Dr. Alex Sommers: Hi. I'm Alex Sommers. I'm president of Astia Health, an advanced direct primary care organization, an emergency medicine and lifestyle medicine physician, as well as a licensed employer health plan advisor from Wisconsin.
I'm curious how you explain the difference in the real world between a carrier administrative services only arrangement and an independent third-party administrator model to an employer looking for more transparency, cost control, and clinical risk strategy for their health plan.
For a full transcript of this episode, click here.
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Stacey: What a great Ask Me Anything from Alex Sommers, MD, ABEM, DipABLM! And let me tell you, if I do say so myself, I got the perfect person to answer this question: the one and only Claire Brockbank, the recently appointed new director of the 32BJ Health Fund.
Before we get to Claire's answer, however, let me just again thank Dr. Sommers for the question, which is especially relevant, since Dr. Sommers, as he just mentioned, is president of Astia Health, which is an advanced primary care practice that's physician led; and they help employers get their plan members the kind of proactive whole-person primary care and also proactive clinical risk management that we talk about over and over and over again on this show.
Listen to the episode most recently, I would suggest, with Patrick Nelli (EP509). I mean, advanced primary care and the data necessary to actually do proactive clinical risk management, that is what is needed as a foundation to build a health plan that bends medical and pharmacy trend below inflation and members actually becoming healthier as an investment to that end in this model.
So, yes, when laying this advanced primary care foundation, access to data (as just one example) really matters. Read that series of posts (Post 1 and Post 2) recently by Kimberly Carleson to underline this point. I say all this to say Claire's response to what is an ASO versus a TPA and her thoughts on the whole ASO versus TPA decision are really insightful news you can use to explain to employers the difference in the best way possible. And yeah, all of this can be very foundational for anybody who's really trying to figure out how to get their health plan back on track.
For a fun graphic illustrating this, see Craig Gottwals' post on LinkedIn.
This podcast is sponsored by Aventria Health Group with an assist by Payerset.
And here is Claire Brockbank answering the question how best to explain to an employer the difference between what is an ASO and what is a TPA.
Also mentioned in this episode are Alex Sommers, MD, ABEM, DipABLM; Astia Health; 32BJ Health Fund; Patrick Nelli; Kimberly Carleson; Craig Gottwals; Aventria Health Group; Payerset; Jerry DiMaso; Luke Prettol; Mark Noel; ClaimInsight; and Tom Nash.
For a list of healthcare industry acronyms and terms that may be unfamiliar to you, click here.
You can learn more at health.32bjfunds.org and follow Claire on LinkedIn.
Claire Brockbank was recently appointed director of 32BJ Health Fund. She joined the Fund in 2022 as director of policy and strategy, illuminating the central role that hospital prices play in healthcare costs and compelling multistakeholder action to lower these prices through public policy, creative benefit design, and direct interaction with hospitals. In 2025, Brockbank steered the Fund's collaboration with Northwell Direct to reach the largest direct healthcare contract of its kind in the country, generating significant savings while expanding access to high-quality care for 32BJ health plan participants.
00:00 Introduction to this episode.
00:38 Dr. Alex Sommers' question.
04:05 Claire's answer to what differentiates a TPA and an ASO vendor.
04:25 What an ASO vendor is.
04:57 What a TPA is.
06:52 The pros and cons to choosing an ASO as a carrier.
08:43 LinkedIn post by Luke Prettol.
09:05 The pros and cons to TPAs.
10:04 EP453 with Claire Brockbank.
Recent past interviews:
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Stacey Richter (EP517), Ophelia Johnson, Michelle Cera, Matt Cantor, Brennan Bilberry, Doug Aldeen, Dr Siva and Dr Monica Lypson, Betsy Seals