The Blueprint for Fixing American Healthcare with Dave Chase

To put it in human terms, when you look at these health plans, you look at the health outcomes. If you could put these health outcomes into a pill bottle, it would be the blockbuster drug of the century. They are so much better in terms of saving lives and getting people the best care, great primary care. And that alone would suggest anybody, once they knew that would, would share that.

Hey, welcome back to the accelerate your insurance sales podcast. Andy Neary here. I'm excited. This one is long overdue. Today I've got Dave Chase, co founder of the Health Rosetta joining me. Dave, welcome aboard, man. It's like I said, it's been long overdue. I'm surprised I haven't had you on before.

Well, I kind of feel like I've been on because I, you know, you've been in my ears for a while, so no worries. Looking forward to the chat.

Well, I'm excited, man, because you've done a lot of good for the health insurance world and this is a very timely episode given that the health Rosetta fest is coming up here in a few weeks. But let's just for the folks, I'm going to say the few who may not know who the health Rosetta is quite yet. But let's, let's start with a high level view. Give us a little background of why you started Rosetta in the first place and really kind of where your focus is today from, you know, the healthcare economy perspective. But let's start with the, the roots. What led you to starting this movement in the first place?

Yeah, hopefully I won't bore you with too long the story, but the, it really started with, you know, really a personal tragedy situation where a good friend of mine had had a pretty similar career to myself and what happened to her happens to far too many people. She got the wrong diagnosis, cancer diagnosis, that happens one out of five times. So of course she gets the wrong treatment plan and you know, at the end of the day, long story short, crushed physically, financially, emotionally, leaving behind a 10 year old daughter and was brutal to watch. And you know, I'm one who tries to find meaning out of tragedy. And I'd been in the health care industry but on the health tech side and you know, the way I had been raised was, you know, you see a wrong, you don't do something about it, you're complicit. So I was like, man, I gotta figure out what the heck's going on here because it wasn't like there was a bad doctor, it's just a system problem. And once you do the, you know, Toyota, the five whys to get the root cause. All roads lead to health plans. They govern everything in healthcare, for better, for worse. And so that's, you know, unlike so many in. In our space, that kind of, you know, you talk about it kind of ended up sort of by accident. Like, I went into it like, this is where I gotta understand what the heck's going on and. And essentially started understanding, right, the scale of the issues, the degree of entrenchment. I mean, this isn't an industry that's just going to change on its own. So you start studying social movements and revolutions, and one thing leads to another. And probably the analogy I've used the most is with the built environment, where the way buildings are built are radically different than 25 years ago. And there was this organization that came up with this new blueprint. So that was really step one for Health Rosetta. Like, okay, I joke. I was, you know, I don't know, Indiana Jones searching for healthcare's Rosetta Stone, right. And. And just like, we never claim to invent anything. We just find what works, and then it's really, okay, this works. I'm gonna give a name to it. I kind of done that with direct primary care. Not that I came up with that name, but I started writing about it and people did it. And I was like, I thought that's what would happen with. With Health Rosetta. And people kept saying, no, you should do it. I'm like, no, you should do it. And it's like, okay, well, maybe I should. And so we're like, okay, well, who's going to carry that message? Well, the answer is obvious. And I actually wrote a piece in Forbes, like, two years before even thinking about starting Health Rosadec. This job could save American Forbes. Talking about the. The insurance professional, benefit broker, advisor, whatever you want to call them. And so like, okay, that was really a second thing. You know, that's most of what people know about us and is, okay. We're going to train these people. A lot of it, frankly, was creating this tribe and this outlet. There was these people they didn't even know. There were people like them around the country. And we were kind of a channel for that, connecting them together. And we see them become business partners and just good friends and all that. So that's been really cool. And then as we got in and we started really getting into the guts of this, like, oh, my gosh, like, whether it's Rosen Hotels or any of these great success stories, going's like, it's crazy these plans work at all. It's just a testament how bad the status quo is because they're being held together by bubblegum and baling wire compared to other industries we've seen. And so we realized, oh, if we want to have repeatability, where things move a lot faster, because at the pace we're going some time between the year three thousand and four thousand, would everybody have these plans?

Right.

It's just going way too slow. And we, you know, know the founders of Health Rosetta, we'd taken things from founding to nation scale and even global scale, and I'd done that in healthcare.

Yeah.

I think there's this conversion of convergence of a few factors. One is healthcare goes through major changes every 50 to 70 years. We're overdue. Two major legislative shifts.

Right.

The consolidated Appropriations act, these transparency bills.

Right.

And now the lawsuits that have resulted in that. Like, that's definitely a factor. Probably the one that gets overlooked the most is a generational shift.

Right.

When current plans were initially designed, what were the issues? It was acute care. Who are the people that had, you know, acute issues? The greatest generation in boomers. Well, you fast forward today, you know, millennials and post millennials, gen Z, they're 70, 75% of the workforce. It's about chronic disease. It's about mental health.

Right.

So we have this huge shift. And the oldest millennials, we're talking mid-40s, right. They're sandwich generation. They may have kids, undoubtedly they have parents that are aging. So even if they were fortunate not to have had their own health issues, they can't ignore the system anymore. And they've grown up with the Internet, where there's transparency and there's consumer friendliness. And they're like, what the hell? Like, this is nothing like this. And so I think that's actually a really big factor. I mean, I've heard you talk about in some of the, some of your past episodes, you know, kind of young blood that's coming in. And like, you know, I. I was coaching high schoolers and, you know, yeah, I coached on the technical part of it, but a lot of it was about being kind of a life coach and, you know, finding that they want meaning and purpose and, like, you know, you wouldn't think, like, if you want to f up the status quo, as Mark Cuban says, like, there's a great opportunity here, right? You can make something that's amazing. It's like something where the day you put in the change, it's life changing for your members. While you're Working on this gnarly 20 year problem, right. It's this cool kind of combination and frankly that's what keeps me going.

Right.

Is those member stories and, and you touch on this. The people affected, the two things that keep me going, the member stories, these life changing impact and seeing the light come back in the eyes of benefit broker advisors, right. People like a Bryce Heinbaugh who were like, they're going to leave the industry, they were fried and now they're like man on fire and you can't stop them. And so I think those are the big factors at this really unique inflection point that we have. And there's a maturity now. Like when I wrote, you know, my first book and did my TED talk, this was like 2016, 2017 time frame, you know, being an archaeologist, you know, in air quotes, like I dug around, I could find five successes. There was probably more, but that's, I looked pretty hard, that's all I could find. There's now thousands of them. So we have plenty of work ahead. There needs to be hundreds of thousands, but we are in the, you know, maybe the bottom of the first inning here.

Yeah, no, I, I, it's funny, you keep bringing up like, you know, when you're trying to do something different, you push against the norm.

Yeah.

It makes me think of there's a wrestler here locally that grew up near, near where we live who's going through some heart health issues right now. His name's Ben Askren, he was in ufc, very successful collegiate wrestler. And I watched a documentary of him because he, he really changed the way wrestling, how people wrestled at the collegiate level. He transformed the, But a lot of people didn't like it, right. They don't want to change how things are done. And he made a comment in the documentaries, he said, when I started winning with this new approach, everybody said you're lucky. He goes, but after I won 87 times in a row, I think you can't call it lucky. Well, peers of mine and they literally changed the trajectory of their career because they're like, wait a second, there's a whole different way of doing this. And so when you fast forward to today, Dave, and then you look at all the changes going on in today's healthcare economy, why do you feel it is such a pivotal yet? What do I want to say? Unique time to be a broker.

Yeah.

I think there's this conversion of convergence of a few factors. One is healthcare goes through major changes every 50 to 70 years. We're overdue two major legislative shifts, right? The consolidated Appropriations act, these transparency bills, right. And now the lawsuits that have resulted in that. Like that's definitely a factor. Probably the one that gets overlooked the most is a generational shift, right? When current plans were initially designed, what were the issues? It was acute care. Who are the people that had, you know, acute issues? The greatest generation and boomers and well, you fast forward to today, you know, millennials and post millennials, gen Z, they're 70, 75% of the workforce. It's about chronic disease, it's about mental health, right? So we have this huge shift. And the oldest millennials, we're talking mid-40s, right? They're sandwich generation. They may have kids, undoubtedly they have parents that are aging. So even if they were fortunate not to have had their own health issues, they can't ignore the system anymore. And they've grown up with the Internet, where there's transparency and there's consumer friendliness and the help. Like this is nothing like this. And so I think that's actually a really big factor. I mean, I've heard you talk about in some of the, some of your past episodes, you know, kind of young blood that's coming in and like, you know, I, I was coaching high schoolers and you know, yeah, I coached on the technical part of it, but a lot of it was about being kind of a life coach and you know, finding that they want meaning and purpose and like, you know, you wouldn't think like if you want to F up the status quo, as Mark Cuban says, like there's a great opportunity here, right? You can make something that's amazing. It's like something where the day you put in the change, it's life changing for your members while you're working on this gnarly 20 year problem, right? It's this cool kind of combination. And frankly, that's what keeps me going, right? Is those member stories. And you touch on this, the people affected, the two things that keep me going, the member stories, these life changing impact and seeing the light come back in the eyes of benefit broker advisors, right? People like a Bryce Heinbaugh who were like, they're going to leave the industry. They were fried. And now they're like man on fire and you can't stop them. And so I think those are the big factors at this really unique inflection point that we have. And there's a maturity now. Like when I wrote, you know, my first book and did my TED Talk, this was like 2016, 2017 time frame, you know, being an Archaeologist. You know, in air quotes, like, I dug around, I could find five successes. There was probably more, but that's, I looked pretty hard. That's all I could find. There's now thousands of them. So we have plenty of work ahead. There needs to be hundreds of thousands, but we are in the, you know, maybe the bottom of the first inning here.

Yeah, no, I, I, it's funny, you keep bringing up, like, you know, when you're trying to do something different, you push against the norm.

Yeah.

It makes me think of there's a wrestler here locally that grew up near, near where we live, who's going through some hard health issues right now. His name's Ben Askren. He was in ufc, Very successful collegiate wrestler. And I watched a documentary of him because he, he really changed the way wrestling, how people wrestled at the collegiate level. He transformed the. But a lot of people didn't like it. Right. They don't want to change.

Yeah.

How things are done. And he made a comment in the documentaries, he said, when I started winning with this new approach, everybody said, you're lucky. He goes, but after I won 87 times in a row, I think you can't call it lucky anymore.

Right.

And I think that's kind of what you're saying is like, the first time you do this with a Rosen, it's like, all right, Rosen, unique situation. Okay. You came out with a success. But now, looking back over the last eight or nine years, I mean, the number of stories I'm sure you have from brokers around the country that are changing completely, changing not just the picture for an employer, but to your point, changing lives for employees, that has got to absolutely revitalize that broker's faith in what they're doing.

Yeah, absolutely. And, and I think that the smart ones, you know, I mean, some of sales is just kind of, you know, humanity 101. Like, if you can speak and empathize with the people you're, you know, communicating with, whether you're a customer or friend, you're going to be more effective. And of course, you can understand their situation a lot more if you spend more time. You know, I was mentioned, I was listening to Episode with Reagan, and, you know, she's in healthcare and human services, and you could tell that she really cares about that. And when I was reflect, you know, reflect listening to the episode, I was like, yeah, you know, kind of my big claim to fame at Microsoft was starting their healthcare business, and it was one of the first two people focused on vertical markets, you know, industries and Guess what? You speak healthcare, healthcare people are gonna understand it. If you speak tech, they basically ignore you. And so it's a really interesting time for folks and, and can pick those niches. And really, rather than the spray and pray, I think so many people do, like, oh, just they got in fog a mirror. I go work with them, you know, and that's when, yeah, maybe you, you're punching the clock, you got a job. But we say people like, you know, once you have some competence, you have a career, and then when you really figure out your why, then you have a calling and you are unstoppable. And that's what we see over and over.

Yeah. You know, one of the, in preparing for this episode, one of the things you shared with me is that you, you reviewed 50, let's call them 50 of the best plans in America.

Yeah.

What would you say a lot of those plans have in common? Why are they so successful right now?

They, you know, it starts with just mindset.

Right.

They actually really care. You know, they always, you know, say the, you know, employee. Our CEOs say employees are your most valuable asset. Like, they really do care that. And they're open, like you said, whether it's a wrestler, they're open to something different. Like, you know, we all know the definition of insanity. That becomes a big thing and they're like, we got to solve this and come hell or high water, we're going to do that. Mr. Rosen did that 30 plus years ago. So that's the most common thread. And then the other thing is willingness to, like, they don't have to become ERISA legal experts, you know, at the level of some $1,100 an hour attorney. But if you look at probably the most unique thing that we brought to the table and we've made a major investment in, is all these contract details. Like most people are they, in fact, we've done two or three thousand of these plan graders. And the single most predictive thing of a high performance plan is do they have complete unfettered access to their claims data? And that's in the contracts. And we find that 95% of those employers didn't even look at the contracts at all. They treat them like a terms of service on some consumer website like check, check. I agree. And so willing to say, yeah, I don't. I'm going to bring in the right people. That's one of the reasons they'll tap us. And then you get into the care part.

Right.

And once you do that, you know, there's A lot of low hanging fruit on the drug supply chain we all know about. It really becomes a big game changer when you get primary care in and, and I think going back that first piece of really caring about the humanity, a lot of them have really good kind of member champions care navigation. There's different terms for it. Nurse, concierge navigators. I love those. So those are some of the, the real common threads is just like, hey, let's just go brick by brick, right? You know, and I know, you know, you've been a high level athlete and people are like this is hard work. I'm like, yeah, you know what else is hard work? Being a great athlete, a great musician, a great parent. Like the things that are the hardest that are also the most rewarding. And so if you're willing to, you know, break a sweat, there's some really cool opportunities. And then as you see the human impact, it just fuels that fire.

Well I, you and I are very aligned with that because I think, you know, we can sit here and point the finger at the employers and say they don't want to put in the work. And there's truth, they, they would, they all want the easy button. But I'm gonna argue there's a lot of brokers out there too who are looking for the easy button as well. And I think that's one of the biggest challenges I still see in the industry, Dave, is you have advisors who want to be different and do it different. Quite frankly, for some of them, they don't know to know where to get started. What would you say? You know, we're an industry that very much prides itself on the past and the things got things have to change if we're going to create different results. From the broker perspective, as you look down 30,000 foot feet from the, at the industry, where can some advisors start to make some of these shifts to become say more of a Rosetta like advisor. But again, if they're stuck not even knowing where to start, what recommendations would you give that advisor?

Well, I mean it really parallels know what you do, coaching people, right on how to build your brand and sales and all that. It's an openness to doing that in a new area of like building new plans. And so having, you know, can be a program, it can be somebody you co broker with. Like this is not easy stuff, it's very rewarding. It's not rocket science either by the way. But why, you know, like would you climb Mount Everest without a Sherpa? Like that would be a Suicide mission. Well, you want to really be thoughtful. And so I think that's really a critical thing is take advantage of people who've been there before. There's some really good programs out there. You know, we think we're one of them, but we're not the only one. And come and talk to those people. We're open book like we, you know, you could argue one of our most valuable assets is the list of our, the advisor in our program. Well, go to healthrosetta.org map you can see either one of them and their contact information. Talk to them.

Right.

And you know, some are, are succeeding at greater levels than others. And certainly, you know, we make available a lot of content out on the, on the web and books and, and all that tough type of thing and find your thing.

Right.

And we all have that passion. And so that's where I was like man, find a buddy, find a pal. You know, it's like again, you have accountability for workouts. You have accountability for a lot of things. That always helps a ton.

Yeah. And I, I again I couldn't agree with you more. Yeah, you want to change. It requires work. This stuff isn't easy but, but work, work, work is required of anything that, that takes a little effort to make the changes appropriate to what we're trying to accomplish. You know, you guys have been on the forefront of some of the more innovative ideas out there for health insurance advisors. I, I have several clients right now that the health plan greater is just a part of their sales process. Are there any like, what are some of the more innovative ideas you see coming out right now that, that advisors should keep a pulse on?

Yeah, I mean one I touched on a little bit. I think that that care navigator thing is so important because healthcare is scary, right. And a navigator that isn't just on the insurance piece. They are there for the emotional and clinical piece of it too. And helping people navigate through that. And then the thing that if you look at you go study the people who are winning, like they're growing the most rapidly, they're putting together, we've given a name to it, community owned health plans. And the idea is, does every single employer that, you know, it's a 70 person company, does every single plan need to be 100 bespoke, like custom created, like man, you just are not going to grow that fast. And so they figured out a way to kind of have these packages kind of like in a way it's an element of what the carriers have.

Right.

There's an easy button. It's easy for them to take a lot of your money too. But it's pretty easy to just say I want that Blue Cross plan. So they're putting together these package plans for their particular niche. It might be a geographic niche, it might be an industry niche. That's the other thing that sometimes people think, oh, you know, I don't want to focus just on this one geography. That's fine.

Right.

You might be all about transportation and logistics. You know, I'll give you a little, you know, secret from the awards we have this year. Disproportionate number of ESOPs and cooperatives, employee stock owned companies plan. It's basically just a, a retirement plan, you know, stake in the, on the company and cooperative. So it's credit unions, it's grocery co ops, it's farmer cooperatives, it's rural electric cooperatives. And then ESOPs can be any. And there's I think 12,000 different ESOPs around the country. And you know, one of the great success stories that we've had is Pacific Steel and Recycling. They were spending like $8 million for the 700 employees a decade ago. By now their peers were spending 12 million. Last five years it's been like three and a half, four million. Guess what? For the forklift driver who just retired, I think making, I think it was $45,000 a year. They had a nice nest egg because of employee and they'd worked there for 30 years. But it doubled because of what they did with their health plan. Like for that company. Just talk to the cfo like hey, what would you have had to do to have that same EBITDA bottom line profit impact as what you did with your health plan? We would have to increase top line sales revenue 25 to 30%. They're probably a $200 million a year company, 130 years old, slow growth, low margin. That's pretty dang hard. And so this forklift driver heard this story, retired with a seven figure nest egg. It basically doubled how many forklift drivers are retiring with seven figure nest eggs. And this is the type of thing where you have these repeatable processes. This becomes possible and an understanding like you could be a thought leader in the ESOP space or the co op space or the credit union space. Those are the types of things that are really making a big difference.

Yeah, I, you know, you got me thinking about when I kick off some of my keynote talks. If it's a health insurance audience, I'll start by saying do you guys understand how important your job is? Your Advice can keep a door. Keep the doors of a business open. Your advice can. Can help somebody avoid filing bankruptcy. Your advice can be the difference between somebody getting the care they need or waiting until it's too late.

Yep.

And I think that's a shift we have to make in the benefits world, is getting more advisors to understand how important their advice is. Yeah, I think a lot, again, I'm going to say a lot. Are trying to hit the easy button, but at the end of the day, a benefits package is only as good as the employee's perception of it.

Yep.

You can throw whatever you want in there, and if employees don't like it, it sucks.

Yeah. Yeah.

And that's the other thing. Like, the. The folks are really doing a great job. They're really good about thinking about change management and communications. Right. Because you have an awesome design plan, but if you don't roll it out well, it's not going to work. And the other thing, I'll say just the easy button is risky.

Right.

Maybe that sounds like it's not risky, but when I came into the space, you know, again with that fresh set of mine, I learned about, you know, overrides and bonuses and da, da, da. And I'm like. And this whole concept of getting an appointment from a carrier, I'm like, what does that mean? And they're like, oh, yeah, they can pull your appointment 30 days. Like, oh, my God, like, 30% of my income could vanish in 30 days. I could never live with that, you know, sort of. Sort of Damocles hanging over my head. And when you. That's one of the cool things when you go work, really, for the clients and getting paid by the clients. And again, there's people, if you haven't been doing that, who can tell you how to go about doing it. It's straightforward. It's very liberating for. For folks.

Well, it's funny you say that because we. We, you know, have a lot of clients that are pushing the envelope, you know, utilizing the Rosetta principles. And we. We do some content, so we do social media content for some of them. And it's interesting, behind closed doors, they will. They will be as bold as they possibly can be. And we're like, all right, let's throw that out on social media now. And like, because. Because of that point right there, they. They still have a lot of business with the Bukas.

Yeah.

And you got to be careful what you say sometimes publicly, because that fear of. They can pull that contract whenever ever they want. And that could be 10, 15, 20% of your revenue gone.

Yeah, well.

And there's some people who, I wouldn't say have the most common sense where, like, I get it. Like, I get some cathartic, you know, feeling when I see somebody punching the bear in the nose. But I'm like, you know, you really don't have, like, people know it's not great.

Right.

I don't remember Steve Jobs talking a whole lot about trios and razors and blackberries. He was talking about how awesome the ipod, you know, the iPhone was. And so you don't need to go insult them. And of course, you'd go do that online. Everybody's going to see it. Like, I don't blame them for pulling their appointment well, but that's also one.

Of the biggest things I've preached, Dave, over the last five years is when I see peers constantly posting about how the health care systems evil and the health care is. I'm like, guys, that kind of information's not helping anybody. No, talk about what you're doing to solve it. Don't just quit. Don't just keep focusing on the problem.

Yeah.

And you end up demonizing people. And, you know, one of the things that, as I was studying kind of system change and, and some of that they talked about, there are some different archetypes. There's like, trailblazers and then there's protectors. Like, there's a lot of times there's somebody inside of an Aetna who can make an adjustment to how things are doing. And we may, you know, we have lots of great plans that are still using carrier networks, and we have people who are helping us inside of some of these, you know, sometimes vilified companies. And so you're not going to help yourself because not everybody is ready to rip off the band aid and go all in on the new thing. And we can add value to those and so that sometimes will. Will get mistaken for some of our most strident voices and that we're telling everybody, you know, they're all evil and rip off the band aid and do all that. It's like, you know that you mentioned the plan grade. Like, frankly, I'm happier when a plan grade score goes from a 10 to a 25 than a 50 to a 65. We're really hard graders, but that means progress is being made and things are going to continue to improve, and they're going to build that confidence to understand what's going on. And that's where you should put that focus. Like I said, let's Go solve the problem. We don't have to, you know, demonize people.

Yeah, yeah, no, I love hearing that. Let's go back. You mentioned earlier in the episode the Nautilus Health Institute used to be called Rosetta Institute but by a new name today for the folks who just have no clue right now what that is. Talk to us about it. What was the motivation behind creating it? What, what are the initiatives of the Nautilus Health Institute?

Yeah, yeah.

Again we have this tech background. So we saw incredibly powerful entrenched companies like IBM and Microsoft basically give way to, you know, the vast majority of Internet is running on open source software. Companies like Linux, companies like well actually the company's called Automattic but the software is called WordPress. Like most of the content sites on the Internet are powered by it and they would have a for profit entity like actually IBM ended up, you know, changing their religion. So they, they actually support a lot of open source but like company like Red Hat and they have Linux foundation and WordPress, there's WordPress foundation and a company called Automatic that helps companies with that. And we saw that be a really powerful tool where again if you zoom out and say what are we actually trying to do? It's pretty, pretty bold. We're trying. You're basically saying you need an entirely new industry supply chain when it all is said and done. And for those on videos like waving around my little iPhone, we didn't get these by tweaking landlines and rotary phones. And if you're going to try to do that, you have to develop a new industry supply chain that needs to have industry standards. And you see it like, you know Tesla's want winning for like the EV plugins, right? They open source their plugin standard. You see that in all kinds of areas in tech, not just like high tech, but other things. You know, you see it in financial services, the doing credit swaps. The transaction cost has gone 97 down 97.5% so there's much more activity there. So the idea was okay, we have these methods and we have technology. And so if you look at what actually has enabled the re thousands of repeated successes and what are the patterns that we've seen in that Number one, they seize control of procurement. So there's certain procurement standards templates, RFPs, those types of things. You define it, don't wait for the industry to, you know, if we're talking to an employer, you don't do that in any other area of your business. And then you got to codify it in Contracts. So we have model contract language and you know, we basically have rebuilt all these contracts plus we have all these tools on how to negotiate against things if you, if you still need to live with the contract for a while and then you got to prove it in data.

Right?

You might have a good contract. You don't get data, you can't prove it. And then you do that rinse and repeat. And the other key piece with that data is we found that the organizations that were doing it well, yeah, they had access to the claims data. Well, where did it go in? And you looked at Point Solutions and it's like, oh my God. Like every one of these companies, if they do it really well, they're probably in it for close to $3 million on basically plumbing. Right. That's not differentiating their diabetes solution or primary care thing or whatever. Like that's dumb. We know how open source works. We're gonna, we actually jointly built that with another company and then we've made that available free. So it's all said and done. That was about $4 million of contract procurement data use standards, technology. They're like, here it is, industry run with it. And you know, I was asked a little while ago, like, how will you know when you're winning on this? I'm like, when? And this has actually started to happen already. Once we've open sourced when people are adopting our stuff and they've never even heard of health Rosetta and they're just doing it like we're winning at that point. And you actually have. That's the only thing that I think has a chance against very deeply powerful entranced organizations. Open sourcing and then having a 20 year long game plan like they're chasing their tail on quarterly and annual, you know, cycles. We're playing a 20, 30 year game and we ought to deliver value today, make no mistake. But this type of strategy, it actually becomes an obvious thing to do. And you know, to, to put it in human terms, when you look at these health plans, you look at the health outcomes. If you could put these health outcomes into a pill bottle, it would be the blockbuster drug of the century. They are so much better in terms of saving lives and getting people the best care, great primary care. And that alone would suggest anybody, once they knew that would, would share that. And we do feel like when we came in as outsiders, we have set this tone of being open about what we're doing and you and it. Success begets success within our broad ecosystem. But also people like Mark Cuban, he's Now going to open source the hospital contracts. Maybe that's a coincidence, but guess what? His company were the early adopters, the TPA field guy that we built out. And they're smart folks because they're an employer too. And he's got the cost plus stuff. But he's an employer too. He is no fool. So it's pretty cool to see how already, you know, the. We're bearing some fruit there. We got a long ways to go for sure, but it really is working nicely.

Yeah, I actually think a measure of success is when somebody's adopting your principles, maybe not even giving you credit for it, but they're adopting the what you practice, what you preach. And I think that that is something I take pride in too is when somebody's doing what we preach, maybe not even giving credit to us for it, and they're out winning with it. You, it makes me feel just as proud as if they were to give us credit for it. Do you have any examples, Dave, where an advisor or an employer has utilized the templates, the principles from the institute and have gone on to see drastic change, drastic savings?

Yeah.

Oh man, there's a lot. But like one that's on my mind right now because I just saw the HR leader at an event and every time I see him, you know, he's like, he tells me his latest health Rosetta dividend story. So that's actually what we define as our purpose. Like how do you take the waste turn into reinvestment, into your people and business and communities, all that. And it's company called Pfeiffer out of Tuscaloosa, Alabama. Russell DeBose is the HR director. Guy has gone and testified before Congress on this stuff and, and they were actually quite thoughtful on what they were doing before they, they kind of became a part of our, our movement. And when they got their first plan grade or score, while most status quo plans are between a 5 and a 17 out of 100. Like we're pretty tough graders.

Right.

But why shouldn't we be given the money and lives on the line. There's people that have scores in the 90s, not a lot, but it's all doable stuff. And they got a 37 and you know, they're like lean six sigma and do Kaizen events like crap. Like we thought we were doing all right, like and he just embraced it. And every year they do more and they do more and they're to 74 right now. They've literally doubled it. Their spending hasn't gone up in I Think it's either five or seven years they're opening primary care clinics that they're opening to their community. And actually the last thing with some other employers, the last thing he told me on the dividend story was, you know what? We found out that some of our retirees, right, we're in kind of a medical desert here and they don't have a primary care relationship. And we've learned from you guys how important that primary care relationship is. 300 of them did not have a primary care relationship. So we just said, you can use our clinic. They had no obligation. This wasn't in their pension or anything like that. I was like, that's super cool. Right? They just, they're impacting their community and they're telling, you know, the other folks, we have these awards we call the Rosie Awards for these best plans. And one of the three criteria is do you have that abundance mindset? Will you share your story with others? And man, they're doing that in spades. And they want everybody in their community to benefit. Their community will benefit. But there's cool things like, like Rosen, they started giving scholarships to some of their dependents kids. They have summer enrichment programs. The kids didn't have that much going on the summer. And, and man, the day that that is announced, it gets filled up in a day with these kids and they've, they actually have a new program for. There's quite a bit of obesity in Alabama. And, and they really want, they're going to use some GLP1s, but they're combining with lifestyle. I mean, it's kind of smart stuff. And so you just see again, that, that kind of manufacturing mindset of this, we're doing these Kaizen events. Right. Okay, great. And so those are the types of stories that you just love. And okay, what's underneath that? They get great contracts, they get great primary care, they're working with the right TPAs, they've got good PBMs, like, you know, kind of the nuts and bolts of it, but it's executing it and executing that repeatedly in this, you know, quality improvement mindset.

I'd love to get your thoughts on this before and then we'll dive into some information, some details about your upcoming Rosetta Festival.

Yeah.

With all these principles people are adopting. So whether it be direct primary care, rbp, pharmacy carve outs, you know, all the philosophies that are helping drive down cost and improve care.

Yeah.

What is your, what are your thoughts? Because I see a lot of advisors who kind of who take a throw the kitchen sink at it approach, where they take all of these at one time and just.

Yeah.

And unfortunately, you often see that turn into more of a disruptive strategy, if in a negative terms.

Yeah.

Versus applying. Like you just kind of described this group here, fifo in. In Alabama. It sounded like they were adopting almost one principle at a time every year. What are your thoughts about that? Should be. Should it be a, hey, let's. Let's. Let's take this whole thing right now and make change, or let's adopt these principles slowly over time.

Yeah, yeah.

No, I, I actually have been trying to practice what I preach and trying to make things happen in my own community. I just had a meeting with employers and I said, there's. There's three options. You need to understand where you're at culturally. There is a small number who are in severe pain and they've got incredibly high trust with their workforce. And, you know, rip off the band aid. Okay, there's some of those generally not what we recommend. You know, it's probably less than 10%. And then there's Others are like, we're. People don't like things taken away. So we're gonna keep old, you know, plan in place, and then we have this new plan. It's gonna be very appealing. And we've seen as high as 60% adopting that new plan. In a way, it's a rip the band aid off because it's all new. But then probably the most common is what you're alluding to with Fifer. Let's just take a chunk at a time. They're a little bigger employer, so the bigger you are, probably the more thoughtful you have to be in doing that steadily. And it's like, okay, we're not getting rid of that signet network, but we realize that's glorified yellow pages. There's good doctors and bad doctors. Good facilities, bad facilities. So we're going to really curate where people go and have, you know, this information. They can make the decision. We're not taking it away. But really good plan design. They'll say, you know, if you go to that surgery center with the fewest complications, the best surgeons. Yeah, you have to drive an hour because we're in a kind of a medical desert here versus a single hospital town. But you're going to pay exactly zero, guess what, you can ladder up that trust. Oh, Martha got a free lab, Bob got a free imaging, and then Sally got a free surgery. It becomes pretty compelling. And then that's the thing that there's the Biggest risk and biggest payoff on the network stuff. The other stuff is cleaning up the contracts. Members don't have to see that. Getting rid of junk fees and things like that. Pbm, even before you change the formulary where people pick up medications, lots of savings opportunity. Members don't even have to see that there's greater opportunities to go further. The only thing that they really have to see, but it's all positive is adding great primary care. Again, don't force them be like, hey, if you go here, wow, suddenly have this, this doctor and probably team available essentially 7 by 24, 365. That sounds too good to be true. So those are the types of things I, I think that steady approach and you build that trust and that repeatability. And then we've seen you know, labor and management, you know, situations where it goes from management kind of nudging to the union is like, man, we got to go faster. This is taking money out of our members pockets. That's one of our duties. Yeah. So I'm more into that approach.

Yeah, I always find it interesting. You know, you brought, but brought about the fact that yeah, that facility is an hour away but if you go there it's free. Oh by the way, it's also high quality.

Yeah.

Think about how we purchase services in everyday life. If I said to you Dave, there's a restaurant an hour away, it's a five star Michelin and if you go there versus where you're used to going in town, it's free.

Yeah.

There's a gas station an hour away. If you go there, they're not charging you anything for gas.

You go right.

Yet when it's healthcare we're like eh, but I've got the, I've got the doctor down the street. It's in, in, in this case we're talking about a matter of life and death in some cases.

Absolutely.

It just blows me away. How still I don't say naive but you know, we as consumers.

Yeah.

Can be when it comes to healthcare. Well, let's, let's wrap here. Let's talk about the Rosetta fest coming up August 24th through the 27th. Yeah. In Denver.

That's right.

I'm sure a lot of my listeners already know about it or they've been there before. Talk to us a little bit about what is Rosetta Fest. If, if an advisor is listening in who's never been, why should they be there? This is an opportunity for you to, to tell us a little bit about the program.

Yeah, yeah, definitely.

You know A few years ago we would just meet within our community. In fact, last time we were in Denver, we had 200 plus folks there. But back to what we were talking about earlier, if we're going to open source this stuff, we need to be open to non health Rosetta advisors. So we're inviting them, they can go take a look, get a feel for the program or see if it's a fit. But the, probably the unique thing compared to other events is we recognize as a team sport, right? Like it's not just the, the brokers, it's the, you know, so is that that group? That's about a quarter of the. Basically we had a thousand plus people at the event last year. It's about what we expect this year. Roughly split about a quarter. Benefits pros, about a quarter. Employer unions, the real payers of healthcare, about a quarter. Solution slash tech companies, right? The TPAs, the PBMs and clinicians, right? We'll probably have 250, 300 clinicians, direct primary care, direct specialty care. And it's really cool how like if you, you have these talks where we're basically breaking it down, right? It's like looking at game film afterwards and breaking it down. Here's how it happened. Here's the employer perspective, here's a solution perspective, here's the, the advisor perspective. And so we're, you know, we mentioned Nautilus. So we basically release a new set of resources at Nautilus each year. The big one this year there's a few. But the big one is a PBM field guide, right? No matter how tiny your client is, how big they are, there's tons of opportunity there. So we're really excited about that. And, and so it's just like this is a group that people say it's the most collaborative and positive event they've been to, right? It's not people up on stage talking ideas or innovation theater, right? Like they're doing it, believe us, talk to them. And so that's what tends to make it super unique is people are really open about it. And then you're like, yeah, like I want to do that or maybe that's the firm I need to work with because maybe I'm getting pushback from my firm to do something. So sometimes you'll see people like connect with others in the program from that standpoint. Or maybe it's just somebody to co broke with. Like, man, I love what he was doing. I've got a credit union client. He has a credit union story. I want to talk to that guy and see, you know, can we co broker. And so a big part of our event is, you know, like any event, it's the hallway discussions, all that we try to put great content together, of course. And like our mobile app, the company that actually does that mobile app, like after the last one, they're like, we need to talk to you guys. We've never seen an event with that much interaction. Like, what did you guys do? And it was funny, like just to uncover a little bit our dirty laundry. Some in our team accidentally like hit the publish button. So it's like gone live already. We usually will do it like we do it like two days before and then it was like two weeks before and like, oh, we'll do a month before it's live and there's people up on the leaderboard, you know, and. But the main thing is they're interacting, they're connecting with each other. And you know, the smartest people aren't just going in there and like doing a boring pitch, you know, on a, you know, a direct message, but they're sharing their stories and doing meetups. And so that's, that's something where we, we just really invite people coming in. In fact, for non Health Rosette advisors, the basically people fly in Sunday. We get going with internal our community Monday morning. Even if you're not a health Rosetta advisor, we're letting you join that. So we have something for the new advisors for an hour, hour and a half and then all the advisors, you're able to come in that get a little taste. And we found that was helpful last year. People like, you know, I've been thinking about this health Rosetta thing. Come right and check it out yourself. It's a fit. Awesome. If not, get all the good information you can steal away right through our earlier discussion. You can learn a lot.

Well, and I think one thing you guys do a great job from the event standpoint is this isn't another conference in the back of a hotel. It's you guys choose some pretty cool facilities. When it comes to hosting the event, I believe part of it. Or is it all, is it going to be at Coors Field?

Well, our Rosie Awards celebration is, is at Coors Field. So Tuesday night, you know, best health plans in America are gonna be up on the Jumbotron and you know, batting cages are gonna be going, you know, build your own bobblehead. You know, it's gonna be fun. I mean, that's cool. Lynn Ann Henderson, who's kind of the events maestro, a lot of credit.

They do a great job.

She's amazing. And we, we went to Denver, you know, because we're thinking about coming back there and we're like, you know, we should think about something different. We go to Coors Field. Like, we both like each other. Like, there's no way we're not having an event here. Like, this would be so cool. So it's kind of crazy. I mean, it feels like, you know, we're preparing for the super bowl and also the, the halftime show. It's crazy amount of coordination. And thank God Lynn Ann and her team are doing it because it's unbelievable all the different movies.

I am a baseball guy, Dave, and I am going to make a cut here. You'll probably be sharing more wins on that field that night than the Rockies have seen all year. Sorry Rockies fan. I do have to put that little, little cut in on, on Rocky baseball this year. Okay, Dave. So if anybody's listening in never been. They want to go. What, what's the easiest way to connect with you or the team to get signed up for the Rosetta Fest? And we'll put some stuff in the show notes as well.

For sure.

Yeah.

I mean Rosetta Fest.org is the URL. So just boom, go there. If you're advisor, there's a thing an advisor. If you're a, you know, whatever, you'll. You'll see there's a few different roles there. And then of course there's health rosetta.org and nautilus health.org I'm very available on, you know, LinkedIn. You know, that's my social media of choice. I'm just Chase Dave. You know, it's not too hard to find me happy to connect with you. You want or you just want to follow whatever your, your cup of tea is. I'd love that. And come to the event. You know, say hello and come with the toughest questions. You know, they can be salty. You know, that's fine.

Right?

That's how we get better. And so love to have people as long as they want to improve things. We have career switchers. You know, from all, you know, we mentioned Reagan earlier. Like she came from pharmaceutical after or prior to being, you know, full time, you know, at home mom. And we have people from the White House. We have doctors, we have ex hospital CEOs. That's another one of the interesting dynamics is this is such a meaningful area. I mean Katie Talento who was in the White House, she saw the entire US Healthcare system. She. This is the only area that really cool stuff was going on. So she like went from a Hill staffer, White House person to coming into the space to our earlier discussion about how meaningful it is.

Well, and you, and I think you, what you just said, you know, come with your skepticism, come with your challenges. I. It's easy for these conferences to turn into an echo chamber sometimes, but you need that collaboration of. Well, I don't agree with you. Here's my opinion. And I think that's what, that's where great ideas come out of. Well, Dave, it's been an honor, man. Thank you for taking the time. I don't share this very often, but I almost, I almost quit the industry in 2011. I was selling small group health insurance for a PNC agency and frustrated, especially when the ACA came about, I'm like, oh, this is going to be annoying. And I'll say, you know, two things changed my career. I switched to another firm where I found my first mentor and he taught me self funding. And then when I made the move to Colorado, it was reading your article that was like, wait, there is a whole different way to do this. So I'm sure there's a lot of people out there who want to, who haven't thanked you but could thank you for changing the trajectory of their careers in this industry.

Well, that's, that's great to hear and hear from you too. And I didn't know that. So, yeah, so many people can make a huge impact and frankly, we really need it. I mean, this is, this is a big societal problem. That is a solvable problem, 100%.

Well, if you're tuning in and you think Rosetta would, Rosetta Vest would be a great place to go, go to healthrosetta.org, get signed up. We still got two to three weeks as this thing goes live. You won't be disappointed. Dave, thanks.

Thank you.

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