Matt Ohrt, founder of Self-fund Health in Wisconsin, to explore groundbreaking strategies in employer health care. Matt shares his personal journey of surviving a severe tractor accident, which catalyzed his resolve to tackle inefficiencies in the healthcare system. His story is a powerful testament to leadership that not only adapts but innovates in the face of personal and professional challenges.

Matt discusses how his experience with a broken healthcare system inspired him to develop solutions that reduce costs while enhancing care quality. Through Self-fund Health, he assists employers in creating self-funded health plans that prioritize transparency and value, enabling both cost savings and improved care access.

Listeners will gain insights into the importance of resilient leadership and the impact of innovative health plan models that challenge traditional healthcare economics. Matt's dedication to transforming employer health care mirrors the foundational principles of integrity and innovation, reminiscent of America's founding fathers, whom he admires.

Want to learn more about Matt Ohrt's work? Check out their website at https://www.selffundhealth.com.

Connect with Matt Ohrt on LinkedIn at https://www.linkedin.com/in/matt-ohrt-6a1335b/.

Key Points with Timestamps

• [00:01:43-00:02:03] Matt's motivation to improve healthcare systems stemming from personal experiences.
• [00:05:17-00:06:31] Tractor accident leading to profound personal and professional change for Matt.
• [00:09:04-00:09:30] Matt discusses the financial and operational burdens of current healthcare systems on employers.
• [00:14:08-00:15:02] Strategic overhaul in healthcare partnerships driven by the quest for trustworthy, value-oriented service.
• [00:18:56-00:19:05] Introduction to Self-fund Health, focusing on employer-driven healthcare reform.
• [00:23:56-00:24:21] Exploring the impact of competitive shopping in healthcare to reduce costs.
• [00:32:00-00:32:12] Future strategies for expanding healthcare solutions to smaller businesses and individuals.

Transcript

00;00;00;00 - 00;00;30;20
Craig Andrews
I was in a coma for six weeks while the doctors told my wife I was going to die. When I woke up, she told me the most fantastic story. My team kept running the business without me. Freelancers reached out to my team and said, we will do whatever it takes. As long as Craig's in the hospital. I consider that the greatest accomplishment of my career.

00;00;30;23 - 00;00;51;10
Craig Andrews
My name is Craig Andrews and this is the Leaders and Legacies podcast where we talk to leaders creating an impact beyond themselves. At the end of today's interview, I'll tell you how you can be the next leader featured on the show.

00;00;51;10 - 00;01;19;28
Craig Andrews
They want to welcome a special guests. I've been featuring different people in the health care industry. They're making a difference. they're fixing some of the brokenness. And for those that know my story, there were many broken things that happened in my three month journey going through the hospital. And then even since then. And it's raised an awareness in May that this is a problem we have to fix.

00;01;20;00 - 00;01;43;19
Craig Andrews
We have to fix it for our nation. We have to fix it for our kids. And I've been running into a few people that are part of that solution. Today's guest, Matt Ohrt is one of those that, runs Self-fund Health in Wisconsin. And we're going to learn a lot more about what that is, in the next few minutes.

00;01;43;21 - 00;02;03;10
Craig Andrews
But we also want to learn. We don't. We also want to learn about what set him on this journey and the leadership lessons I learned in this. But please tune in this. It's hard for me to think of many things that are more important than the work that Matt and people like Matt are doing. So, Matt, welcome to Layers and Legacies.

00;02;03;12 - 00;02;07;10
Matt Ohrt
Thanks, Craig, Glad to be here. Certainly look forward to our discussion.

00;02;07;13 - 00;02;28;21
Craig Andrews
Yeah. And so, you know, one of the things that we talked about, before we go and, go in the green room and for those that are looking at the video, you see the chopped off heads of two presidents. You can probably guess who they are, but apparently your office is just like, packed full of of, historic dead people.

00;02;28;24 - 00;02;52;02
Matt Ohrt
It is? Yeah. It's actually one of my one of my many passions. People always, talk about my background and they say it's it's not really a design background. maybe a few pieces of it, like my book. There is, was design, but the whole room, actually, it's kind of a small room in my basement of about 10 to 12 and, floor to ceiling pictures and documents and all sorts of things from American history.

00;02;52;05 - 00;02;57;10
Craig Andrews
And what's what what makes that so fascinating to you?

00;02;57;12 - 00;03;19;14
Matt Ohrt
I think it, yeah, several things. I think it was, the passion. So the passion of our forefathers and foremothers, the integrity and just kind of the down to earth realness that, they, they knew what they stood for. They knew what they believe. They believed in freedom. And, I think a lot of those things resonate with me today.

00;03;19;17 - 00;03;20;00
Craig Andrews
You know.

00;03;20;07 - 00;03;21;03
Matt Ohrt
As probably many of.

00;03;21;03 - 00;03;52;06
Craig Andrews
Us. Yeah. Wow. Yeah. And, I mean, we could do an entire show, and I know it's not popular. Just speak of the Founding Fathers glowingly today. But I'm happy to go on the record that when I look at what they did in structuring this nation as genius, we remain, as far as I know, the only nation in the world that has a constitutional right to free speech, and that is so powerfully important.

00;03;52;09 - 00;04;10;27
Craig Andrews
And I just look at them and and, you know, Washington, when he had the chance, he could have become emperor or king or whatever title he wanted. And these men, after fighting so hard to grasp so much power, decided to turn around and put it in the hands of people.

00;04;10;29 - 00;04;27;18
Matt Ohrt
The greatest government experience, experiment ever. Right? And, Yeah. And I and it frustrates me a little bit. And some of them maybe, you know, we can. We're all imperfect people. I think one of the key things about them is they they admitted they were imperfect people, and they never said that they were perfect or knew everything.

00;04;27;21 - 00;04;43;24
Matt Ohrt
That's how they designed our country to be open and to keep the lines of communication open. And so, yeah, we could all pick up their faults, but we could all pick at each other's faults, too, because we also have plenty. But yeah, if you look at what they accomplished in our country today, it's unlike any other. And so yeah, I love to study the history.

00;04;43;24 - 00;04;54;16
Matt Ohrt
I also love to study the history of just what worked and what didn't. Right. So the best practice approach and, there's certainly a lot of best practices in our country's history.

00;04;54;18 - 00;05;17;20
Craig Andrews
Well, and it's it's interesting to see the continuation of that thread, because what you're devoting your life to now is putting power back in the hands of people. But the power in their health choices. And so I just see the consistency of that thread before we dive into that. There's apparently some story about a tractor and a tractor.

00;05;17;22 - 00;05;24;20
Craig Andrews
Plays into the story that we're telling today. And I'm I have no idea what this is other than I need to ask you about a tractor.

00;05;24;23 - 00;05;45;07
Matt Ohrt
Yeah, that's certainly, certainly get some attention. I jokingly say that I got into health care by accident, and there were really two parts, but it had to do with a tractor accident. the first part, when I was VP of Air Mail Steel, I showed up and ironically, they had hired me. My game was to change cultures and, make it a great place to work.

00;05;45;07 - 00;06;05;29
Matt Ohrt
And. But soon we found ourselves delving in health care because the owners had said the last five years were, really unsustainable increases. We've been absorbing those. Can we do anything about it? So we started on a path where we were doing some things. but a couple of years in, I was working on a Saturday, close to midday in my backyard.

00;06;06;01 - 00;06;31;11
Matt Ohrt
And I live on the Wisconsin River. And there's this, this big bluff that's over 40ft down, something like 42ft down pretty steep, walkable if you grab trees or bushes, but not walkable otherwise. Right. So kind of a bluff more than a hill. And I was pulling up some trees from the side that was going to actually have a backhoe come in and dig it down so I could put in a dock later.

00;06;31;13 - 00;06;55;29
Matt Ohrt
And on my very last tree, I was having trouble getting traction. I wouldn't pull it up in a big, big log tree, then trees. And so I hooked it up and then re hooked it up. And I was in the tractor was on the flat up above. And as I was hooking up the chain, what I thought would have been the last one, probably a I had the best angle, the parking brake popped loose and I heard a click.

00;06;56;02 - 00;07;08;20
Matt Ohrt
And so I this wasn't my restored tractor, it was a 90. It was, old Ford work master. 841, a 59. And so I kind of, jumped up on the flat and I attempted to just.

00;07;08;23 - 00;07;09;10
Craig Andrews
Stop.

00;07;09;10 - 00;07;27;19
Matt Ohrt
That very slow momentum. Right. Because I what was on my mind at that time was my restored tractor is about to roll into the Wisconsin River. And that would be really a big loss for me because I love the tractor. Plus, it'd be really embarrassing to have to go in and tell my wife and family that I just, lost my tractor, so.

00;07;27;21 - 00;07;46;20
Matt Ohrt
But, things changed very quickly, from a, the fact of losing my tractor to possibly losing my life because as I did, that, it hit a little dip in the, in the land, and it kind of jolted. And I had steel toed boots on, and, I had my shirt off. I was just catching some sun as an old guy.

00;07;46;20 - 00;08;07;19
Matt Ohrt
Right. Just out in the nice summer day. but it it caught my foot. And within about a nanosecond, I was somehow under that tractor as it was rolling backwards. Then down over me, directly over me, not pushing me aside like the the big red marks on the rear wheels later showed up about three days right here.

00;08;07;21 - 00;08;13;03
Craig Andrews
So oh my goodness. And for those are listening to the the the wheel marks went across your chest.

00;08;13;09 - 00;08;42;13
Matt Ohrt
Right across. Yeah. Making a motion across my chest from my shoulder down to my. So it broke five ribs and it was, you know, so and then the front wheel went over my leg because it was numb for over a month on the back of my leg. and then it was kind of like a blackout. I wasn't actually out, but as I was under that tractor and these, like, literally even thorn bushes and look like I took lashings, there's actually a picture in my book of this, and I tell the tell the story as part of just the brief introduction.

00;08;42;13 - 00;09;04;17
Matt Ohrt
But, so if you want to read about the details, you can see that many are fascinated by that. but I should have died, I almost did. and so there's a lot of details there. But basically, as I came to, I wasn't bleeding, I wasn't gouged, I was very injured. and the tractor did roll in in the river, but my son got it out even that afternoon.

00;09;04;18 - 00;09;30;24
Matt Ohrt
That would be the fairest bill I would have of this whole ordeal. $300. But I had a bad, er, experience, a very, uncanny thing and, expensive air and then, and then also a bad billing experience. So that was really what boosted me to do what I did at Merrill Steel and what I'm doing today to help and, fix health care, employer health care, commercial health care specifically because I lived it firsthand.

00;09;30;26 - 00;09;37;16
Craig Andrews
Yeah. So what, you know, inputs and meat on that. What what was the bad experience?

00;09;37;18 - 00;09;54;23
Matt Ohrt
So I, being the stubborn soul that I am, right. And and knowing that I, I had was before we fixed our health plan. So my deductible was something like 8000. And then I maxed out a pack. It was I forget 12. Right. So I'm thinking about this. Do I really need to go? Do I really need to go?

00;09;54;25 - 00;10;13;14
Matt Ohrt
and somebody then of course, my wife, who had talked some sense into me and the ER doc, who was actually our direct primary care doc, said, you need to go get checked out. You could be bleeding inside. So I had my daughter drive me and, and then, she rolled me, and she's actually going to be an R.N. here in a month or two.

00;10;13;16 - 00;10;33;11
Matt Ohrt
but, she rolled me in, and, the lady wouldn't even look at me for, like, a minute, at the front desk. And then she looked up and handed me a clipboard and said, fill this out. And I said, ma'am, I've just been run over by a 4,000 pound tractor. I could be really, really hurt. I need, you know, and then and it still wasn't urgency even after that.

00;10;33;11 - 00;10;35;19
Matt Ohrt
Well, fill out the paper then like, wow.

00;10;35;19 - 00;10;37;06
Craig Andrews
So,

00;10;37;09 - 00;11;00;17
Matt Ohrt
And then I got in and they let me up with CTS, which I'm told they're about, equivalent of like a hundred X-rays. so I think I still glowing from that. but what they found was really, I had some a couple of dislocated fingers that looked like, you know, lots a long list of my shoulder went out, I think, and back in and five, six, seven, eight notable injuries, but no procedures, no surgeries and so forth.

00;11;00;19 - 00;11;16;26
Matt Ohrt
And but over 20,000 in bills I couldn't I tried to leave, I couldn't I got nauseated, somebody had to give in. So I ended up spending the night. But the next day as an as an example of the billing. So then a physical therapist stopped by. He was almost apologetic. He said, I have to do this. Forgive me.

00;11;16;26 - 00;11;31;23
Matt Ohrt
You know, I have to they require me to do this. But he and I said, I have a physical. We had just added one at work. I said, I have a physical therapist 100% free to me. I don't I don't need any here, I don't want any here, etc.. Well, he said, let me ask you a quick questionnaire.

00;11;31;23 - 00;11;54;24
Matt Ohrt
And it took about four minutes. But later on I had to get an itemized bill because they also don't send that, but they charge me something like, 380 plus dollars for physical therapy. And so that was one of the various, you know, fraudulent even things that. Right? I never received any physical therapy. And certainly it can't be $400 for a few questions.

00;11;54;26 - 00;12;01;18
Matt Ohrt
I said, I don't need this. so yeah, but these things are rampant in our in our health care system today.

00;12;01;21 - 00;12;31;08
Craig Andrews
Yeah, yeah. I, some of the fraud that happened to me, there is a oxygen provider, one of the leading providers of, oxygen for for him in America. They, they defrauded both me and my insurance company for two years. I eventually had to sue them. They they were never my provider. And I got oxygen from someone else, and the insurance company knew this.

00;12;31;15 - 00;12;38;04
Craig Andrews
I eventually had to sue them to wipe my record clean and make them go away.

00;12;38;07 - 00;12;52;03
Matt Ohrt
Yeah. It's unfortunate. It's it's almost, you know, it's if you look at these companies that audit bills, they will tell you that it's basically almost every bill has something fraudulent or mistaken within it, which add up to a ton of money.

00;12;52;06 - 00;13;17;26
Craig Andrews
Yeah. So, you know, there's a there's a question that's on my mind and it's almost one of these cliche questions. But when I think about for myself because I shouldn't be alive, it's, you know, it's had an interesting impact on me. You know, you got run over by a 4,000 pound tractor. you should have your injuries should have been way worse, and you should be dead.

00;13;17;28 - 00;13;26;02
Craig Andrews
what does how did that change you in terms of your view of life?

00;13;26;05 - 00;13;51;17
Matt Ohrt
Yeah. Great question. We we do have that in common, don't we? I know we've talked a little bit, but I tell that to people off and I shouldn't be here. so yeah, you know I didn't see any angels or anything that day. And that's always, you know, people ask me that. Did you see anything? I think there was something happened, you know, because, I would say 99 out of 100, I'm, all sorts of morbid descriptions could come out of my mouth of what should have happened or could have happened.

00;13;51;17 - 00;14;07;11
Matt Ohrt
And I don't even like to think about that part. I think, you know, ironically. So I was I was a person. I'm a person of faith and just, have been since I was strongly 33 years old. So I was before and after, so I, I won't say that, you know, it really changed who I am, per se.

00;14;08;18 - 00;14;33;28
Matt Ohrt
Maybe it was an example of where I, where I feel like there was some help there. but it certainly changed me dramatically in terms of how I feel about health care and my motivation to fix it. You know, I was always I was motivated before we were doing things. but after that, I ended up changing every single health care partner under plan, which was 5 or 6 partners that I viewed as untrustworthy.

00;14;33;28 - 00;14;51;23
Matt Ohrt
And I said, I can't work with untrustworthy, I can't I don't have time to watch you, I don't have time to pull you along. And I started doing count disclosures and understanding how they were paid. And then I then I realized why they were being resistant or complacent, that they were being paid more from the other side, from the insurance side, than they were from me.

00;14;51;25 - 00;15;02;00
Matt Ohrt
And, that was very clear to me as far as why why they weren't, being strategic or coming along. So when we changed partners, some amazing things happened.

00;15;02;02 - 00;15;27;28
Craig Andrews
Yeah. You know, I think for me, the change was kind of two things. One, I live with less fear than I used to. I didn't live with a love fear before. I live with less fear now. And the other is, you know, I feel a responsibility to speak up for those that didn't make it, I should be dead.

00;15;28;01 - 00;15;44;21
Craig Andrews
and, you know, obviously that's some survivor's guilt speaking but still meaningful of how well I live my life moving forward to speak up for those that don't have the privilege.

00;15;44;23 - 00;16;03;03
Matt Ohrt
I never, of course, you know, I never imagined even even after I, you had healed and gone back to work, which the healing process was pretty amazing. But I never imagined that it would be part of a health care story. And it was. Or, you know, anything like that. so as I reflected that, you know, I realized how much it had motivated me.

00;16;03;03 - 00;16;24;07
Matt Ohrt
And I put that in the book at the very end, just, you know, not too long before publishing. but it's amazing how those experiences really affect our lives. You know, I'm a I've always lived a very active life, and so I, I'm very thankful. certainly we had just adopted where foster parents. We had just adopted our first, son.

00;16;24;10 - 00;16;45;20
Matt Ohrt
we have four kids of our own, and then our first adopted son, like a month before. And I just think about the tragedy that could have happened, right, with with foster kids in our home and a newly adopted son and our kids and all sorts of just really bad things. I could have been paralyzed, which would be, very frustrating for me as I just I move around a lot.

00;16;45;20 - 00;17;03;23
Matt Ohrt
I don't sit still, you know, and or or badly injured in some way. so I'm just very thankful. I guess very more grateful would be one of those outcomes for me of don't, take for granted what you have, because in a split second it can be lost. It can be a car accident. I certainly didn't.

00;17;03;26 - 00;17;16;28
Matt Ohrt
I was I had about five other things to do that day, and I'm like, I'll finish this task and I'll move on to the next, well, life got interrupted, right? And, for the next year or two, I was healing overall.

00;17;17;00 - 00;17;27;15
Craig Andrews
Yeah. So eventually so were the VP of HR. But you eventually left that and you did. You then start Self-fund Health?

00;17;27;18 - 00;17;47;07
Matt Ohrt
Yeah in 2022. So we're starting our third year now. So as we as we built this self-funded plan, we were already self-funded. And that's one of the mistaken things about companies being self-funded. It wasn't the way we were funding our plan. That was the issue that was leading the high cost. It was our spend that we had to look, that we were we shopping for value.

00;17;47;07 - 00;18;05;29
Matt Ohrt
Did we have our design built in that we could get the best care at the best price? That was our gap, or we needed a medical strategy. but one. So so that's what we built out. And so then we had saved about 20% off of our total plan cost. When I took over it in 16, it was about $5.5 million.

00;18;06;01 - 00;18;26;09
Matt Ohrt
And so employees saved and their families saved about 20% of that. So they saved significantly. We got same or next day care. We got, just higher quality care. And so we have this model, if you will, this this idea of this highest performing self-funded health plan that we then turned into Self-fund Health. We said we can go help.

00;18;26;09 - 00;18;43;25
Matt Ohrt
I met this guy from Madison. His name's John Barron. We said, we can go help a lot of employers. This is the this is the future of health care. Free. Free of the free, market health care model is the future of health care for employers. And because we know how many employers are struggling today, which is nearly all of them.

00;18;43;25 - 00;18;56;18
Matt Ohrt
And employees go into these meetings and they hear about these horrible increases, their raises are gone. And we actually discovered a way to stop that mess. And so that was inspiring.

00;18;56;20 - 00;19;05;02
Craig Andrews
Yeah. So roughly what is Self-fund Health. Yeah. Who are you? Who do you who do you help and how do you help them?

00;19;05;05 - 00;19;33;11
Matt Ohrt
People. People often. Often. call us a broker. Advisor. We're not. We actually work through forward thinking advisors. and, that that's how that's so they that we are a health plan. And so, that's a slight difference. There are some, great advisors out there who are building plans. but we are this kind of standardized, high tech, real time data, over overseen by a nurse that's attached to each account.

00;19;33;11 - 00;19;53;24
Matt Ohrt
High support, hand-holding, high education, health plan that takes a monopolized market and opens it up to a free market so that the shopper can shop. Right. We use simple examples like you go to a restaurant, you're unconsciously evaluating the service and the food, and whether it's hot or cold and how much it costs and how good it tastes.

00;19;53;27 - 00;20;14;13
Matt Ohrt
Same as when you shop for a car. When you go into Sam's or Costco and buy a TV or power a shopper is shoppers is to walk away. And the health care industry has been monopolized that we're in that work and we don't see the quality and we don't see the price until far afterward. And so our whole ability to shop has been removed in that.

00;20;14;13 - 00;20;34;00
Matt Ohrt
And therefore, the health care industry can really run wild with it. a lot of people are waiting for them to fix these problems. The sellers of health care in different forms. And I will tell you firsthand these are problems for them. Therefore, if you don't have a problem, you don't need to fix that. They're getting very wealthy.

00;20;34;02 - 00;20;46;07
Matt Ohrt
but the buyers of health care, the employers and the employees have a big problem at hand. They're driving toward a cliff, and they're not pumping the brakes or turning the wheel. those are the ones that need to solve this problem.

00;20;46;09 - 00;21;07;29
Craig Andrews
Yeah, well, you know, and I ran into that once. I, you know, I've been susceptible to lésions, which are basically where you get, like, this, big lump of your eyelid and back during Covid, it just gotten so bad, I wanted to have somebody take care of it. And I'm on a high deductible plan. And I started calling around, and they had these.

00;21;07;29 - 00;21;35;09
Craig Andrews
They're like, well, you have to come in for a consult. I'm like, that's silly. It's a chelation. Anybody who's seen as lazy and I'm will say, that's just lazy on lay back. We're going to lance it. and and so that was the first negotiation. Then the second negotiation was on the price. And I ran into one place that they never gave me a price, but based on what they said, the estimate I had was I was going to pay $800.

00;21;35;09 - 00;22;00;21
Craig Andrews
There. I ended up finding a place that was, I think it was 230 or $250 in a very nice part of Boston, next to a very nice hospital. You know, this wasn't some rusty needle joint. or rusty scalpel joint. I got a half hour with a nurse, 45 minutes with a surgeon and a follow up check.

00;22;00;23 - 00;22;21;23
Craig Andrews
check up for, like, 230 or 250 bucks. But it shows the power. What you're talking about was a competitive shopping. And I realized the place was charging 800 about. They were just a insurance extraction machine. They were just trying to figure out how to maximize reimbursements.

00;22;21;25 - 00;22;39;11
Matt Ohrt
Yeah, it's the oddest thing ever. You know, in in health care, we find that cost and quality are inversely related. I don't know any other industry where that's the case. I think that's the result of a monopolistic environment. But when you find these lower costs, you actually get and I get to I, I've yet to find an exception.

00;22;39;11 - 00;23;03;00
Matt Ohrt
I don't want to generalize too much, but, this is the norm that you receive better care. You get in much faster, you know the price up front, and you get and you get a very fair price for the services versus this other traditional system that is a patient focused but profit focused. So, that's a lot of what we do is we find these free market doctors and the doctors make more in those cases, too.

00;23;03;00 - 00;23;28;07
Matt Ohrt
They make more on a $20,000 joint replacement than they will at the hospital, and $100,000 joint replacement. so you see the the entities that are pulling money out of this system and often aren't they're not the ones providing the health care. So when we take out all the middlemen and we say, here's a buyer person needing health care, here's a seller, a person giving health care, a lot of that, we get better care and a lot of that can be removed.

00;23;28;09 - 00;23;30;24
Matt Ohrt
excessive cost, you know.

00;23;30;27 - 00;23;56;25
Craig Andrews
So when we talk about the prices, if so, you represent exclusively some, companies that have self-funded plans. They're basically buying your plan. And so the, your clients, you know, your customers are basically the, the employees of companies, they have purchased a plan. And so is that right?

00;23;56;27 - 00;24;05;28
Matt Ohrt
Yeah. That's right. We work for the employer. We taking no money from anywhere else. And we are an employer designed plan. And yeah, we work for the employers to get it right.

00;24;06;01 - 00;24;21;07
Craig Andrews
So when the employee. So let's take this scenario where I had to get, you know, lazy on plans. If I was working for one of the companies that's one of your clients, what would that experience look like from under your plan?

00;24;21;09 - 00;24;39;19
Matt Ohrt
Well, we, what's interesting about us is we still offer all the traditional options. So if you wanted to go to them, your old doctor or your current doctor at the hospital, you still could. Now you're going to pay. You're going to pay your old school prices, though. You're going to pay your high deductible up to your college with your co-insurance up to your max out-of-pocket.

00;24;39;19 - 00;24;59;04
Matt Ohrt
So that option is still there. However, what we do is then we bolt on this, all these new, no cost options. So these these other options are where we shop, right? The hospitals. Really? I hope they change someday. If they lose enough revenue, they will. but we can actually evaluate the prices. So we call them preferred providers.

00;24;59;04 - 00;25;15;28
Matt Ohrt
So, you could call our nurse right away and say, I've got this. What can I do? You could go to our independent what's called direct primary care clinic. There's 123 now in Wisconsin all over the state. And all of that care, no matter what they do, if they could do that procedure, there would be no cost to the member.

00;25;16;00 - 00;25;32;03
Matt Ohrt
And they could get you in within a couple of days and a week stop, usually within a couple of days. If the if we need to refer to, say, to a dermatologist or something, we would find a preferred provider there and then same thing, no cost to the member and typically would be in in a week or less.

00;25;32;06 - 00;25;51;27
Matt Ohrt
So it's really it's, it's a new option. It's not a replacement. It's not taken away. Your doctor and ours, the patients will, over time, will certainly gravitate to the no cost care. Right. If I can get a, $600 MRI for free versus a $6,000 MRI, or I have to pay the first five. We don't have to be great at math.

00;25;51;27 - 00;26;00;11
Matt Ohrt
You know, they say 70% of people are good at math. And the other 40% aren't. But we don't have to be good at math to see these things. These numbers are pretty obvious.

00;26;00;13 - 00;26;24;20
Craig Andrews
Well, in the example you just gave, this was something I ran into, a year or two ago. I had to get, Cat scan and they'd scan and again, still in high deductible, and they'd scheduled me at, like, the leading provider of radiology in Austin. And I was like, wow, that's expensive. And was also hard to book an appointment.

00;26;24;20 - 00;26;34;09
Craig Andrews
And literally across the street from one of the biggest hospitals in Austin was another provider that did for half the price and would get me in sooner.

00;26;34;12 - 00;26;49;05
Matt Ohrt
Some of these are outrageous. We had one where in an infusion, where you sit in the chair and you get a drug infused, it was 25 grand for one sitting. We found it independent. That was one floor below in the same hospital, 4 or 5000.

00;26;49;08 - 00;26;50;02
Craig Andrews
Wow.

00;26;50;05 - 00;26;53;15
Matt Ohrt
Just go down the stairs or the elevator.

00;26;53;17 - 00;27;00;23
Craig Andrews
So this is great. The employees pay nothing. Did did their employers? Does that mean the employers are paying more?

00;27;00;26 - 00;27;23;12
Matt Ohrt
Yeah. So if you think about yes well not not more. But the employer then would pay 100%. So take a simple use MRI as a simple example. Right. So it's 6000 in the independent side or a 6000 sometimes more. We'll just say six, 6000. So 600 versus 6000. What would you rather pay just right. Go back to the math joke 100%.

00;27;23;12 - 00;27;43;24
Matt Ohrt
So if you're the plan, the health plan of the employer, you're self-funded 100% of 600 and the and the patient gets it for free. So the plan is paying all 600 or 80% of 6000. Plus the patient has to kick in. They're part they're deductible. Right. So it becomes pretty easy math that it's a win for the plan.

00;27;43;26 - 00;28;02;16
Matt Ohrt
And it's a win for the member. What a lot of people don't realize is they only look at what their card covers, which is fine. That's that's normal. But if we don't look at what the plan spends as well. So if we're overspending for health care because this year's claim cost, even if you didn't pay a lot from your card, this year's claim cost is next year's premiums.

00;28;02;18 - 00;28;22;20
Matt Ohrt
So everyone's frustrated. They say we have great insurance, right? Even if it's self-funded. And then they get to the next enrollment meeting and they say it's going up again. It's there goes your raise, there goes your raise, there goes your raise. We can actually prevent that. And still, I believe I have to verify this when I if I believe they're on their seventh year of no premium increase.

00;28;22;21 - 00;28;35;07
Matt Ohrt
And so they get to go into their enrollment meetings and say same as last year, same as last year. And so what companies can say that when when we start shopping wisely for health care, that's how we achieve those things?

00;28;35;09 - 00;28;45;10
Craig Andrews
Well, I know at a time where employee retention and recruiting has been, you know, historic difficulties, that's a huge, huge thing, big time.

00;28;45;14 - 00;29;07;28
Matt Ohrt
Yeah. We, you know, in the and I think they if they haven't moved. Right. So we were at the give you an idea. It wasn't not only were they frozen, they were low $40 per month, not per paycheck, $40 per month. Premiums for single one, 60 a month for a family that's not breaking your budget. I've seen people paying 500 700 per month and then opens up to a high deductible plan.

00;29;07;28 - 00;29;17;12
Matt Ohrt
A bad a crappy plan. Yeah. And so this starts to really hit our pocketbooks so we can get great care at an affordable price, which is really what we all we're all after.

00;29;17;14 - 00;29;28;12
Craig Andrews
So the folks you work with are employers, who self-fund what's kind of the the floor of the number of employees. They, they need to have.

00;29;28;14 - 00;29;47;24
Matt Ohrt
We use that general number now some would even say five. but the lower the number, the higher the risk in terms of, say, you get a high claim, it affects the plan because there's less cushion there. But we would give a general number to say we like to have at least 50 employees. And then you could kind of double that usually for their members, for their family members.

00;29;47;26 - 00;30;08;23
Matt Ohrt
But we have a plan I think is at 35. But generally you wouldn't see us. So, you can go what's what's called level funded, which is like self-funded but a little differently, runs a little differently. But yeah, those would be kind of the minimums. Now, the top sides pretty much wide open. In fact, the more the better, you know?

00;30;08;23 - 00;30;38;10
Craig Andrews
And so and this is where I'm so appreciative of what you guys are doing because like you said, you're you're you're breaking up the monopoly. You're bringing in the solutions and you're chipping away at a big part of health care. there's but it leaves me, leaves me a little frustrated because, you know, smaller businesses or when people buy their own insurance are still kind of stuck with the crappy plans that exist.

00;30;38;13 - 00;31;00;18
Craig Andrews
What's the future look like? You know, how do you see this changing over time? Do you see this getting all the way down to the point where, you know, maybe I join a co-op or something like that. Some some group that distributes the risk or how what's the future look like for smaller companies or individuals?

00;31;00;20 - 00;31;19;16
Matt Ohrt
Yeah, it's a great question. It's one that we currently don't have a at least a quick answer for many I've chosen to go in health share plans which are not legally insurance, but can be much more affordable there. The catch there would be that if you have a preexisting condition, they can not cover you. but that's one thing.

00;31;19;16 - 00;31;37;14
Matt Ohrt
So this creativity, there's also the idea which I think we are going to explore, and there are different ways, but where you take maybe you have a hundred companies and maybe they have some kind of commonality of area or industry. There are some some laws here that restrict some of these things, but let's say 100 companies of five people.

00;31;37;16 - 00;32;00;02
Matt Ohrt
Well now but you then you have a group. And how could you bring those groups together and have them kind of share but yet still have good a good health plan, a good insurance coverage? I have not cracked that. Not yet. I have not solved that one yet. because I do have a heart for these smaller employers that are, having some desperate acts.

00;32;00;02 - 00;32;12;21
Matt Ohrt
In some cases, they're laying know if they lose their employees, they lose their business. so many have had to be creative. But, I don't have the polished, solution for that group as I do for the 50 and above right now.

00;32;12;23 - 00;32;48;06
Craig Andrews
Yeah. Well, and I believe I believe what you're doing will lead to that, you know, know I told you about, you know, I know, CEO of a very large hospital locally. And then seven years ago, we were sitting down having barbecue. and it's talking about the price of antivenom. So I live in Texas, right? People get bitten by snakes, and the, you know, vial of anti-venom in Austin cost about 5000 bucks.

00;32;48;08 - 00;33;10;23
Craig Andrews
If you go 250 miles south and cross the border, it's like 250 bucks. And it became very clear the hospital doesn't care. They're not working on reducing the cost. And I told them, I said, at the time, I told him, I said, if you don't change, your customer will be the government. And he went through and told me all the reasons that would be bad.

00;33;10;23 - 00;33;41;22
Craig Andrews
And, and I said, look, I've lived overseas. I've experienced, you know, tier one nation, foreign health care. I've experienced it. I don't want that. I'm telling you, you will lose the argument. And my view has shifted then since then, because by 2030, the projections are 70% of the US budget is going to be, Social Security Service on the debt, Medicare and Medicaid.

00;33;41;24 - 00;34;12;12
Craig Andrews
And so the US government will be too broke. I mean, that doesn't even fund our military. You know, if we give 30% of, you know, the US government will be too broke to take on health care, I believe. And so that's where people like you are more important. I mean, just for the just for the security of this nation so that what six years from now there's a solution to this health care problem that the government's been unable to crack?

00;34;12;14 - 00;34;41;11
Matt Ohrt
Yeah, I think the they say there's something like seven lobbyists per, congressional person in Washington. hold me to that. But I've heard that, different conferences. but if that's anything close to that, right. We think about the influence of these really wealthy industries, how the votes go. If we look at, ACA, for instance, the Affordable Care Act, not only didn't did it not do anything to make here affordable, it skyrocketed the affordability.

00;34;41;11 - 00;34;58;06
Matt Ohrt
What it really did was increased accessibility, which is fine. but it should have been labeled as such. And, we see we see, I think, often, a mis understanding of what our issue is. So we talk about we always talk about who's going to pay for it, but we never talk about how much it is and the cost.

00;34;58;09 - 00;35;15;24
Matt Ohrt
The issue with health care is the cost that we have. We have two people. I testified in front of the Wisconsin Senate once, and I realize this the day after that, we have two parties sitting at a negotiation table. We have the sellers of health care, let's say the hospitals. You also have the independents, but in this case, the hospitals.

00;35;15;27 - 00;35;37;18
Matt Ohrt
It's natural for them to want the price to go up. We would expect that they're the seller. Then we have insurance in the middle. But because of this wonky ACA requirement that said that they can only keep 10 or 15%, 15% for large of the medical loss ratio, meaning that they get to keep 15% of the claims of the premiums.

00;35;37;20 - 00;36;05;23
Matt Ohrt
They're other. So, so they the only way that they make more, the only way that C goes and CEO goes in front of the board is to say claimed claims or premiums went up. Therefore we make more. Right? So you have two parties that are so-called negotiating at a table. Both want them to go up and and the payers not even at the table, the peers in the dark, just getting these in these bills that are sent after the service is performed, where there's no known prices.

00;36;05;26 - 00;36;25;17
Matt Ohrt
And we wonder why this is and we wonder why this is happening. Yeah, it's the cost of health care that we must address. And that's exactly what we're doing in our plan, that we're shopping for value, just like, you know, businesses, by the way, already have these skills. They already know how to shop for raw materials and products and even office supplies.

00;36;25;17 - 00;36;53;10
Matt Ohrt
As I joke in the book. Right. Have you ever seen the office supply email? If you've been in the corporate world, please return your extra folders and staples and to the office supply room, which is which is just fine, by the way, right? Yes. but we'll save, you know, maybe we'll save $3,000, but yet we'll overspend for health care by 20 or 30 or 40 or 40% of our second or third largest expense in the whole company, hundreds of thousands or millions.

00;36;53;10 - 00;36;58;29
Matt Ohrt
And never blink an eye and never realize that we just got ripped off by the industry.

00;36;59;02 - 00;37;12;26
Craig Andrews
Well, well, Matt, I am so incredibly thankful for you. we need you. We need you to succeed. how how can people reach you?

00;37;12;28 - 00;37;30;16
Matt Ohrt
So my email is Matt at Self Fund Health. Com. we're also have the website and we do offer a free book. there as well. So if you want to visit the website you can see that. So the book is called Don't Feed the Beast. Notice I didn't title it. And that's just part of the title.

00;37;30;18 - 00;37;50;13
Matt Ohrt
Save your company. Don't Feed the Beast the employer health care success formula. It's a guidebook for advisors, employers or doctors or others who want to fix the commercial side of health care. but notice I didn't say fight the beast. I'm not interested in fighting the beast. just. Just like our forefathers, they didn't want to fight, but they were willing to fight for their freedom.

00;37;50;16 - 00;38;10;20
Matt Ohrt
And I think the same is here when we when we say, don't feed the beast. The beast could be anyone. It's anyone who's not sharing prices or offering fair prices, or they're putting profits ahead of patients, etc. if we stop feeding those folks and we feed the practices that actually care about us, then it'll hurt the revenue of the other side, and they'll have to come back and share their prices and play fair.

00;38;10;20 - 00;38;20;27
Matt Ohrt
So we're not against anyone. but that's, just how the book works. And so, yeah, that would be the best way to reach me on LinkedIn as well. you can find me.

00;38;20;29 - 00;38;39;29
Craig Andrews
All right. Well, Matt. Thank you. Thank you for being part of the solution. I do hope people reach out to you. and I think you will succeed. You know, not only do you have to succeed, but I think you will succeed. And when. Thank you for being part of that. Thank you for being on leaders and legacies.

00;38;40;01 - 00;38;51;17
Matt Ohrt
Thanks, Craig. Yes, traveling around the nation, by the way, in 17 cities in 2024. So, if you're unsure, it's becoming very evident. This is the future of health care.

00;38;51;19 - 00;38;53;27
Craig Andrews
that's good to hear.

00;38;53;29 - 00;38;57;13
Matt Ohrt
Thanks for having me.

00;38;57;13 - 00;39;26;11
Craig Andrews
This is Craig Andrews. I want to thank you for listening to the Leaders and Legacies podcast. We're looking for leaders to share how they're making the impact beyond themselves. If that's you, please go to Alize for me.com/guest and sign up there. If you got something out of this interview, we would love you to share this episode on social media.

00;39;26;13 - 00;39;49;23
Craig Andrews
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00;39;49;25 - 00;42;00;09
Craig Andrews
Please go ahead and subscribe your thumbs up! Ratings and reviews go a long way to help promote the show. It means a lot to me. It means a lot to my team. If you want to know more, please go to Alize for me.com. or follow me on LinkedIn. Thanks for listening. We'll see you next time.