while back when we spoke and you spoke about creating a private doctors panel and you Gave an example of two different surgical institutions. I think in your locale it might have been a hip replacement or a knee. Can you share how that worked from the one to the other?

Absolutely, yeah. Yeah. And again, that's the area of my expertise. That's where I work every day in our country.

There's a lot of people that need hip replacement, that need written knee replacements. It's just amazing what these doctors can do today, either surgically or robotically, and replace people's knees or hips.

And they're up and walking, you know, literally within hours of the surgery. They're recovered within six to eight weeks and they've got a new life. So it's awesome. But at what price?

You know, you go to here in Tulsa, Oklahoma, you go to one of the, you know, the number one hospital here, and you're going to be charged the plan out of the claims bucket. They're going to be charged. They're going to be paying $80,000 for that knee replacement.

I can take them literally less than two miles away with just as good or better doctors, and I can pay $25,000 for that. What's the difference? Well, two miles and about $55,000. That's the difference. Why pay $80,000 when you don't have to? And so it's absurd to me.

And I do claims analysis all the time for clients and prospects and brokers. And I see this every day.

You see a hernia replacement that is 14 or $15,000, and you can go down the road, go to one of my surgeons, and it's 4,000 or $5,000. So why would you pay that? But they pay that because they don't know. And that's the unfortunate part. There's not transparency.

They don't have the prices listed. They don't know that that's an option for them. And again, the buca's Blue Cross United States, Humana, they don't want you to know that.

They don't want you to be aware of that. They don't want to really give you a choice.

You know, for the last, you know, 30 years, the buckets have been telling us, oh, we've got the biggest network, we've got the most access, we're the best. And yet, when you really think about it, what choice are they giving to people?

You know, Joe, we've seen an unfortunate transfer of the risk to the employees because through hiring, you know, when I came into this business 18 years ago, a $500 deductible, a thousand dollar deductible for the medical plan was common back then. Today, $3,000 is the low end, and it's 5 and it's up to 7 and higher. So there's. And it's all been transferred to the employees in terms of the.

Out of pocket, what they bear, what they have to pay.

So we haven't gotten our bill yet.

Yes, I'm going to get that bill and I'm going to share it with you because the knee surgeon who we chose, who was recommended to us highly by several different people in different areas in town, has his own outpatient surgical center. Evie had a total knee replacement two months ago. Now, and we do choose a high deductible.

I was kind of amused when the medical assistant or clerical person called our. Our house and said, hey, you know, you have a $10,000 deductible that apparently you haven't met yet for this year. Yeah.

She says, how are you going to pay that? As. As if there's an option, as if you're going to let me have the surgery if we don't pay it. And, and Right, right.

And may, you know, maybe there was a. Maybe there was an option. I didn't ask, hey, can I have the surgery without paying the. You out of pocket?

And so my wife said, well, would it be okay if we wrote a check?

Right.

Oh, yeah, that'll be okay.

Yeah.

So will you bring that check the next time you come in for the pre op? Well, yeah. Like, what else would people do? And so now once I get that bill, Troy, I'm going to share it with you, and then you can.

And you'll probably have some kind of data that you're familiar with, with what the local hospital here, it's upmc, University of Pittsburgh, University of Pittsburgh Medical Center. That would be the alternative. So. And I know that this doctor can do either.

So we'll find out if in fact there was any savings through the insurance because we went to a surgical center. And then I have a question here about, about the kinds of clients that you work with. So for.

Let me. Before you go into that question, Joe, let me say one thing. So here's what's interesting about what you just said.

Yeah.

So you picked a surgeon. He's got his own surgery center, which is great.

The surgery centers that I work with, the surgeons that I work with, they actually get paid more at my $25,000 price than at 80. Isn't that absurd?

So in the local hospitals, these surgeons, these men and women who are doctors who have gone to school for 15 or more years to be fellowship trained to become the experts at. In their field. You know how much they're going to be paid for that knee replacement at a hospital? Fifteen hundred dollars.

In my pricing structure, the surgery center is going to make money. The anesthesiologist is going to make money. We're going to pay for the implant. Everybody's actually going to make more money for paying less.

It's like, how does that even work?

Well, there's a lot of math involved, but simply put, we're paying our physicians more, the anesthesiologists more, the people that are experts, the people that you depend on, that, hey, I want to make sure I wake up after this deal. I want to make sure my knee is the correct length after this deal. Yep, those people were paying more. We're paying a fair price.

To me, it's not about whittling them down less money. We want to pay them a fair price. Paying them four or five thousand dollars, that in my mind, is a fair price.

Paying the fifteen hundred dollars to go to the hospital is not a fair price.

Wow, that's, that's amazing. And for me, I mean, I'm a civilian, right?

As far as health insurance goes, I sold health insurance for a long time back in the 70s, 80s, 90s, and I decided my, my focus needs to be on the financial side. Insurance, annuities, disability, financial planning, retirement investments with clients that. That side of the house.

Hey, guys, Hope you enjoyed part one of this episode. It's just too good to limit to one show. Join us next week to hear the rest. This is the podcastfactory.com.