Transcript for Encore! EP372: Step One for Employers and Unions—Get Your Data,  With Cora Opsahl

Introduction and Importance of Data

[00:00:05] Stacey Richter: Encore Episode, Step One For Employers and Unions. Get Your Data. Today, I am speaking with Cora Opsahl, 

American Healthcare Entrepreneurs and Executives You Want to Know. Talking. Relentlessly Seeking Value.  

Why did I decide to encore this episode where Cora Opsahl from 32BJ spends 29 minutes talking about the importance of getting your data if you are an employer or a union health fund?  

The Role of Employer Data and Analytics

[00:00:44] Stacey Richter: Let me quote Jeff Hogan with some light edits here. 

Jeff wrote about the, in air quotes, outsized role that employer data and intentional analytics can and will play. This is emerging and a must have. The show with Andreas Mang from two weeks ago, the show with Dan Mendelsen, the one with Mark Cuban and Ferrin Williams. Everything that has been talked about in all of these shows and more is gonna be hard to do without having the data so you know what's going on. But I will let Cora Opsahl explain far more succinctly than I can here. 

One more note before we dive in here. After you listen to the show, you might want to go back and listen to episode 373 with Cora, and that one is entitled "How to Kick a Big Hospital Out of Your Network". Because this is one of the things that 32BJ did when it got its data. 32BJ realized that if it kicked out the really expensive hospital from their network, it would, and did, save $35 million dollars. 

Kicking this one hospital out of its network enabled the union to get its biggest wage hike in however many years, and also the employers, employing union members, got a premium holiday and did not have to pay into the health fund for a few months. Imagine if they didn't have this data and realize the millions and millions of dollars being siphoned out of the plan by this one hospital charging way too much. 

It's just crazy how many employers or unions wind up becoming imprudent fiduciaries because they just don't have the data to know better. But I'll tell you who is realizing it: Class Action Attorneys. My name is Stacey Richter. This podcast is sponsored by Aventria Health Group.  

The Power of Data in Healthcare

[00:02:27] Stacey Richter: Today I am speaking with Cora Opsahl, who directs the 32BJ Health Fund. 

Important to know about Cora's background is this. In previous roles, she's worked deep in the inner workings of the healthcare industry. So she came to 32BJ Armed with a BS meter that is finely tuned, which is unfortunately an essential skill for anyone trying to help the patients and members relying on them to successfully navigate the healthcare industry. 

This conversation gets into everything that the 32BJ Health Fund does with their data. They have lots of data. They demand it. So, besides kicking out overly expensive health systems from their network, here's other things that 32BJ is currently doing with their data, and which other employers and unions may get a few ideas from. 

The Impact of Data on Healthcare Decisions

[00:03:14] Stacey Richter: If you have the data, you, like 32BJ, can use it to, number one, make smart decisions. Benefit decisions that are validated, not just guesses. Before you decide to do something at a wellness program, etc. Be able to model it accurately for how much it will actually cost you. Which, spoiler alert, is most of the time not what the vendor will estimate. 

You have way more data than the vendor does. So you can certainly use it to great effect in this way. Another thing, you also can use data to make sure that the right members are being communicated with so that benefit designs are successful.  

The Role of Data in Communication and Leadership

[00:03:50] Stacey Richter: As Ashley Gunter said in episode 368, success when changing benefit designs has a lot more to do with communication than many realize. 

Another thing that you can do with data is create dashboards for leadership that may show trend lines, for example, which could be very helpful to ensure that the fund doesn't run out of money, etc. Little things like that. Another thing you can do is figure out how much the fund is spending on various procedures and where. 

There's all this talk right now about the crazy variability of prices for the same exact service in the same local market. Like, at one hospital, a colonoscopy could literally cost ten grand, and in another hospital, same quality, same basically everything, that same colonoscopy will be two or three grand. 

I mean, there's a 500 percent delta or something in some of these cases.  

The Importance of Data in Vendor Management

[00:04:36] Stacey Richter: Another thing you can do with data is ensure that if a vendor said they were going to do something, That they are actually doing it. This is especially meaningful for point solutions because of the whole squeezing the balloon thing. 

I can save money in a silo and you won't realize that those dollars are getting transferred elsewhere unless you are doing your own math. This is a big deal if you start thinking about how pharmacy benefits are typically siloed from medical benefits. So if I'm a pharmacy benefit manager, I can talk about how much I'm saving by denying patients drugs without consideration of the medical downstream implications of that. 

Here's another thing you can do with data, ensuring you're not paying a bill and writing a check for more than the bill was for, which is weirdly common. There's a whole show with Dawn Cornelis about this. That is episode 285. And then lastly, 32BJ has an engineering team. That is creating an app to help members navigate to great doctors with fair prices. 

The Role of Data in Financial Management

[00:05:34] Stacey Richter: All of these things roll into basically three categories. The first being cutting wasteful spending and finding fraud. Number two, making smart benefit decisions. And then lastly, being able to see trends and forecast the future. Which is really helpful for financial solvency, etc. As Cora Opsahl says, I think we all can recognize that you cannot make smart decisions and be a fiduciary of a fund without having data. 

This conversation, this whole conversation has been really a big bright spot for me. And will provide hope, I think, for any employer slash union who is seeking ways to protect their members and patients, the ones on their plans and therefore under their aegis and whom they have a fiduciary responsibility to look out for. 

The Importance of Data in Union Health Funds

[00:06:16] Stacey Richter: 32BJ represents about 200,000 members. They are mostly in residential and commercial real estate. So, for example, your doorman, your maintenance workers, your security, your cleaners, amongst others. Members are in about 11 states, but a lot of them are in the New York City metro area. These union members who are in the fund work for over 5,000 different employers. 

The 32BJ Health Fund has zero dollar premiums. Wowza on that point. That's a huge benefit. My name is Stacey Richter, and this podcast is sponsored by Aventria Health Group.  

The Role of Data in Healthcare Entrepreneurship

[00:06:54] Stacey Richter: Cora Opsahl, welcome to Relentless Health Value.  

[00:06:56] Cora Opsahl: Thanks, Stacey. I'm excited to be here.  

[00:06:58] Stacey Richter: So one of the things I think is really unique about what you're doing is how much data you have. 

Why don't we talk about that?  

The Power of Data in Healthcare Innovation

[00:07:07] Stacey Richter: Where does your data come from? How do you use it?  

[00:07:10] Cora Opsahl: Sure. So you're right. Well, I think one of the things that sets us apart as a health fund is the use of data and how much data we have. We receive 100 percent of our claims data from all of our vendors, which I think is very unique, which means that I have all of my medical claims, my pharmacy claims, my dental and vision claims. 

We're able to then use that data in multiple ways. First at a very high level, it allows us to know how our spend is looking and how we're tracking against our contributions from the employers. It always is helpful to know where your money is going and how much you're spending. But the bulk of how we use our data is to drive our benefit decision making. 

We get our claims data daily and weekly depending on the vendor, which allows us to look at what we're spending our money on. So we know about who our high cost utilizers are. We know where our high cost drugs are. But we also know, even from a perspective of which doctors may be seeing more, how much are we paying per hospital for different procedures? 

The Role of Data in Healthcare Decision Making

[00:08:10] Cora Opsahl: It puts us in a position to then be able to make decisions that are based in data, rather than based in a lot of ways, healthcare decisions that get based in emotion. This has made us, allowed us to have the flexibility to create some benefit designs that really benefit both us as the fund and our members, because we know that what we're doing really does provide high quality outcomes, but then it does give us the lowest priced possible options that are out there. 

[00:08:37] Stacey Richter: We'll talk about the, the benefit designs. Coming up here.  

The Importance of Data in Healthcare Transparency

[00:08:40] Stacey Richter: Let me ask you this, though, and I know 32BJ as an organization has had this data for quite some time, but this is just such a unique thing. There are so many unions and employers across the country that just don't have the data and they don't really fight for it. 

You said you got the data from 100 percent of your vendors. There's just so many circumstances across the country where the employer or the union, you know, the vendor says, Oh, well, we can't give it to you for insert XYZ reason, which is not really valid, but on the surface, it's like in some term and condition somewhere, right? And they're like, Oh, okay. How is this realization made? Was there anything that really caused this organization to say, absolutely not, not going to play those reindeer games? Like, give me my data. 

The Role of Data in Healthcare Fiduciary Responsibility

[00:09:27] Cora Opsahl: I think we recognize you can't make smart benefit decisions and be a fiduciary of the fund without having this information. 

And you're right. It's not as though it's been always been an easy road to get the data. I think the default answer is, well, you don't need that. We'll do it for you from vendors. But we feel it's really important that we own this information ourselves. It's our claims. It's our money. We are a self funded plan, which, you know, means that we pay the claims that come in. 

So if we're paying the claims, we should be able to see them. There's no reason that it's essentially our money. Why would we not be able to see how that money is being spent? I think you're correct in the sense that a lot of vendors don't want to give this information. It always concerns me if a vendor doesn't want to give you the information, what are they hiding? 

I think in this way, we can always know exactly what we're spending our money on. And I feel like it, you know, it's our data. It really does boggle my mind, Stacey, the amount of people who, who A, can't get their data or B, aren't even asking for it. My hope is the legislation within the No Surprises Act and the Consolidated Appropriations Act with gag clauses and things of that nature will help plans and employers get more data. 

But it's not just getting the data, it's then using the data.  

The Power of Data in Healthcare Analytics

[00:10:40] Stacey Richter: Yeah, I was gonna say that because, for example, the first thing that you just said there, you're tracking how the spend is looking versus the contributions that you're getting from all of the employers. Who are funding your fund, you have to have all of this aggregated like you have to have a pretty serious database that is able to take the feeds from all of these different or the uploads from all of these different sources to create one aggregated total at the end of the day. 

Like everything has got to be regularized. Do you want to just describe the analytics operation that you have there? Like how many people work there? What are they doing all day?  

[00:11:17] Cora Opsahl: Absolutely. We have our health fund analytics and then I would say we have our employer analytics because we are a Taft-Hartley Multi-employer Fund. 

We have an entire department that does nothing but manages the employer contracts and ensures that they're getting the contributions from the employer. That I will say is outside the scope of the health fund except that, that is a very complicated operation in order to ensure that we're getting what all of the income for the fund in order to pay our claims. 

On the health fund side, we have a, what I would call significant analytics team. It's a team of about between about 15 to 20 people we're growing, which is why I say 15 to 20. And that team does a whole range of activities. We are building out dashboards so we can look at a leadership and an internal level to understand how are we spending our money. 

What claims are being paid on each invoice and does that match the money then being paid to the vendors? We look at trends. How much should we spend this quarter versus last quarter or this quarter last year to be able to see what kind of trends we have. The team will dig into things such as what are we spending on certain procedures? 

What procedures do we spend the most on? Then what are we spending at each place? How do we want to build our plan? So as we've expanded our benefit design to talk about things that which I think we'll talk about later related to like our maternity program, our centers of excellence, our analytics team is validating the data that vendors say, you know, when, when vendors come to you and say, buy our program, it will save you X dollars because we have the data. 

My analytics team can go in and say, let me check that for you. And we validate all of those assumptions that are being sent to us. We also then make sure we are capturing the savings that we've anticipated from these programs. So that's one element of our analytics team. The other element of our analytics team is really the more enhanced data engineering. 

We have our own homegrown find a doctor tool. that members can use on our website. And so this team does a lot of the more intricate, I'll be honest, things that go a little bit over my head and a little too technical for me, which is why we have a great analytics team. But they're the folks who are taking in the data, ensuring we've got high quality data, loading it into our systems, allows our members to find the doctors, navigate the benefit. 

And so it's a really comprehensive team that It allows us to use our data to make benefit decisions that are smart and right for us. Without data, you're really just taking a guess and guesses are never going to get you where you need to go.  

[00:13:53] Stacey Richter: Okay. So making smart benefit decisions that are validated, not just guesses, also cutting out wasteful spending. 

You mentioned having dashboards for leadership that may also show trend lines, for example, which could be helpful to ensure the fund doesn't run out of money, etc, little things like that. And then how much is the fund spending on various procedures and where? There's all this talk right now about the crazy variability of pricing for the same exact service and the same local market. 

Like in one hospital, a colonoscopy will cost literally $10,000 and in another hospital, same quality, same basically everything, that colonoscopy will be like two grand. 

I mean, there's like a 500 percent delta when you start looking into it. Also just ticking through the other things you do with your data. You just mentioned we have ensuring that if a vendor said they were going to do something that they are actually doing it. And then the engineering team you just talked about as a sidebar who are helping members navigate to great doctors with fair prices, which is something I could certainly see being helpful for individuals and families since it's a big source of stress to know you need care when there's no great way to determine where to go for it from a quality and price standpoint. 

As we all know, PPO networks and their alleged, in air quotes, discounts are not built for any reason that has to do with quality, dare I say. Oh, and I forgot, you mentioned ensuring you're not paying a bill and writing a check for more than the bill was for, which is weirdly common. There's a whole show with Dawn Cornelis that gets into this. 

I mean, there's just example after example where the carrier for some unknown reason as well. It's somewhat known, but they are, they're paying more than what the bill was for example. 

[00:15:38] Cora Opsahl: There was, it's just the story last week related to the Medicare overpayments.  

[00:15:44] Stacey Richter: Exactly. So let me ask you: Is the view worth the climb kind of CFO style question.  If you compare the results that you're able to drive through your data and analytics team is the cost of standing up that business unit? 

I mean, you compare that cost and aggravation with their net result. Is it worth it? How do you compute the value of doing all of this with your data and analytics?  

[00:16:11] Cora Opsahl: Well, let me give you an example. One of the programs that we do have been working on is claims recovery related to eligibility of our members. 

I think any plan sponsor out there knows that managing the eligibility of members and ensuring we're only paying claims for members that are actually eligible can always be a challenging piece. When we stood this program up. We stood up our process up about a year and a half ago. In the first year, we saved over a million dollars in claims by having, but through this claims recovery process and ensuring that we weren't paying claims on members who were no longer eligible, which in that instance just shows you that within one year we were able to, you know, easily make the costs of anyone we would have needed to hire to manage that program. 

[00:16:56] Stacey Richter: And that was just like, that's just a sliver of what this department is doing.  

[00:17:00] Cora Opsahl: Right. It was just, it's the easiest concrete example I have. I think we recognize that investing in our analytics team and in our data pays off. We can't always show you a dollar for dollar figure, but we know the more we know, the better choices we make. 

And that doesn't always mean that the more we know doesn't mean we still don't make benefit decisions. Because changing your benefit or enhancing your benefit is the right thing to do, even if it costs you more. But knowing that, for example, we made some copay changes and enhanced our dental benefit, the estimate we did internally was about two times higher of a cost than it was from the vendor because we have a better data set to pull from. 

When we take some more conservative assumptions, we still move forward with enhancing our benefit, but it was nice to be able to validate that information internally and build our own cost assumptions into those types of program enhancements.  

The Role of Data in Healthcare Benefit Design

[00:17:50] Stacey Richter: And of course, based on that data, your team also made the probably unprecedented decision to cut a major health system that also happened to be wildly expensive out of your network. 

We'll get back to that and really get into it next week. But just for now, one of the things that I have been digging into lately, especially from the standpoint of a jumbo employer is just the difficulty level that they are having in fundamentally changing their benefits to cut out waste and effectively do all the things that you're saying because of the in air quotes disruption that things might cause. 

Understanding how to use data is something that most jumbo employers understand just at the construct level. So standing up a group like this and just simply understanding what's going on that in and of itself wouldn't seem to be all that disruptive and is something that a CFO. Should like conceptually maybe want to understand relative to the benefits, even if it's a CHRO who's responsible for the benefit design, even if the intention is not necessarily to meddle it just to validate what all the vendors are saying. I could certainly see as being of use, right, just even if it's considered a knowledge building exercise at the very beginning. 

[00:19:06] Cora Opsahl: Well, and I can tell you that we have that the use of data has really built our knowledge. And, you know, one of the things we've been able to do is really understand how we spend our dollars. And that has resulted in us making these decisions that we've made and really understanding how we spend our money. 

[00:19:23] Stacey Richter: So let me summarize what we just talked about into let's just say three distinct categories. Using data to cut waste for sure, but then also number two to define benefit design decisions. Like if you know which vendors are performing really well and what programs are working and how much they cost. If you know which hospitals, for example, are totally taking advantage of you and which are offering a decent value. 

All of these things can be evaluated so that smart benefit design decisions can be made. And then number three, contemplating the future of the programs, looking at these trend lines and whatnot. So we talked a little bit about removing waste and next week we'll talk about kicking out overly expensive health systems from the network. Not sure if that falls into the removing waste or improving benefit designs category, but let's talk about the second thing that you're doing with your data right now, which is helping to define benefit design decisions. And you know, as you said, and this is pretty unprecedented in, in and of itself, that for maternity care, just the incredibly low out of pocket, what did you say? It was like $40 or something.  

[00:20:27] Cora Opsahl: Correct. Our members can have a baby. The only copay they pay is their first prenatal copay visit.  

[00:20:33] Stacey Richter: How are you using the data, number one, to figure out that that's even possible, number one, but then number two, what other decisions are you making relative to benefit design using the data that you have? 

[00:20:45] Cora Opsahl: So I think because we have, we value having a zero dollar premium sharing. It becomes really important that we manage the dollars that are being provided by through these employer contributions and our multiemployer plan. And so it's really important to us that as we make benefit decisions, we're doing it smartly. 

One of the things I would just highlight is that from my perspective, benefit design alone will not solve your problems. They're not going to bend the cost curve. That's where prices come in. But it doesn't mean that we shouldn't look at benefit design. And so one of the things we did was our maternity program. 

We've also built out Centers of Excellence Programs. This is a somewhat common or becoming more common way of addressing some more standard procedures. And so we have a centers of excellence program for bariatric procedures and total joint replacement where our members can have these surgeries for a $0 copay. 

For a total joint replacement that also includes transportation, but it also includes physical therapy after the surgeries. And what makes that, what we believe makes our Centers of Excellence Program unique is that we just expanded it. While, while the good portion of our members are based here in the New York City area, we do have members in Pennsylvania, Massachusetts, Connecticut, New Jersey, Florida, among other states. 

And we expanded our Centers of Excellence Program outside of the New York City area. We did this by partnering with Mount Sinai Health Systems to create our Centers of Excellence Network where they partnered with hospitals in each of these areas to offer the same program they're offering our members here in New York City, where the program has a member concierge. 

It's a program that has patient navigators that helps our members from the moment they're identified as being eligible for these surgeries through the whole process. These hospitals also agree to the same financial terms, which has a certain pricing based that we'll do reconciliation in on the back end to ensure that we're paying a fair rate for these surgeries. 

We've built these programs, but one element of the program is our data. So, while we're super proud of this program and we really think it's exciting the way that we've been able to partner with Mount Sinai Health Systems to build this network, I think you probably are, you know, Stacey, understand like it's unusual for hospitals to work with each other in something like this, but we use our data to target our members. 

So we have a team here in the health fund that uses, we have our data that identifies members through claims of members that we think are starting down their bariatric surgery or their joint replacement journey. And then we outreach to our members and help them understand, are they in this journey? 

Where are they? And then get them steered to our Centers of Excellence, physicians and providers, and hospitals because if they don't use our centers of excellence providers and hospitals, then it's not covered. And so we do use data to help find these members and ensure that they're being steered where they need to go. 

[00:23:36] Stacey Richter: That's certainly impressive. And I think, you know, just thinking about this from the member slash patient slash consumer standpoint. Getting a total knee replacement or a total hip replacement, that's stressful enough as it is. Then trying to find the right surgeon, you know, who has the quality outcomes, like that's stressful. 

And then it's also stressful to, again, make sure that you don't wind up getting hit with some exorbitant out of pocket spend. So the fact that you have the Center of Excellence program, I mean, not only does it, in air quotes, save money for the plan itself, but it also is, I would think, a very appreciated service amongst the members. 

[00:24:15] Cora Opsahl: It is. We survey all of our members who go through both our maternity and our, our Centers of Excellence Programs and they are, you know, our positive response rate is at or near 100%. It's 100 percent in our maternity program and I think about 98 or 99 percent in our Centers of Excellence Program, but 100 percent would recommend it to others. 

[00:24:35] Stacey Richter: Wow.  

[00:24:36] Cora Opsahl: And again, I think it goes back to when you build the trust with your members because we create programs, we use data to help our members navigate these programs. We're able to build trust. So when we do have to make tougher decisions, like removing New York Presbyterian, we've really been able to build the trust with our members that we're doing this really for them and for the longevity of their benefit. 

[00:24:56] Stacey Richter: Yeah, indeed. Well, I mean, considering that some people are happy with net promoter scores of like seven or eight, 70 or 80%, the fact that you got 100 percent is unprecedented. So I think that certainly speaks for itself. Another thing that you've sort of woven throughout the course of this conversation has been really ensuring the future of these programs. 

The Importance of Data in Healthcare Future Planning

[00:25:15] Stacey Richter: I mean, we all know that when you're overspending on what did Warren Buffett called it, the, you know, health spend is the hungry tapeworm of American business. We've got middle class wage stagnation. We've got problems with global competitiveness because benefits can be so high. We've got medical debt. 

We've got, we had Dr. Wayne Jenkins on the show a bit ago talking about how medical costs create mental health concerns and, and stress and people abandoning care, which creates a downward spiral of, of their health. So there's a lot of reasons why the work that you're doing, certainly it's pretty obviously going to accrue present tense and also future tense types of benefits. 

But is there anything that you want to specifically mention relative to how you're making that data actionable that lends itself to considering the future of the program?  

[00:26:06] Cora Opsahl: We know the impact of healthcare trend being high and the increase of healthcare costs has cost our members about $5,000 in their paycheck. 

Had healthcare trend increased at the rate of inflation over the last five or so years, members would have had $5,000 extra in their paycheck. But instead of being able to go to their wages, it's had to go to the, you know, to fund the health fund. So for us, it's really important that we leverage our data. 

We leverage innovative benefit design. We leverage the information that we have to create solutions that will help drive down these prices because we want to ensure our members continue to be able to put food on their table. Afford housing and be able to have an increase in their wages and not have that all be funneled back into their health plan. 

[00:26:57] Stacey Richter: Yeah, we talked about the trends and the trend line at the beginning of this conversation. So I could definitely see that it would be really critical right now for everybody, not just 32BJ to be very much studying that cost curve and attempting to bend it because all of the issues that we're having now are just going to get exacerbated in the future if we don't. 

The Role of Data in Telehealth and Virtual Care

[00:27:18] Stacey Richter: One last question. That's about digital health, telehealth, virtual care options. I am just so intrigued by your thoughts on whether some of these virtual health solutions can reduce local health system costs, especially in areas where there's one game in town that there's a monopoly where you can't just say, yeah, you know what, we're going to cut out this one really high cost hospital and go to another one. 

And, you know, there's some areas where. There is no competition. How do you see virtual care as a potential way to incite a competitive environment that could ultimately impact the prices that some of these consolidated health systems are able to?  

[00:28:01] Cora Opsahl: People are used to using healthcare in a very specific manner. 

It's why I think. I think that transparency is key but does not solve our healthcare problem because members don't shop for healthcare the way you shop for a car or even shop for your groceries. I think that if we can figure out how to make telehealth accessible for everyone, whether they have a smartphone or not, have the ability to find a private place to have conversations, then I think that, you know, there may be an opportunity for telehealth or virtual health to upset some of these more monopoly systems or low choice options, but it's gonna take helping members understand that the care you're getting when a doctor is able to talk about your symptoms over a zoom meeting and not actually look in your throat with their tongue depressor, is gonna get them the same results. 

So I think the jury's out and I. I am curious in the long term benefits, will telehealth actually increase costs because you're paying for the telehealth visit that eventually ends up in the doctor's office anyway? Or are you really truly going to be able to avoid an urgent care visit, an ER visit that then could potentially spiral from there? 

So personally, I think the jury is still out. If it can be done effectively, I think it'll be great. I'm just not sure consumers are really ready to embrace the telehealth movement when it comes to, to healthcare.  

[00:29:19] Stacey Richter: Arguably, there's different kinds of telehealth, just like there's different kinds of all kinds of care. 

And there's tele-urgent-care, of which Teladoc is, that's pretty much their, their model. Like I'm, I'm here if you need an antibiotic for your UTI, as the probably reductive quintessential example. But then there are obviously the virtual point solutions, which are more longitudinal in nature and their goal is to really guide patients through certain conditions. 

It will be interesting, maybe TBD, what we can talk about this again in a year after you have been able to look at your data and determine whether any of the maybe point solutions which you have taken on board, like what you think the results are that they have created for your members.  

[00:30:05] Cora Opsahl: I think you're right, Stacey 

I think if I were to say, you know, I had a healthcare crystal ball, which none of us have, I think some of your point solutions maybe would be beneficial. I think you're seeing some of that already in the behavioral health space to increase access in an area that I think we all recognize as challenging. 

[00:30:21] Stacey Richter: Is there anything that I neglected to ask you?


Conclusion and Final Thoughts

[00:30:27] Cora Opsahl:  I'll go back to what I said probably multiple times. It's really easy to think that we can solve this problem through benefit design, that you just need to have the right copay structure or the right this or the right that. But in the end, when we're spending 56 percent of our costs on hospital care, it's the price. 

It's the price of healthcare. Until we can get those prices down, you're not going to bend the cost curve by benefit design alone.  

[00:30:49] Stacey Richter: Indeed, it's that Huey Reinhart, it's the price is stupid, or if you want to pay less for health care, you got to pay less for health care, right?  

[00:30:57] Cora Opsahl: That's perfect. That's exactly right. 

[00:30:59] Stacey Richter: If someone is interested in learning more about 32BJ, is there anywhere that you might direct them?  

[00:31:05] Cora Opsahl: Yes. We are happy to share what we're doing,  

[00:31:13] Stacey Richter: Perfect. Cora Opsahl, thank you so much for being on Relentless Health Value today.  

[00:31:19] Cora Opsahl: Thank you, Stacey. It was my pleasure.  

[00:31:21] Stacey Richter: Links to everything discussed on the program today can be found at If you visit the website, you will also find a complete listing of all of the shows. 

Another cool feature is, you know, you can subscribe to the show so that every week the episode is automatically sent to you so you don't have to remember to go to the website to download it. Thanks so much for listening.