In this episode of ShiftShapers, host David A. Saltzman welcomes Dave Chase, co-founder of Health Rosetta, a movement that has become a national force in transforming employer-sponsored healthcare.

Dave shares the deeply personal story that drove him to create Health Rosetta and the powerful framework that emerged—one focused on transparency, outcomes, and economic sustainability.

The conversation explores how Health Rosetta empowers benefit advisors and employers to break free from the traditional health plan model, the crucial role of data access, and the open-source tools now available through Nautilus Health Institute. Dave also unveils the evolution of RosettaFest from an internal network event into the premier gathering for high-performance health plan innovators across the country.

👉 Join RosettaFest 2025 in Denver: https://rosettafest.org/
👉 Explore open-source tools from Nautilus Health: https://www.nautilushealth.org/

🤖 Sponsored by BenePower
BenePower is an AI-powered platform helping advisors build high-impact, self-insured health plans quickly and seamlessly. By integrating best-in-class point solutions and eliminating inefficiencies, BenePower reduces costs, improves member outcomes, and positions advisors as industry leaders.
🔗 Learn more at BenePower.com

🔑 Key Takeaways from This Episode

📌 A Personal Tragedy Sparked a Movement
A system failure that devastated a friend’s life inspired Dave Chase to create a new framework for health plans.

📌 It All Starts with the Health Plan Contract
Perverse incentives and system dysfunction stem from opaque, outdated plan contracts—Health Rosetta sets a new standard.

📌 Training a New Class of Benefit Professionals
Health Rosetta focuses on empowering benefit advisors with the tools and standards to drive measurable change.

📌 The TPA, PBM, and Hospital Contracts Matter Most
Dave breaks down the three most critical contracts and how employers can renegotiate smarter, data-driven deals.

📌 Nautilus Health Is Open-Sourcing the Playbook
With $4M+ of legal, contracting, and tech investment, Health Rosetta is giving away the tools others would keep locked up.

📌 Unfettered Data Access Is a Game Changer
Claims transparency isn’t optional anymore—especially under the Consolidated Appropriations Act.

📌 RosettaFest Is the Epicenter for Innovation
Once closed-door, RosettaFest now brings together employers, advisors, clinicians, and tech innovators for radical collaboration.

⏱️ In This Episode

• 00:00 Introduction to Health Rosetta
  
  
  
• 01:02 Founding Story and Inspiration
  
  
  
• 02:11 Building the Framework and Ecosystem
  
  
  
• 08:28 Challenges and Pushbacks
  
  
  
• 16:08 New Developments and Future Plans
  
  
  

26:20 Conclusion and Final Thoughts

In this episode of ShiftShapers, host David A. Saltzman speaks with Joanna Conti, founder and chairman of the nonprofit Conquer Addiction. Joanna’s journey began when her own daughter faced life-threatening alcoholism, prompting a years-long search for effective treatment—and an urgent realization: no one was measuring long-term success.

Joanna shares the results of her groundbreaking research following over 100,000 addiction patients, and exposes the massive gaps in transparency, accountability, and outcomes in today’s treatment centers. She also unveils how employers and families can now access verified recovery data to choose truly effective care—and how a new bundled care model is reshaping the rehab industry.

Conquer Addiction Website: https://conquer-addiction.org

🤖 Sponsored by BenePower

BenePower is an AI-powered platform helping advisors build high-impact, self-insured health plans quickly and seamlessly. By integrating best-in-class point solutions and eliminating inefficiencies, BenePower reduces costs, improves member outcomes, and positions advisors as industry leaders.
🔗 Learn more at BenePower.com

🔑 Key Takeaways from This Episode

📌 Most Treatment Centers Don’t Track Outcomes
Joanna explains why fewer than 1% of rehabs conduct post-treatment follow-ups—and how Conquer Addiction is changing that.

📌 Verified Success Rates Vary Widely
While the average recovery rate is 36%, Joanna’s research shows some centers achieve 50%+ and others less than 15%.

📌 Aligning Incentives with Accountability
New bundled-rate models require rehabs to offer relapse support—creating better outcomes and real transparency.

📌 Employers Bear the Cost
Substance use disorders can cost employers $25,000 per year per employee—before treatment even begins.

📌 A National Claims-Based Registry Is Coming
Joanna’s team is building a predictive model using de-identified claims data to rank treatment center effectiveness nationwide.

📌 Hope and Progress
Joanna’s personal story ends with hope: her daughter is thriving after 13 years in recovery—and now four kids of her own.

⏱️ In This Episode

00:00 Introduction to Treatment Duration and Outcomes

13:59 Accessing Treatment Center Data

14:31 Challenges in the Treatment Industry

14:51 Aligning Incentives for Better Outcomes

16:32 Financial Struggles of Treatment Centers

16:58 Using Data to Identify Effective Treatment Centers

17:56 The Role of Compliance and Legislation

18:35 Developing a National Claims Registry

19:28 Predictive Modeling for Treatment Effectiveness

20:40 Sharing Data with Rehabs and Payers

21:42 Future Goals and Conclusion

Why Reducing Variation = Better Outcomes

In this episode of ShiftShapers, host David A. Saltzman welcomes Kate Grohall, co-founder and Vice President of Value-Based Solutions at Holista. Kate shares her powerful journey from working with patients in a teaching hospital to building a transformative platform focused on reducing variation in care, cost, and outcomes.

She unpacks how Holista restores trust in the provider-patient relationship, leverages real-time communication tools to improve outcomes, and helps employers drive change by demanding value—not volume.

🤖 Sponsored by BenePower
BenePower is an AI-powered platform helping advisors build high-impact, self-insured health plans quickly and seamlessly. By integrating best-in-class point solutions and eliminating inefficiencies, BenePower reduces costs, improves member outcomes, and positions advisors as industry leaders.
🔗 Learn more at BenePower.com

🔑 Key Takeaways from This Episode

📌 Quality = Reducing Variation
Kate defines healthcare quality as reducing unpredictability across cost, outcomes, and patient experience.

📌 C Still Equals MD
Most consumers can't distinguish between top- and bottom-tier physicians. Holista’s proprietary vetting process closes that gap.

📌 Restoring the Provider-Patient Relationship
Holista rebuilds what’s been lost by re-emphasizing relationships and collaboration across care teams.

📌 Real-Time Care Prevents Crisis
Through a patient app and nurse engagement, Holista helps patients avoid unnecessary ER visits and complications.

📌 Incentives That Actually Change Behavior
Forgiving copays and reducing premiums for high-value care choices gives patients immediate financial benefits.

📌 Employers Take the Wheel
Employers are stepping out of the back seat and demanding better results—and Holista helps them drive smart, sustainable change.

⏱️ In This Episode

00:00 Introduction to Better Health Outcomes

00:47 Kate Grohall’s Journey into Healthcare

03:12 Understanding Quality in Healthcare

05:19 Challenges in Reducing Variation

06:50 Provider and Patient Experience

08:57 Quality Metrics Beyond Standards

13:13 Real-Time Communication in Healthcare

14:41 Changing Behavior and Incentives

21:31 Future of Healthcare and Technology

22:56 Employers Taking the Driver's Seat

24:53 Conclusion and Final Thoughts

Why Are We Paying More for Worse Health? | ShiftShapers

In this episode of ShiftShapers, host David A. Saltzman welcomes Helene M. Epstein—writer, speaker, and patient advocate behind the Substack series Patient No More. Helene dives deep into America’s epidemic of medical errors, misdiagnoses, and system failures. She breaks down why even the most advanced technology and training haven’t improved patient safety, how profit-driven healthcare puts patients at risk, and—most importantly—what individuals can do to protect themselves and their families.
From shocking statistics about misdiagnosis to the hidden realities of rural hospital closures, Helene provides practical advice and hope for patients who are ready to become their own advocates.

🤖 Sponsored by BenePower
BenePower is an AI-powered platform helping advisors build high-impact, self-insured health plans quickly and seamlessly. By integrating best-in-class point solutions and eliminating inefficiencies, BenePower reduces costs, improves member outcomes, and positions advisors as industry leaders.
🔗 Learn more at BenePower.com

🔑 Key Takeaways from This Episode

📌 Medical Harm Is Underreported and Overlooked
One in four hospital patients is harmed—and most of those incidents aren’t even recorded. Medical error remains a massive, hidden problem.

📌 Diagnostic Error Is Common—and Dangerous
5–25% of U.S. adults are misdiagnosed each year. The most common errors? Testing failures, insurance barriers, and lack of communication between patients and providers.

📌 The System Is Built for Billing, Not Healing
EMRs, insurance company rules, and corporate healthcare ownership have prioritized profits and paperwork over patients—leaving safety and transparency behind.

📌 Rural and Marginalized Patients Are at Greater Risk
Access to care is shrinking as hospitals close pediatric and maternal units, especially in rural and underserved communities.

📌 Patient Advocacy Is Rising
Helene shares why empowered patients—armed with information, organized records, and second opinions—are the best defense against medical error.

📌 Practical Steps: Protect Yourself
Keep copies of your records, use health portals, seek second opinions, and research providers before major procedures. Being “patient no more” means taking an active role in your own care.

More from Helene M. Epstein

Patient No More is a free Substack by patient advocate Helene M. Epstein, offering practical advice to help you avoid misdiagnosis and medical error. Read her ongoing guide to surviving American healthcare at https://helenemepstein.substack.com/

⏱️ In This Episode

• 00:00 – Why Does U.S. Healthcare Cost So Much and Deliver So Little?\
• 01:00 – What Counts as Medical Error and Harm?
• 03:00 – The Impact on America’s Workforce
• 04:30 – Corporatization and the Decline of Access
• 07:45 – The Prevalence of Diagnostic Errors
• 10:00 – The Role of Insurance in Delaying Proper Treatment
• 12:00 – Medication Errors, Pharmacy Mistakes, and Communication Gaps
• 15:00 – Why Electronic Medical Records Don’t Fix the Problem
• 18:30 – Patient Advocacy, “Patient No More,” and Surviving American Healthcare
• 21:00 – Misdiagnosis in Women, Children, and Marginalized Groups
• 24:30 – The Future of Patient Safety and System Reform
  
  

Rethinking PPOs: How High-Performance Networks Deliver Value | ShiftShapers

In this episode of ShiftShapers, host David A. Saltzman sits down with Scott Smith, founder and CEO of Logro Network, to discuss a revolution in health plan design: the nationally curated high-performance network. Scott unpacks the origins of PPOs, why the old “discount everything” approach is broken, and how a focus on total value—cost, quality, and outcomes—can transform employer health plans.
You’ll learn how Logro Network uses massive data sets and provider scoring to give members more choice and better information, all while helping plans rein in costs and fulfill their fiduciary duty.

🤖 Sponsored by BenePower
BenePower is an AI-powered platform helping advisors build high-impact, self-insured health plans quickly and seamlessly. By integrating best-in-class point solutions and eliminating inefficiencies, BenePower reduces costs, improves member outcomes, and positions advisors as industry leaders.
🔗 Learn more at BenePower.com

🔑 Key Takeaways from This Episode
📌 Why PPOs Are Stuck in the Past
Traditional networks focused only on unit cost, not total value—leaving members and plans exposed to higher downstream costs and mediocre quality.

📌 Volume and Discounts Aren’t Enough
Providers are leaving old PPOs as deep discounts become unsustainable. The cheapest care isn’t always the best, and a “race to the bottom” can cost more in the long run.

📌 High-Performance Networks = Data-Driven Choice
Logro Network’s national footprint scores providers on cost, quality, and appropriateness using over 50 billion claims—empowering members to pick the best care for their needs.

📌 Quality ≠ High Cost
Surprisingly, the best providers are often not the most expensive. High-quality care can lower total cost of care through fewer complications and better outcomes.

📌 Member Experience Is Central
With transparent, easy-to-read provider profiles (using AI to simplify 300+ metrics!) and broad network access, members get more control, less disruption, and the right information to make informed decisions.

📌 A Win for Employers and Brokers
Plans using high-performance networks can see immediate cost reductions, better renewal rates, and lower medical loss ratios—while meeting growing fiduciary expectations.

⏱️ In This Episode

• 00:00 Introduction to High Performance Networks
• 00:47 Guest Introduction: Scott Smith
• 01:30 The Evolution of Networks
• 04:22 Challenges of Traditional Networks
• 07:09 Introduction to High Performance Networks
• 09:55 Building a High Performance Network
• 14:04 Member and Plan Benefits
• 21:02 National Coverage and Future Plans

In Part 2 of our powerful conversation with David Contorno, president and founder of ePowered Benefits, we go beyond the strategies and structures of health plan design—diving into the real-life struggles that are shaping smarter, more compassionate solutions.

Host David A. Saltzman and David Contorno discuss the realities of scaling direct primary care, creative ways to bridge care gaps, and the challenges of educating employers and advisors about fiduciary responsibility. But the heart of this episode is personal: David shares how his own battles with chronic pain and mental health have transformed his perspective—and the way he builds health plans.

The conversation uncovers the hidden crisis of mental health in the workforce, the need for more accessible and innovative care models, and the legacy that disruption can leave when leaders dare to do things differently.

If you missed Part 1, catch it now for the story of smart plan solutions and shifting structures.

🎧 Listen to Part 1 now: https://www.buzzsprout.com/2045524/episodes/17232879
📺 Watch Part 1 on YouTube: https://youtu.be/rYP7-z8WD0A

🔑 Key Takeaways from This Episode

• Direct Primary Care & Beyond: How scaling DPC and innovative provider relationships are breaking down care deserts.
  
  
  
• Cash Pay Pathways: Why starting with cash pay—and embedding it into employer plans—can dramatically change access and cost.
  
  
  
• Fiduciary Responsibility: Why ignoring smarter plan options is a risk for employers, and what needs to change for true accountability.
  
  
  
• Educating for Change: How complexity and legacy promises are barriers, and what it really takes to shift mindsets.
  
  
  
• The Mental Health Undercurrent: David’s raw account of dealing with chronic pain, mental health stigma, and his personal journey toward healing—including non-traditional therapies like virtual support and psychedelic treatment.
  
  
  
• A Legacy of Empathy: Why the next wave of health plan design must address the whole person—physically and mentally—and how employer-sponsored plans can help lead the way.
  
  
  

⏱️ In This Episode

00:00 Introduction and Guest Welcome
00:54 Scaling Direct Primary Care (DPC)
01:33 Challenges and Solutions in DPC
03:19 Employer and Provider Perspectives
07:50 Cash Pay and Reference-Based Pricing
17:47 Mental Health and Innovative Solutions
25:56 Closing Thoughts and Personal Reflections

What does “smart” health plan design look like in an industry packed with legacy thinking and rising costs? In Part 1 of a special two-part ShiftShapers interview, host David A. Saltzman welcomes back David Contorno, president and founder of ePower Benefits—and one of the industry’s most well-known disruptors.

David pulls back the curtain on his journey from traditional insurance to innovative plan design, explaining why “business as usual” can’t fix the healthcare system. He discusses creative strategies like reference-based pricing, direct provider contracting, and the evolution of self-funded health plans. Through stories, data, and first-hand insights, David lays out the “shifting structures” that are changing how employers, brokers, and providers think about benefits.

🔜 Don’t miss Part 2 next week! We’ll dive even deeper as David shares the personal struggles that reshaped his perspective on plan design, including lessons from his own healthcare journey.

🤖 Sponsored by BenePower
BenePower is an AI-powered platform helping advisors build high-impact, self-insured health plans quickly and seamlessly. By integrating best-in-class point solutions and eliminating inefficiencies, BenePower reduces costs, improves member outcomes, and positions advisors as industry leaders.
🔗 Learn more at BenePower.com

🔑 Key Takeaways from This Episode

• The Origin Story of a Disruptor: David shares how starting in insurance as a teen led to a lifetime of challenging the status quo.
  
  
  
• Why Health Insurance Is Failing: Hear David’s epiphany about how current health plans fall short of protecting people from catastrophic loss.
  
  
  
• Reference-Based Pricing & Beyond: Understand the pros, cons, and evolution of “blunt instrument” cost-saving strategies.
  
  
  
• Direct Provider Contracting: Learn how building new provider relationships can drive savings and better outcomes.
  
  
  
• Fiduciary Responsibility for Employers: Discover why doing what’s always been done is now a liability, not a strategy.

⏱️ In This Episode
00:00 Introduction and Guest Welcome

00:59 David Conno's Background and Early Career

03:03 The Epiphany: Realizing the Flaws in Health Insurance

09:35 The Power and Challenges of Reference-Based Pricing

18:23 The Cash Pay Experience and Personal Health Journey

28:03 Innovative Solutions: Direct Primary Care

31:24 Conclusion and Final Thoughts

Understanding Trump's Executive Order on Drug Pricing | ShiftShapers

In this episode of ShiftShapers, host David A. Saltzman welcomes Tiffany Ryder, emergency medicine PA, host of Healthcare Liberty Lab, and writer at Red Flag Hero on Substack. Tiffany breaks down President Trump’s executive order on drug pricing and what it could mean for patients, providers, and pharmaceutical companies.

She explores key issues like most favored nation pricing, transparency in drug costs, and the role of PBMs and middlemen. Drawing from her frontline experience and policy knowledge, Tiffany explains how these changes may impact everything from consumer behavior to research and development in the pharmaceutical world.

🤖 Sponsored by BenePower
BenePower is an AI-powered platform helping advisors build high-impact, self-insured health plans quickly and seamlessly. By integrating best-in-class point solutions and eliminating inefficiencies, BenePower reduces costs, improves member outcomes, and positions advisors as industry leaders.
🔗 Learn more at BenePower.com

🔑 Key Takeaways from This Episode
📌 Trump’s Executive Order Is Not What It Seems
Initial reactions framed it as a price control, but deeper analysis reveals an effort to create competitive pricing similar to standard market structures—challenging the global imbalance of U.S. drug costs.

📌 The U.S. Pays More—And It’s Unsustainable
Americans make up only 4% of the world’s population but generate 75% of pharma’s profits. Tiffany explores how this executive order could shift the burden globally rather than stifling innovation.

📌 Transparency Could Empower Consumers
One of the most promising aspects of the order is a potential direct-to-consumer model and increased pricing transparency. It may spark a shift in consumer behavior, giving patients tools to understand what drugs should actually cost.

📌 PBMs and Middlemen Drive Up Costs
Tiffany highlights how pharmacy benefit managers (PBMs) and other intermediaries inflate costs, create confusion, and block consumers from accessing the best value for their medication.

📌 Generational Shift in Patient Trust Is Happening
Today’s younger patients are skeptical of the healthcare system but often feel powerless. Tiffany argues that consumer apathy is a major barrier—but rising costs could force change from the ground up.

📌 Clinicians and Patients Both Hold the Key
Tiffany believes change can start with both groups opting out of the broken system. Asking more questions, rejecting rushed visits, and demanding accountability are small acts that can fuel major reform.

⏱️ In This Episode
00:00 – Introduction to Trump's Executive Order on Drug Pricing
01:08 – Meet Tiffany Ryder: From Rural Louisiana to Healthcare Advocate
03:55 – Key Takeaways from the Executive Order
06:40 – Impact of Most Favored Nation Pricing
09:56 – Challenges and Potential Outcomes
15:23 – The Role of Transparency in Healthcare
24:36 – Generational Shifts in Patient Attitudes
27:06 – Future of Healthcare: Incremental Changes or a Major Overhaul?
29:45 – Conclusion and Farewell