Risk & Resolve
The Risk & Resolve Podcast is your go-to resource for insightful conversations at the intersection of leadership, business ownership, and the insurance industry. Hosted by Ben Conner and Todd Hufford, this podcast dives deep into the challenges and opportunities that leaders face in an ever-changing world.
Each episode features candid discussions with business owners, industry experts, and thought leaders, exploring topics like innovation, risk management, and the strategies that drive success. Whether you’re an entrepreneur, executive, or insurance professional, you’ll gain actionable insights and inspiration to navigate today’s complex business landscape.
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Risk & Resolve
Why Your Doctor Shouldn't Be a Bureaucrat
Nelson Griswold, founder and chairman of the NextGen Benefits Network, joins us to discuss his mission to revolutionize employer-sponsored benefits and protect America's private healthcare system through innovative supply chain management strategies.
• Passionate about preserving private healthcare to maintain innovation and avoid government-run systems like those struggling in the UK and Canada
• Helping employers manage their healthcare supply chain by steering employees to highest quality providers
• Counterintuitively, highest quality care often costs less because good surgeons don't make mistakes requiring additional procedures
• Many NextGen plans eliminate out-of-pocket costs for employees who use recommended high-quality providers
• Transitioning from selling insurance to managing healthcare risks, just like employers manage other business expenses
• Creating an "open source" collaborative environment where advisors share strategies and innovations
• Emphasizing the importance of population health management to address health risks before they become serious conditions
• Challenging the traditional broker model that's incentivized to place business with insurance companies rather than lower costs
• Combining the triple approach of skill set, tool set, and mindset to create meaningful healthcare change
Visit NextGenBenefits.com to learn more about our mission to make the highest quality healthcare accessible and affordable for all Americans, starting with the employees of our clients.
You're listening to Risk and Resolve, and now for your hosts, ben Conner and Todd Hufford, welcome back to another episode of Risk and Resolve podcast with your co-hosts, ben and Todd. Today we have the one, the only, nelson Griswold founder, chairman and chief evangelist really the NextGen Benefits Network. Nelson, thanks for joining us today.
Speaker 2:Guys, it is a pleasure to be here. I wish I was with you in Indy, but we'll have to make this do virtual.
Speaker 1:Absolutely, nelson. Just for our listeners, viewers, however they're consuming this. Give a little bit of a background to the NextGen Benefits Network and how it came to be and the mission that you're on this is actually a mission.
Speaker 2:It's a crusade, it's a revolution that we're leading in healthcare and employer-sponsored health plans, employer-sponsored benefits. Our vision statement at NextGen Benefits is the highest quality healthcare, accessible and affordable for all Americans, starting with the employees of our clients. And let me emphasize the highest quality. Understanding healthcare some healthcare can kill you and accessible as well as affordable. So it's affordable, but I don't have any doctors in my area. I mean, we've got to make sure that the care is available as well as affordable.
Speaker 2:The purpose what gets me up every day? We can talk about this later maybe, but my background is public policy. I ran think tanks at the state level here in Tennessee, lobbied the legislature, worked with big think tanks in Washington Heritage Foundation, cato Institute, partnered with them while running my think tanks in Tennessee. But our goal was free markets my think tanks in Tennessee, but our goal was free markets, limited government, individual responsibility when it comes to health care. Our goal and my why is to protect and improve the private health care system in the United States. If we lose that and we go to government run health care, we will never get a private health care system back.
Speaker 2:And if you look at countries like Great Britain, canada, where they have a single-payer, government-run health system. It is nothing we want. There's no innovation there. The National Health Service in the United Kingdom is imploding. It's absolutely falling apart. It's just not sustainable. Do you want your doctor to be a bureaucrat? I don't think so. And without a profit motive there's no incentive for innovation, there's no incentive to find new cures, to find new treatments. So, protecting and improving the healthcare system in the United States it's largely government run now, government funded now Medicare and Medicaid. But, as you guys know, half of Americans get their healthcare through their employer, through their private sector employer. And that's our arena and that's where we're working to affect what I'm calling private sector healthcare reform. The government can't fix healthcare but, as you two know, employers, ceos and CFOs are doing it every day, company by company.
Speaker 1:So how long have you been running the NextGen Benefits Network and along that mission? What's the prognosis network? And along that mission, like, what's the prognosis? Like, are things improving or is it more dire? Or what's the circumstances that you're seeing today?
Speaker 2:Well, we have a four-year reprieve. There's no national healthcare on the horizon. With the current administration, it would be vetoed and it wouldn't be overridden, and not a vote to override it if it were to pass, which it's not likely to anytime in the near, near, near future. But so we've got a four year respite that, they are investing in their employees' healthcare and managing the supply chain of that healthcare. As an employee needs a doctor's appointment or a surgery or a drug cancer treatment, we make sure that it's the highest quality provider available in that market and we make sure that that price is reasonable. Now, sometimes you pay the highest price because that's what the best doctor is charging, but usually it's counterintuitive. The highest quality care usually costs the less, the least amount, and so if you go to the high quality providers, cost automatically comes down For one reason good surgeons don't make mistakes, requiring a second surgery to fix the first surgery and a readmission to the hospital, all of which the health plan pays for, even though the doctor made a mistake. He gets paid twice once to make the mistake, second to fix the mistake. The best surgeons don't make those mistakes, so they don't require those additional costs we've been doing this about.
Speaker 2:Let's see, nextgen was developed I mean, I gave it the name, but I became aware of it in 2016 and it's evolved and grown and continues to evolve. I like to say that this healthcare revolution, or benefits revolution that we are a part of and helping lead, is the most evolutionary revolution in the history of revolutions, because we just keep learning and we keep finding better approaches and new ways to explain it, new strategies, better strategies to help employers take control of their care and provide their employees better healthcare. Better outcomes because of better healthcare at less dollars, not just for the employer but for the employee. And in fact, as Connor Insurance knows, a lot of next-gen plans actually eliminate the out-of-pocket for the employee. Their healthcare is free.
Speaker 2:Follow the guidance of the medical team, go to the highest quality providers and the employer just says yeah, we'll waive your out-of-p pocket because you're doing the right thing. You're going to the best provider, the best doctor, the best hospital and therefore we're going to be saving money. You're getting better care, so sure we'll waive you out of pocket Free healthcare. When was the last time you heard that? That's actually the?
Speaker 1:total opposite of anything that you'll ever hear in any news publication or otherwise, absolutely true.
Speaker 2:Well, the problem with healthcare is it's too expensive and the quality is not consistent. We have great healthcare in this country, but it's not consistently great. So you need help to identify which is the good doctor and which is the bad doctor so you can avoid the bad and go to the good. And that information is not readily available. It's expensive and it's hard to find. Our plans, nextgen plans, make that available to employees so they can make a choice Do I want to go to the best doctor and pay nothing out of pocket, or do I want to go to a bad doctor and pay $6,000 to $9,000 out of pocket? Up to you.
Speaker 1:How did you find yourself into the employee benefits and healthcare space? I mean, you talked about public policy and then you talked about this mission that we're on since I'm a member of the network this mission that we're on to revolutionize healthcare in the absolutely most positive way possible. How did you find yourself into this space and when did you like it's a two-part question, I suppose like, did it really occur to you that, oh my gosh, we are onto something?
Speaker 2:Well, first question how did I get here? Which is a great question. I never would have guessed that I would be in the employee benefits space, and so I was with my second think tank and I had been running it as the acting president because our president had passed of cancer. I was the acting president and the board brought in a new president, so I'm working with him and I'm head of policy, vp of policy. So we're doing our thing and we're well. Pardon the expression.
Speaker 2:I pissed our governor off one time too many, and people who are on boards of public policy organizations tend to be fairly influential people and often have an interest in public policy. So we had the owner, the CEO, chairman, ceo of a very large nursing home chain. He told me, nelson, I'm down at the Capitol once a week, hat in hand, asking for a favor, free me from this regulation. Give me some relief. I don't need the governor mad at me. Another board member was a senior partner at a law firm that lobbied the Tennessee legislature and the governor's office. They were doing very, very well because they had close ties to this governor. Sam the attorney told me, nelson, the governor's told me if we don't get rid of you. My lobbyists aren't welcome in their office. So, having annoyed the governor one time too many, I was gone. They let me go. So I'm casting about. What am I going to do? I'm a policy guy. There's nothing else I can do. And a former board member of mine called me and said what are you up to? And I said you know what? I'm looking for a job. He said come talk to me. And he was in employee benefits. On the voluntary benefit side ran a benefit communication and enrollment firm said hey, why don't you come and be VP of communications for me? I said I can do that. So that's how I got into benefits and after several years I was top producer. I was out running everybody on the sales side, but I was getting a little bored and decided to become a consultant and help brokers and advisors do better. Help their clients better, make more money, have a better business, better career. Help their clients better make more money, have a better business, better career. And that was when I started working directly with brokers.
Speaker 2:In 2010, obamacare passed and I realized this is huge for our industry. I mean, I actually read most not all, but most of the law. The relevant parts relating to brokers said this is like a massive earthquake, epicenter Washington DC, and the tremors from that earthquake are going to collapse the ground under employed benefit firms. They're going to have to reinvent themselves. So I wrote a book called Do or Die Reinventing your Benefits Firm for Post-Reform Success and we thought we would hand out a few copies to prospective clients. We sold over 5,000 copies of that. The insurance companies were buying them up by the case, handing them out to other brokers, and so that really set us up, and my partner at the time and I built a mastermind group, which you're a part of, which is top advisors. Come together, collaborate, work together to find solutions to improve what you do for your clients.
Speaker 2:And after three years of that I ran into a woman named Deb Ault of Ault International Medical Management and I said to Deb what do you do? She said, oh, we help employees find the highest quality medical care so that we can save their employers lots of money on their healthcare. And I looked at her and I'm thinking to myself wait, the insurance companies tell us a claim is a claim is a claim. There's nothing you can do about the cost of healthcare. A claim is a claim. There's nothing you can do about the cost of healthcare. It's an immutable fact. A $100,000 hospital claim is $100,000. Nothing we can do about it. And I looked at her and I said you can't reduce the cost of healthcare. And Deb and you can see her doing this stepped back, looked at me and said I never got that memo. Well, I started at first I thought she was crazy, and then we I started talking with her more and exploring this and I realized, wait, there are a lot of you can manage the cost of healthcare. And that's when the epiphany hit. It's like, oh my gosh, we've been fiddling around while Rome burns, selling insurance company programs that fully insured plans that don't control the cost of healthcare.
Speaker 2:When, for the right companies, not everybody's ready for a self-funded plan, they aren't eligible. But the ones who are can control their healthcare costs. Manage their healthcare costs like they manage every other expenditure in their business. Reduce the cost of care while improving the quality of the care for their employees, their business. Reduce the cost of care while improving the quality of the care for their employees. And I remember a mastermind session we had. It was in the fall of 2017. And it was, and we were in Denver at the Brown Palace Hotel. I looked at the group and I said I've got a new job description for you healthcare supply chain manager. A new job description for you healthcare supply chain manager. And that was the big shift. That was when we really shifted to focus on managing and controlling healthcare costs.
Speaker 1:That was the match that lit the whole thing, because you talk about healthcare across the country at this point and it is a concept of supply chain management and I think that that's been broadly adopted in talking point by most consultants not necessarily practiced by most consultants. So just an incredible shift in the entire industry that was launched. Shift in the entire industry that was launched like epicenter denver, next gen benefits network. You know it wasn't even called that at the time, I don't even think.
Speaker 2:But no, no, we had. I was adopting in 2017 the next gen label. The next gen benefits label, next generation benefits, was the first iteration, actually. Well, I will tell you, it's gratifying. I was the first person to talk in the industry, to talk about health care supply chain management, and now we're seeing it used. The problem is the language has been appropriated by a lot to your point, by a lot of brokers and advisors who they're implementing it by brochure. Yeah, we do supply chain management of health care. Read about it in our brochure. So it's gratifying that the language is spread, but frustrating that it hasn't been more widely adopted as a strategy instead of just a talking point.
Speaker 3:Nelson, I see a real close connection between the work of a think tank and the work you're doing today. It's policy driven. You have, if you will, constituents. Your constituents that you're trying to sway in a think tank are policymakers, legislators and, within the next gen benefits. The policy is the supply chain management and the people you're ultimately trying to sway are plan managers, employers, through the help of the advisors. So a couple of things come to mind In a think tank.
Speaker 2:help me understand where's the funding come from? How are think tanks funded?
Speaker 3:It's a darn good question. I really don't. I just assume donations of some sort.
Speaker 2:Well it is. It's donations, individual donors. There are some foundations that will support think tanks if they have proven themselves worthy of the support we got. We received some foundation support from several foundations, smaller, more conservative leaning foundations. There is corporate money available at times but, as Ben has heard me say, we work for whoever signs our paycheck Right and you take corporate money and you put yourself at risk because corporations well, everybody wants something back from their money. They're putting it in for a reason, but individuals who give are usually ideologically aligned. They just want you to go out and beat the drum for the issues on which they agree with you. The same with foundations they give, usually based on ideological basis. Corporations rarely do. These are the same corporations who give money to both the Republican and the Democrat candidate Because they want access, they want results.
Speaker 2:I don't know that I took any corporate money. I don't know that any corporate money was offered to me to be fair, but I would have had a hard time taking it. So something very interesting though I learned from John von Kannon, the longtime executive VP at the Heritage Foundation and head of development for Heritage and Heritage is probably a half billion dollar organization today in terms of fundraising per year and I rented to John at an event in DC and we were talking and I told him I was running a think tank in Tennessee and I was asking about fundraising. You know a little bit about it. He said what are you doing Wednesday? And I said I'm in town for Thursday, so I'm here.
Speaker 2:Can you come to my office at one o'clock on Wednesday? Oh yeah, absolutely. He sat me down and gave me a lesson in fundraising, but the thing I remember most was if you want someone's opinion, ask them for money. If you want money, ask them for their opinion. And so whenever you all and I know you are philanthropically oriented when you're asking for money for an organization or your church, instead of asking them for money and telling them what you're going to do with it, ask them what they think is important and what needs to be done, and they'll tell you. And then you can say you know, we have a new initiative on that very, which may have been born that moment that exact moment.
Speaker 2:Let me go back and talk to the team, but I think we have something around that and then you come back and say what would you think about the Todd Hufford Center for XYZ?
Speaker 1:Yeah.
Speaker 2:Well, I know you're going to love the XYZ part because you told me so, but it's not cynical at all. If it's not our agenda we're not going to do it. Find out what people want to give to and then give them an opportunity. You know, if they're not interested in anything you're doing, obviously they're not a good target, but you're probably. You probably know they've got some affinity for what you're doing, right. But anyway, that's how fundraising it's primarily individuals, at least for small thing times so then you pivot to next gen.
Speaker 3:The revenue model on that is more supported by each individual member right.
Speaker 2:Yes, and we run a mastermind group. We've run that for the. We are in our 13th year, wow Of the NextGen Benefits Mastermind Partnership. We are in the 10th year of our Ascend Conference, which has been held every year until now in January. This year it's in July. We had to move it because of a renovation project at the hotel we were going to be at, and so we put on a lot of events. We're really an event company in a lot of ways. We've gotten pretty good at that, and so I have vendor solution partners that will sponsor these events, and that's another part of our business model.
Speaker 3:So when you think about 13 years of doing a mastermind, how many total you know Ben would equal one he's participated in that mastermind. How many Ben's have gone through or still part of or once were part of the mastermind in those 13 years roughly?
Speaker 2:I think we're around 75 to 80 people. This is a very small, intimate group. I think the most we had at one point was 40 and that was a surge. We've been around 25 to 30 most of the years and we had six charter members. Four of them are still in the mastermind after 13 years, which does my heart very good. I value loyalty and I value partnerships and they have been great partners and great members and great friends over the years.
Speaker 3:So let me pivot to you talking 70 total over 13 years. I don't know how many benefit brokers are out there total, but that's got to be a very small percentage of the total addressable market, if you will. But yet the impact they've had is pretty significant. I mean, they're definitely punching well above their weight. I guess, when you look at the business going forward, do you feel like those 70, those 80, those 100 can affect the real change that you're hoping to make through all these policy and supply chain adjustments?
Speaker 2:Probably not, which is why we have growth, very ambitious growth goals. The group that Ben is a part of and I don't mean the current group, I mean the mastermind and the next gen network of advisors in the next gen, the next gen network outside these haven't necessarily been in the mastermind but they've been through our next gen benefits boot camp training. They are Ascend alumni. They've been to our Ascend conference and they're doing next gen strategies. It's more like probably around 200 or so, about two to 250, I would guess. But they are the point of the spear, the tip of the spear, the phalanx, and it's going to take more than that. But there is a tipping point I don't know where it is.
Speaker 2:When I spent a week with Richard Branson on his island in the British Virgin Islands and we were talking about health, he wanted to know about American healthcare. I was there representing the work I was doing, disrupting healthcare. This is a group of disruptive entrepreneurs that Richard hosted on his island, and so he was asking about American healthcare and I was explaining it's misaligned incentives. And that's really the problem is, people are getting paid to do the wrong thing. So, instead of meeting the needs of an employer and lowering healthcare costs. The incentives actually favor the insurance company letting healthcare costs go up because that causes premiums to go up. Premium is the revenue of insurance companies and they have a fixed profit margin because of a clause in the Obamacare law the Affordable Care Act that caps their profit margin. So with a capped profit margin, they can't increase that. The only way they can generate more profit, more EBITDA for their shareholders, which increases shareholder value, which is a CEO's job is to increase revenue, because four and a half percent of a bigger number is a bigger number. I was explaining this to Richard Branson and he thought for a minute after I finished and said how are you going to get them to change? And I told him what we were doing and he said okay, but you know, organizations will not change their behavior until their incentives change. So the challenge that we have Ben's a part of this is to impact the incentives to make it less profitable to do business the way they currently do business. So the CEO is forced to scratch his head and said OK, we need to pivot here. These people are taking business away from us.
Speaker 2:Conor Insurance has taken substantial companies, lots of employees, away from bigger national agencies. You all had no business doing that. There's probably some law in insurance that says you're not allowed to do that. But you broke the law and you did it. The more that happens, it's not necessarily the employers that will change.
Speaker 2:In fact, I had a recent conversation. Which of the big houses, which of the big box stores, as we call them, the big brokerages, is the closest to maybe changing their business model? Because the first one that does is a huge market advantage. Huge, if Conor Insurance can take a 500 life group from a top five broker, what could a top 10 broker take from other top 10 brokers if they were using your strategies, ben, they'd be beyond dangerous because they have the brand equity and the big thick binder of capabilities all of the A-team the ERISA, attorney and actuary and medical director that most of our firms don't have individually. They do through the network we don't have individually. That firm could change.
Speaker 2:So I'm looking for where's that fissure F-I-S-S-U-R, where's that break in the wall that maybe we can put a crowbar in and start to open it up and create a little more room for change to get through? And if we could get a large firm like that to start doing business differently. It's the business model. It's just a business model. The insurance company's business model is let's put all of the premium with the big insurance company and fully insured plans, because that pays us the most. If I were running Aon Brown, brown, gallagher, willis Lockton, I'd be doing the same thing. I'd be fired. If I didn running Aon Brown, brown, gallagher, willis Lockton, I'd be doing the same thing. I'd be fired if I didn't do that. But I'd be doing it because that's the model. Somebody's going to say let's break that model, let's do another model, like Ben Conner is doing. Let's model Conner Insurance's approach and we're a lot bigger than Conner and any of the other groups doing this. We could really have an impact. Have you seen the big guys do it?
Speaker 2:Yet there is one agency and it's not one of the bigger ones, but it's big that is toying with it. They have sort of a division. It's out there doing a lot of self-funding. They're leading the self-funding which no broker does. That's not where they make their money. Make their money fully insured, stick it with the insurance company. You get override bonuses, you get retention bonuses, you get all sorts of additional dollars. You get a multiple on the commission. So instead of 3%, you get 3% times 1.2 or whatever the multiple is for volume. This one agency is leading a division, not the whole agency, but they've got a division out there playing with this, toying with this, and that's actually the one I'm most hopeful and I might even have a conversation with at some point.
Speaker 3:Because 7,500 agencies bought by private equity in the last 10 years. So you're talking 13 years of a mastermind. In about the same time, the competition that was out there that might do these kinds of things is now under an umbrella that's no longer incentivized to do it. I mean we're incentivized to do it because, well, number one, it's the right thing to do. Number two, it's a great way to attract clients. And number three, when you save clients tons and tons of money, it's not that hard to say hey, mr Employer, if I can get this done, would you be willing to pay me this fee and tell you what? Let's just take a one year at a time and then when you show them the results, they're like man, I'd be glad to pay you double. And we're like well, maybe we'll get there next year.
Speaker 2:Well, you know there are advisors on the next gen side that are taking your percentage of savings, which you talk about aligning incentives, right. I don't make a penny unless I generate the savings I've promised you in the first place. And every CEO, cfo. They may not accept it they all do not accept it, but some do but you are totally aligned. You've taken your chair from one side of the table, set it around the table next to the CEO or CFO and said we're on the same side, absolutely the same side, which, by the way, makes it easier to get a yes to implement a new strategy. We'd like to bring in medical utilization management. What is that? You tell him okay, sure, go, because he knows the only reason you're bringing it in is to lower his spend so you can make more money yourself. Well, your incentives are aligned. So that's. You make a great point, though, todd, about the mergers and acquisitions, the consolidation in in the industry. There are a lot fewer independent agencies out there, but I will tell you this I wrote an article about this.
Speaker 2:I used to write a monthly column for Employee Benefit Advisor Magazine until they got folded into their sister publication for HR, and I wrote a column entitled, was it, I think? The title? Well, I don't remember the title, but it was. It was about the decision that agency owners were making to sell, and for most of them it was a tragic decision. They were making it for one reason, and one reason only. Now there were a few that made it because it was a godfather deal. Couldn't refuse it, offering so much money.
Speaker 2:I was sitting across the table in Wichita from an agency. Well, wasn't an agency owner? He had just sold to one of the big houses and I said hey, you might be asking how was the negotiation? I'm always curious, before you sold, how was the negotiation? He said well, they sent their people in. We sat down at the conference table. My partner and I were on one side, they were opposite. They slid a piece of paper across the table. We looked at it and said, okay, that was the negotiation.
Speaker 2:So, godfather deal, exit strategy. You guys are now, you know it's 40 years from now and you decide you want to go off and hang with the great grandkids. Exit strategy yes, I don't have anybody. There are no more people in the Connor clan to take over this organization, so the grandkids don't want. So we're going to sell. Okay, exit strategy, godfather deal, exit strategy. The third, and this is why most agency owners sell, even today they don't know what's next. They know that what they're doing is not winning them more business. They're seeing that they're worth this much in the market and they're seeing that value go down and they figure if I sit around here for another 10 years it's going to be down here. I better sell while it's up here because I don't know what to do next and I'll let Gallagher, brown and Brown figure it out. And it's a shame, because then we'll tell you we know what's next. You guys are doing it. It works and it wins business. Not just good for the employers, it's good for the agency as well.
Speaker 1:Something that Todd brought up about bandwidth that I've been thinking about is and you talk about this religiously among anyone that intersects with the network is it's three equal parts of skill set, tool set and mindset. Three equal parts of skill set, tool set and mindset, and it's. You know, do you have the tools? Do you understand how to use them? And then what is your mindset? And I've found over the years and just kind of just reflecting and watching, that mindset is actually one of the big limiters to growth or change or whatever the desired outcome is. And even when I apply that to healthcare in general, in the deliverable of changing the game, mindset is the biggest limiter. And, todd, you brought up the point of like hey, can those 30 people or 70 people or even 200 people, can they change the system? Can they be the revolution? And it's right, the answer is no.
Speaker 1:But I kind of come back to like I've been studying, learning about through various podcasts or otherwise, about AI, and it comes back to a conversation about closed source and open source and they talk about for the United States, for economic excellence, to be a world power. It's going to be around this concept of open sourcing AI in going faster, stronger, better than the competition. And open source is the idea of shared model, and I've been thinking about that within healthcare and even with the mindset of a broker in general, and it's absolutely the opposite of that. Everything in healthcare is closed source. You can't know about the network agreement, you can't know about a direct contract. You don't know what another broker is doing. This person gets this deal and this other person gets another deal. Everything is hidden in the shadows and I've just more of a comment than anything.
Speaker 1:I've just found that to be just a fascinating look at two things and how competition views it so differently. Technology, people, it's let's go fast and open source and those sorts of things. And in healthcare it's like let's keep everything to ourself, let's not share, it's all about profit margin. And you know WIIFM what's in it for me, everyone's favorite radio station. If we actually wanted to solve something, it would be totally opposite of that. It'd be open source. We wouldn't be afraid of the competition having the same access to the same thing, because you can innovate off of that.
Speaker 2:Ben. What is the hallmark of the mastermind? Open source Collaboration? Open your kimono and show your warts, your scars, your bruises and then share what's working. Quick story on that this is because this is really inspirational.
Speaker 2:I did a mastermind meeting in DC and invited an advisor who was doing really really well and he told me it was a mastermind meeting. We got started and I said all right, so who wants to share what's working? Share your fastball. And Mick. Mick says Nelson, I'm not sure I want to share my fastball and I've worked really hard to build this. I've had a lot of success and I don't think I want to tell her about what I'm doing. I said well, mick, first of all, this is a mastermind meeting, it's all about sharing. I told you that and then, all of a sudden, one of our charter members now retired, playing golf in Scottsdale instead of selling benefits and health care in Omaha in the winter stood up and said Nelson, I've got this, he's standing right. He was seated right across from Mick and this was Tim Olson, olson Benefits. Tim said Mick, I've been in this group for several years now. It's about four years, three, four years. He said I give everything away. Everything I do, I give away. I just invested $5,000 in a marketing program. I gave it all to every mastermind partner. Just here you go. Here it is. I spent the money but you get the benefit of it and my business has grown 27% in 18 months. We're having to move buildings. We've outgrown our building Sharing works and he sat down. Mick goes okay, all right, fine. So he ends up sharing what he's doing in detail. He calls me two weeks later and says Nelson, you're going to believe this.
Speaker 2:Ever since I was at your mastermind meeting, I've had more clarity around what it is I do, how to make it better, the areas where it's a little bit weak that I want to polish up, areas that are really strong that I want to boost. I understand it and see it so much better. I said, mick, of course you do. You've been keeping it in your head. At the mastermind meeting you took it out of your head, put it on the table for everybody else to look at, including you, and now, like looking at a diamond, you get to turn it around and see all the different facets and you get to explore what makes up that diamond and you see it clearly in a way you never would see it if you had it stuck in your head. That's the open source part. When you put it out there, you've got to look at it too. You know? Wait a second, I didn't realize it did. That's not right, we can fix that, or that's great, but that gives me an idea to do something else Right. And that's the mastermind process.
Speaker 2:How many times have you been in the room where somebody asks a question first person, not a great answer. But the second person hears that and goes well, how about this? No, that's not it. But the third person heard both of the other two comes up with an idea that he never would have thought of without the prompting of the previous not so great ideas and provides the answer, the solution. But it wouldn't have happened had you locked him in a room for a year and said solve this problem.
Speaker 2:It's a collaborative, interactive and cooperative process and that's why the mastermind worked and that's why open source works, is it inspires people. It's like, oh, that's a great idea, but it gives me an idea. They aren't just copying it. Sure, some are, but others are going I can improve this or I'm going to do something completely different. That's much better than this. I didn't realize that's what they were doing. I thought they were doing this, I'm going to do this, and next thing you got a second generation that's far superior to the first, and that's what we do. That's exactly what we do. I've never thought of it as open source before, and we had this conversation the other day about AI and open source. Closed source and healthcare is notorious.
Speaker 1:You're right, yeah, everything's closed source, and I think that's been probably one of the most fascinating things I've learned through the mastermind process and even some of my first meetings, where Mick was the guy standing there saying like, hey, we're sharing here, so it's funny that you know Tim imparting on Mick, mick imparting on others, and so continues. But we have to do that so that you have dozens and hundreds of consultants, leaders, that are taking the understanding or are learning about what it takes to begin to solve the behemoth that's healthcare and impart it on knowledge. And then, from knowledge that traveling a foot south so to where it's actually a belief system and a calling right of this actually is incredibly important to be solved, and this mission needs me to be part of it, which that's where you kind of get into rare errors when is who's actually getting to that portion of calling, rather than it's just about a paycheck or landing a client or whatever it may be?
Speaker 2:That's a big part and I probably don't emphasize it enough. This is a cause, this is a mission. I have been saying for a while, if it's not about the mission, it's just about the money, and that may be okay for some people, but I think most people would rather have a purpose, a cause, a calling, a mission to be a part of, to inform their actions, to inspire their actions, to motivate them, to energize them, as opposed to just another day, another dollar. Money is incredibly sterile valuable got to have it, need it, want lots of it but sterile and uninspiring.
Speaker 1:So one thing I wanted to ask you about, nelson, is and there's some of the examples behind you but you've spent a lot of your time, talent and treasure investing in the story and making sure that and we'll put links to the books that you've authored as well as like a link to the documentary that you were significantly part of. It's not personal, it's just healthcare. Why have those communication efforts been so important for the movement and for the education for employers around what's occurring in this healthcare revolution?
Speaker 2:I'm in Nashville, as you know, and Nashville has been called Tin Pan Alley. It's been called the songwriting capital. More songs are probably written in Nashville than anywhere else, and in the music industry there's a saying it all begins with a song. In sales, in public policy, in persuasion, in education, it all begins with a story. If you do it well, you can teach facts, but people don't retain facts, they don't care about facts. There's no context for facts. Stories provide context and meaning and they're also memorable. I could give you three dates right now and you would forget them. But if I told them in a story and I point out why they're so significant, you would probably remember those dates.
Speaker 2:People respond to story and story educates and teaches without being pedagogical, without the lecture. It's not me telling you, I'm telling you a story, the story is telling you, but I'm arm's length, I'm not the story. Now I might be in the story, which is the best way to tell about something, about you. Don't tell them that you did that. Did you notice? I didn't tell you I spent a week with Richard Branson on his island. So that was in the context of a story. But now everyone knows who's listening about this guy spent a week with Richard Branson. So it's a way to communicate your truths and your message without being preachy, or actually, people might not agree, but they're not disagreeing with you, they're disagreeing with your story that you just happen to tell. So there's so much power.
Speaker 2:I've got probably 10 books on these shelves behind me about storytelling using humor in your stories. I've got a couple of books on TED Talks how to tell that story in 18 minutes, which is what they give you for a TED Talk, which, by the way, that 18-minute time frame is based on how long human beings can pay attention. It's the maximum attention span 18 minutes. So when you're speaking and I don't always do this 18 minutes and some sort of disruption you ask a question or you bring somebody up and talk to them on stage, but don't keep talking for more than 18 minutes. I violate that all the time. So the story is everything, what we are. It's his story, history, his story and her story, but you get the point.
Speaker 3:Nelson. We talk about multiplication 7,200 agents. Ben and I have had a great opportunity last year to be asked by two different universities to come speak. They think we've gotten to some level and have something to say. So we come and speak and I enjoy it thoroughly to talk to college students. High school students share everything we've learned. Is there a medium, a story for which you guys at the Next Gen Benefits organization could create curriculum, slash material and then throw down the gauntlet to the 70 or 100 mastermind members to say your job, since you're in every corner of the country, is to find a local college and go present this, go, become invited to present this to college juniors and seniors. Those might be future employees at our benefit shops. Those might be future legislators. Those might be future employees at carriers. They're going to work somewhere and if they've got the knowledge of how a benefit plan could and should work, wow, that could be powerful.
Speaker 2:That's a great idea. I certainly can. We certainly can put together a presentation based around a PowerPoint. The beauty of PowerPoint for most speakers is, if you haven't been doing this speech and rehearsed it and you know it by heart, it's a prompter. Oh, next slide. Oh, I'm talking about this, right? So it makes it easier for people who are not professional speakers, like I am, to go out and give a presentation and not be constantly looking down at a page of notes. That's a great idea. I love that idea, and leveraging the national presence we have is a terrific, terrific strategy. We have them out there talking to employers, but taking another step and go to their old high school. You can usually get invited back to your old high school, especially if you don't have a little money, or back to your college. Great idea, todd. Thank you. I will be implementing that somehow or other sooner than later.
Speaker 3:We've just got so many people who trust the quote-unquote good doctor, and I grew up in a household where my grandfather graduated as a physician from IU Med School in 1926. So he was a physician for 50 years and you just trusted the good doctor. And the reality is we still want to trust the good doctor but unfortunately their own incentives are disaligned. They're working for an employer whose incentives are disaligned. And if we could create just another 100 or 200 college graduates who just ask questions? Ask good questions, because that will lead you to interesting answers. Good questions, because that will lead you to interesting answers.
Speaker 2:I love it Great, great great thought, great idea.
Speaker 1:One of the final questions I have, and then we'll wrap up with the two questions we ask everyone. But in this healthcare revolution, nelson, what does the next phase look like in your mind, or where is the puck headed? To An old Wayne Gretzky famous saying where's the industry headed?
Speaker 2:Well, if I have anything to do with it, it will head in a direction of demand management to complement the supply chain management that we do now. And supply chain management is so much easier than demand management because demand management in healthcare means employees in our world. We deal with employees, employees changing behaviors. I think we all know how difficult that is and it's even more difficult I don't know if it's well. It's probably more difficult to get other people to do it than it is to do it ourselves, and it's near impossible to do it ourselves.
Speaker 2:I do not support New Year's resolutions because they're just New Year's broken promises and people don't stick with it. And then you feel guilty about making it and not doing it. Just don't do it. Pick something and just say I think I'm going to go work out. Don't say I'm going to work out every week, twice a week. Just go do it.
Speaker 2:The problem is, as risk managers which is what you and everyone in your firm, on both the property and casualty, as well as the benefit side you're risk managers. You're helping employers, business owners, manage risks. On the benefit side, you're helping employers manage the risk around the commitment they've made to pay for healthcare for their employees. Well, that's a huge potential risk and without some plan design strategies that delimit that risk, that mitigate and control that risk, they could bankrupt them.
Speaker 2:I mean a million, $2 million claim for one patient would bankrupt most companies. A quarter million dollar claim would bankrupt most companies. So you put in means to control that upper risk threshold. But then how do you manage the rest of the risk, that 40,000 per employee? Perhaps that the employer has decided that he would insure himself or herself? The problem is benefit advisors, brokers, who are attempting to do that to manage the risk of the healthcare costs, are using the rear view mirror and the side view mirrors. They're looking backwards, they're looking at claims experience, looking at claims data, and that's fine and good, except you're looking at a claim for someone who's already had the heart attack.
Speaker 1:What about?
Speaker 2:his co-worker who hasn't had the heart attack yet, but he's going to. If something doesn't change, he's going to. And if it doesn't change, at least you know we better be planning. This guy's going to have a heart attack and we need to financially. Let's put aside some funds. This guy's going to have a heart attack or this person is predisposed to a very serious type of cancer. There's nothing we except we can catch it early if we know it. But if we don't know it, it's a year, two years down the road. She's stage two, stage three, which you can hardly manage and is very expensive to treat, nevermind cure.
Speaker 2:Population health management managing the health of the employees of a company by doing biometric tests, blood draw and doing a panel of tests to find out where your health is today, and then a health risk assessment, which is the cheapest, most inexpensive and most effective genetic test available. You don't need anybody's DNA, it's family history. Wow, you have three generations of women in your family with breast cancer. Let's do regular checks. In fact, why don't we do a genetic test and see if you have the marker? If you do now, we know to do those regular tests and we catch it early. Some women will even. Angelina Jolie, for instance, had two radical mastectomies because she had the marker. She knew she was going to get breast cancer. She didn't want breast cancer so she had mastectomies, so she didn't have to deal with that.
Speaker 2:It's a radical decision, no pun intended, but it is a legitimate decision. But you can't make it if you don't have the evidence. So, helping employers understand I'm not talking about the CEO and CFO actually knowing this it's the medical team, it's the advisor knowing which employees are at risk of serious health conditions, which employees need intervention. Today he's pre-diabetic, but we can reverse that if we can get to him and put him on a program if he's willing. And you're going to see, I think, with this new administration, a relaxation of the limits on the awards and the incentives that employers can offer employees to participate in programs like diabetes management and other population health management.
Speaker 2:So it's like, well, you don't have to do this population health management, but you can't be on the health plan, oh. Or you can be on the health plan but you're going to pay a hundred dollars, a paycheck more, oh, maybe I'll do the blood test, the blood draw, okay or not, but you'll pay for it and at least you're contributing more into the plan to help offset the eventual cost you may be causing the plan Because, don't forget, it's not the employer's money, it's the employee's money. If the employer can spend less and less and less on healthcare, he can give more wage increases, he can provide other benefits to the employees. So population health management that empowers an employer to manage the health of those employees to help mitigate, avoid and manage the risks that those employees pose, both in terms of their own health but also in terms of financial obligation to the plan.
Speaker 1:Yeah, I think you're spot on. I think we've learned to manage the supply chain. So when we see large claims come or the emergence of large claims, we know how to mitigate that. But I think what is that a lot of people don't have answers to is the chronic conditions that are growing in cost by 15, 20, 25% across dozens of people and at that point it's over. You're paying for it, right, and obviously we want to take care of folks. That's the primary motive. So if the money is not the problem, if you look at in general, your population's getting sicker. And if they're sick, are they able to invest in their family life? Are they their most productive worker? Are we helping them live their life to the fullest? And the answer is probably that we aren't helping them do that the answer is definitely no.
Speaker 2:I don't think employers need to be paternalistic, but when they are providing a resource like healthcare, it's a healthcare plan. Today it's a sick care plan. That's right. You don't need it really. It may be some preventative checkup, but other than that there's no wellness involved. There's no well care. You interact with the health care system when you are sick or hurt, and hurt you can't necessarily avoid unless you have a really good safety program at work that you all have implemented for your employer client to mitigate their work comp expenses. You can't really control injuries, accidents outside the workplace anyway, but you can address disease and other medical conditions and this isn't just good for the employer, this is good for the employee.
Speaker 2:And there are story after story I mean I need to assemble these stories of the employee who went for one of these checkups. He didn't want to do it but the employer had the doctors on property because he was two days away from a widowmaker. Another person came in, had cancer, didn't know they had cancer, no idea. They would have gone months to years without knowing it while the cancer grew Internal, not mental. People are on a razor's edge and they don't know it and these types of programs can identify that. But more than that, it's just taking care of your people and helping them take care of themselves.
Speaker 1:Yeah Well, Nelson, appreciate the time today, Appreciate the work that you are putting in at the NextGen Benefits Network. That really has had ripples into the entire industry. It's funny that people will say, well, you'll say several hundred people have participated in Ascend and 70 or so brokers that have been in the mastermind. But the reality is the ripple effect is much more expansive than that. So we end our sessions with two questions that we're going to ask you. First question what is a risk that you have taken that has changed your life?
Speaker 2:Well, there are a number, I would think. The one that comes to mind, though, was leaving the employee benefit enrollment firm I was with and hanging out my shingle as a consultant to brokers. Nobody asked me to do that. There was no clamor among brokers. There was a need because I was going to help them be better in their job, make more money, help their clients better. But that was a huge risk, and my wife questioned it, because I don't question things like that, I just do it, but it was a huge risk. I left a good, stable job and paycheck every pay period to be on my own. It was rough at first. It was very rough at first. I just about starved. My wife was not happy, but eventually things picked up and a couple of good contracts came in and good opportunities. And had I not done that made that investment, something I realized recently, by the way.
Speaker 2:Change, changing, making change, doing change is an investment. So when you ask your employer clients to change your health plan, you're asking them to make an investment. Time, energy aggravation, disruption all that's part of it. Any change has those factors involved. So when I made that change, it was very disruptive and difficult. I mean it wasn't difficult to make the decision, but it was difficult to live with it for a couple of years. But it's gotten me here and so the payoff has been huge, not so much financially as I like to tell my wife our wealth is a lagging indicator of my success but in terms of the difference that I've been able to make, the impact I've been able to have.
Speaker 2:And years ago my wife said I wasn't running a not-for-profit and I wasn't making a lot of money. And she said it was a thing to the think tank, but it was a not-for-profit organization. She said can't you pay yourself a little bit more? I said, honey, I work for not-for-profit. I have a board. I can't do that. She said, well, you're not making a lot of money. And I said well, I'm not really interested in making a lot of money, I'm interested in making a difference. And that's been my mantra, or my operational idea is that I just want to make a difference. I figure I'll be rewarded for doing good things and doing good work eventually.
Speaker 1:That's right.
Speaker 3:Well, nelson, you speak about it like a true pastor. You've been caring for and tending to the fields which are these 200 advisors and growing across the country, helping them to change their agencies, their clientele, their corner of the world, and I can tell just by our conversation that you're nowhere, even close to done yet. And so that brings me to our second question, which is what is left yet unfinished that you have the resolve to complete.
Speaker 2:I'm going to go off script here, but I know you're both family men. I have not been a model husband. I'm married to my work, I'm passionate about it. I have given my work more attention than I've given my marriage over the years and it's suffered as a result.
Speaker 2:If you think of life as a hockey game, I'm entering the third period, the final period, but, by the way, that's when the game is won or lost usually, and my resolve and we're working on this, my wife and I are actively working on this is to be a better husband in this third period, to be more present for her, to be a better dad for my kids. I mean my kids suffered too. I mean, ben, I truly admire your dedication to your family and to your girls. It's annoying at times when it keeps you from coming to one of our meetings and I slightly resent it for a brief second, but I mean it's truly admirable. And that wasn't me and I traveled a ton One year. I was out 210 days speaking. It was a very, very heavy, great financial year but a very heavy speaking schedule. So I've resolved that we're going to have a much better third period together as a couple than we had our first two periods and I want to be that husband that she deserves and that I'm called to be.
Speaker 3:Thank you for that encouragement. I know that, appreciate being vulnerable and transparent, but you know, like I do, that that message, like your coaching message of benefits, is going to resonate and people follow, and so they're going to hear that and they're going to rethink what they're doing in their first and second period so that when they get to their third period they can maybe have a different answer. So I very much appreciate that.
Speaker 1:Yeah, thank you. Well, thanks to everybody for listening and Nelson thanks for joining us today and make sure to tune back in for the next episode of the Risk and Resolve podcast.
Speaker 3:Thanks for tuning in to Risk and Resolve. See you next time.
