You are about to be inspired and challenged about how you think about value-based care. Since 1991, Rosen Hotels & Resorts has offered an innovative in-house healthcare program called RosenCare that has saved the company approximately $450 million since its inception, affording the opportunity to provide associates (employees) incredibly low premiums and innovative programs.

Our guests this week are Harris Rosen, businessman, investor and philanthropist who founded Rosen Hotels & Resorts and serves as the company's president and chief operating office, Kenneth Aldridge, Director of Health Services for Rosen Medical Center, the onsite medical home and primary care ecosystem, and Ashley Bacot (Ba-Coe), the President of Provinsure, an independent insurance consulting arm owned by Rosen.

The takeaways from this conversation are multi-faceted and they can applied to ACOs, health plans, and employers. This interview will allow you to re-think how local community engagement and partnerships fit into your healthcare strategy. RosenCare’s approach will force you to reconsider how you approach access, quality, service, costs, innovation. This model is ripe for replication and needs to become the norm in our race to value.

Episode Bookmarks:

01:45 Background on Rosen Hotels & Resorts and its innovative in-house healthcare program (RosenCare) that saved $450 million!

03:45 Introduction to Harris Rosen, Kenneth Aldridge, and Ashley Bacot

07:00 Rosen Hotels & Resorts spends 50% less per capita than the average employer (cost “per covered life” is ~$5,500)

08:20 Mr. Rosen explains how the military adages of the 6P’s and KISS guides his entrepreneurial vision

09:20 The birth of RosenCare in 1991 due to uncontrollable and rising health insurance premiums (Mr. Rosen)

10:00 Lowering healthcare costs 20% but still facing premium escalations…time to become a self-insured plan and build our own clinic! (Mr. Rosen)

14:20 “Our success wasn’t that complicated. Scary…yes. Uncertain…of course. But we did it, and we saved $450-500M in healthcare costs over the last 40 years.”

16:05 How Mr. Rosen leads others and built a such a strong culture that company associates want to be a part of (Ashley)

18:40 How working diligently to keep people healthy drives both good outcomes and a healthy bottom line (Mr. Rosen)

19:05 Social determinants of health and the challenges of keeping associates healthy (Kenneth)

20:20 “This is advanced, direct primary care on steroids!”

22:00 The strength of Rosen’s self-insurance plan, Third Party Administrator, and direct contracting model (Ashley)

24:00 Designing steerage into the benefit design (Ashley)

25:30 The unfounded fears by employers in redesigning health insurance benefits (Ashley)

27:30 An Overview of Rosen Medical Center, A Place for Healing and Wellness

29:00 The importance of relationship-based care at Rosen Medical Center (Kenneth)

34:30 How RosenCare addresses the issue of low value care with PBM formulary selection and surgery options (Kenneth)

36:00 How non-traditional treatment (e.g. medical marijuana) have a role to play in eliminating traditional options of treatment that are of lower value (Kenneth)

39:00 How RosenCare approaches direct contracting with hospitals (Ashley)

40:15 The importance of employers having the courage to be self-insured and the need for reforms in hospital reimbursement (Mr. Rosen)

42:00 “Hospitals must try to be fair and equitable.  They should publish costs and outcomes online.”

43:20 The powerful hospital lobby and its concern for income preservation at the sake of ethical business behavior (Mr. Rosen)