"If we can do it for Whole Foods, which is a very large organization, why can't we do this for other employers?"

Is the era of relying on national, opaque "BUCA" networks finally coming to an end?

My guests this week are Blake Allison, CEO of Employers Health Network (EHN), and Philip Eaves, from Ascension. Together, they break down the exact blueprint they used to build a direct-to-employer, high-performance network for Whole Foods - and how they are scaling that exact same model for self-funded employers across the country.

In this episode, we explore the hospital system's perspective on direct contracting. Phil explains why massive health systems like Ascension are eager to bypass traditional carriers to work directly with employers, citing faster payments, zero collection risk, and the ability to proactively manage patient care.

We also discuss how to successfully integrate Direct Primary Care (DPC) into a localized network, the lessons commercial plans must learn from Medicare Accountable Care Organizations (ACOs), and why the future of healthcare relies on "re-localizing" how we buy medical services.

If you are an employer, benefits consultant, or healthcare provider who is fed up with the transactional, nickel-and-dime nature of traditional insurance carriers, this conversation proves that a better, more collaborative model already exists.

Thank you to our 2026 sponsors!

ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more.

Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more.

Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more.

Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com.

Chapters:

(00:00:00) Intro: Whole Foods and the Move Away from BUCAs

(00:07:29) The Whole Foods Case Study: Building a Direct Network

(00:12:15) Why Health Systems Want Direct Employer Contracts

(00:17:15) The Evolution from RBP to High-Performance Networks

(00:19:21) Integrating Direct Primary Care and Care Management

(00:23:41) The Challenges of Scaling Direct Contracts Nationally

(00:28:15) Re-Localizing Healthcare: Buying Care in Your Community

(00:33:36) Overcoming the Negative Stigma of "Networks"

(00:36:55) Applying Medicare ACO Lessons to Commercial Populations

(00:42:31) Defining True Value-Based Care and Downside Risk

(00:45:51) The Ideal Employer Profile for Direct Contracting

(00:50:52) Lowering Costs with Local, Community-Based Care

(01:05:17) Future Predictions: Site Neutrality and Price Transparency

(01:11:25) Closing Thoughts: Providers Are Open for Business

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"Employers are at a point where they want to help create that ideal healthcare system, not the one that they have been dictated to."

Is your company's health plan actually keeping your employees healthy, or is it just waiting for them to get sick?

My guest this week is Ben Miller, Chief Revenue Officer at Premise Health, the nation's largest direct healthcare provider operating over 850 onsite and near-site wellness centers. Ben joins the show to discuss why the traditional fee-for-service model is failing both employers and employees, and how Advanced Primary Care is stepping in to serve as the new "front door" to the healthcare system.

In this episode, we break down what Advanced Primary Care actually entails, from integrated behavioral health and lifestyle medicine to onsite pharmacies offering 90-day prescriptions for $1. Ben shares the results of a massive Milliman study showing how this model reduces total claims costs by an astonishing 30%. We also cover how employers of various sizes can implement near-site clinics, address employee privacy concerns, and utilize Epic-integrated care navigation to guide patients to high-quality, cost-effective specialists.

If you are an employer or benefits consultant looking for a proven strategy to bend the cost curve while delivering an incredible healthcare experience to employees, this episode is a must-listen.

Thank you to our 2026 sponsors!

ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more.

Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more.

Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more.

Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com.

Chapters:

(00:00:00) Intro: The Shift Towards Advanced Primary Care

(00:00:33) Meet Ben Miller & Premise Health

(00:02:17) Defining Advanced Primary Care, On-Site, and Near-Site Clinics

(00:05:06) Ben's Journey from Kaiser Permanente to Premise Health

(00:10:32) The Breaking Point: Why Employers are Flocking to APC

(00:16:07) How to Build and Customize an On-Site Clinic

(00:20:11) Creating the "Front Door" to Healthcare & Navigating GLP-1s

(00:25:20) Integrating Behavioral Health & Lifestyle Medicine

(00:28:29) The On-Site Pharmacy Experience ($1 Medications)

(00:30:22) Overcoming the "Big Brother" Privacy Stigma

(00:32:36) The Milliman Study: Proving a 30% Reduction in Claims Cost

(00:36:12) Group Size Requirements & The Power of "Coopetition"

(00:39:35) Managing Catastrophic Risk & Epic Care Navigation

(00:43:43) Expanding the Clinic: PT, Dental, and Vision Services

(00:49:54) How Claims & TPA Integration Actually Work

(00:52:33) Closing Thoughts: The Future of Employer-Sponsored Care

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Welcome back to Last Month in Healthcare! This month, Spencer and Nathaniel sit down without a guest to unpack the biggest healthcare headlines and regulatory shifts from April 2026.

From state-level crackdowns on PBMs to a surprising loophole that allows urban hospitals to siphon rural hospital aid, the guys dissect the policy changes and market moves that are actively reshaping the industry. They also discuss the affordability crisis driving a 26% surge in ACA Bronze plan enrollment, Amazon's aggressive new play into the GLP-1 and primary care market, and why CMS is finally (and officially) killing the fax machine by 2028.

Plus, Spencer plays a game of "Blind Ranking," attempting to properly order the top 10 best practices and features of a modern self-funded health plan (including pass-through PBMs, cash-pay surgery networks, and pharmacogenomics) without knowing what's coming next.

Thank you to this year's sponsor, Walk On Clinic!

If you'd like your question answered on next month's episode, call/text 469-213-6381 and leave us a voicemail/text.

Chapters:

(00:00:00) Intro & Sponsor Shoutout: Walk On Clinic

(00:01:42) Bipartisan State Healthcare Regulations & PBM Oversight

(00:04:40) ACA Shifts: The Rise of Bronze Plans & HSA Eligibility

(00:08:38) The FTC's Vague New Healthcare Task Force

(00:10:10) The Rural Hospital Aid Loophole Exploited by Urban Hospitals

(00:11:27) Amazon Launches a $149/mo GLP-1 & Primary Care Program

(00:15:18) CMS is Finally Ending the Fax Machine (Saving $781M)

(00:16:48) Game: Blind Ranking the Best Self-Funded Plan Features

(00:24:45) PSA: Watch Out for These Hidden Carrier Contract Clauses