Trevor Daer, President and Founder of Granite Peak Analytics, reveals the hidden complexities of Pharmacy Benefit Managers (PBMs) and why specialized consulting is crucial for self-funded health plans. He shares his journey from corporate burnout to creating a company that helps employers navigate the convoluted PBM landscape and avoid overpaying for prescription benefits.

• PBM consulting helps benefits advisors navigate pharmacy complexity and secure better contracts for clients
• Granite Peak Analytics was founded after discovering independent pharmacies were being squeezed by PBMs while employers overpaid
• The pharmaceutical supply chain involves manufacturers, wholesalers (McKesson, Cardinal, AmeriSource Bergen), pharmacies, PBMs, and employers
• "The Big Three" PBMs (Optum, Express Scripts, CVS Caremark) control 80-85% of the market and are vertically integrated with insurance carriers
• PBMs have approximately 45 different revenue streams, creating misaligned incentives where they profit as drug costs increase
• Employers without specialized PBM consulting typically overpay by up to 50% on their pharmacy benefits
• Pharmacy costs have grown from 4-5% of self-funded plans to 25-30% today
• Rebates create perverse incentives where higher-cost drugs are often preferred over lower-cost alternatives
• Current trends include rising GLP-1 costs, specialty medications, and biosimilar adoption challenges
• Active management of pharmacy benefits is essential, especially with expensive new therapies

The Marshall Allen Project preserves the legacy of investigative healthcare reporter Marshall Allen through an AI clone trained with his expertise to help Americans navigate medical debt. Founded by his widow after his sudden passing, the nonprofit organization aims to give 100 million Americans struggling with healthcare costs the tools to make better decisions and fight unfair billing practices.

• Marshall Allen spent 18 years investigating healthcare from the patient perspective before his death in May
• The MAC (Marshall Allen Clone) contains knowledge from 475 articles, books, podcasts and speaking notes
• One in six Americans has medical debt in collections, making healthcare costs their #1 financial concern
• The AI tool provides practical guidance on negotiating bills, finding fair pricing, and writing appeals
• Available in 115 languages to serve non-English speaking communities
• Victory Stories newsletter shares real examples of people who successfully fought medical bills
• Accredited educational curriculum available for brokers (NABIP) and HR professionals (SHRM)
• In 106 documented cases, Marshall helped individuals save an average of $15,000 each
• The foundation aims to save Americans over $10 million in its first year

Visit the Marshall Allen Project website to access the MAC and learn how to fight unfair medical bills and win.

Brett Billups, CHRO of Marketplace Chaplains and author of Biblical HR, shares his 30-year journey in human resources and how he bridges his Christian faith with workplace challenges.

• Stumbling into HR after seeing disconnects between management and employees at a manufacturing company
• Writing Biblical HR as a personal guide before publishing it to help others apply faith to specific workplace situations
• Challenging the notion that Christians should avoid accountability—holding people accountable in a godly way is actually biblical
• Approaching conflict resolution with the understanding that resolving conflict is ultimately God's job
• Reframing work-life balance as having one unified life dedicated to honoring God in everything
• Explaining how workplace chaplains provide confidential support that traditional HR departments often cannot
• Discussing the challenges of writing about diversity from a biblical perspective
• Sharing how the book led to his current position at Marketplace Chaplains

If you're struggling to align your faith with your work, remember that biblical principles represent how we were designed to function—they work whether we label them as religious or not.

In this NextGen Healthcare Summit episode with Steve Santangelo of Garner Health, he delves into healthcare costs heading toward an unsustainable threshold where nearly 9% of company revenue will go toward benefits packages—the same percentage that contributed to GM's financial crisis in 2008. Data analysis reveals that which individual doctor a patient sees has the greatest impact on healthcare costs, with significant variations in quality and expense that don't necessarily correlate with each other.

• Top-performing doctors maintain complication rates around 5% for major surgeries while bottom-performing doctors approach 20%
• Approximately one-third of all healthcare procedures are deemed medically unnecessary
• Basic office visits cost around $100 with top doctors versus $250 with lower performers
• Traditional methods of evaluating doctor performance are highly inaccurate
• More granular assessment of doctor performance includes factors like tendency to jump to surgery, techniques used, complication rates, and setting choices
• Employers can save approximately 27% by directing employees to higher-quality providers
• Current provider directories are only about 27% accurate, creating barriers to finding good doctors
• AI and machine learning can help clean provider directories and deliver real-time information
• Using incentives to encourage patients to see high-quality doctors creates better outcomes while reducing costs
• Implementing these approaches can reduce employer healthcare spend by approximately 12%

Brett Varvel shares his journey from creating backyard films to becoming an Emmy Award-winning filmmaker dedicated to faith-based storytelling. His creative foundations were shaped by growing up in an artistic household as the son of an internationally syndicated cartoonist, where exploration of various art forms was encouraged from an early age.

• Growing up in a creative household with his cartoonist father provided early exposure to visual storytelling
• Started with 2D art as a child before discovering his passion for filmmaking around age five
• Used action figures to create stories before gaining access to the family video camera
• Found that filmmaking combined all art forms he loved - visual design, writing, acting, and production
• Family garage became "Varvel Studio" where he and his brother created music videos and short films
• Negotiated with high school teachers to create films instead of written reports
• Won a statewide competition with a faith-based short film that changed his career direction
• Professor Jim Shasky at Ball State University provided tough but necessary criticism that shaped his development
• His film "Disciples in the Moonlight" took seven years to develop and explores what would happen if the Bible were outlawed in America
• Continues to embrace collaboration and dreams of creating a film about the crucifixion from both physical and spiritual perspectives

To experience Brett's work, watch "Disciples in the Moonlight" on Amazon, Apple TV, or Google Play.

AI isn't magical but mathematical, and understanding how it works removes mystery while helping make informed business decisions. We break down the fundamentals of AI in a way that demystifies its inner workings and explains why it's transformative for businesses.

• Understanding how AI processes a simple request like "write a haiku about puppies" reveals its potential for business applications
• AI converts language into mathematical vectors to find relationships between words and concepts
• Context windows limit how much an AI can "remember" in a conversation, similar to human short-term memory
• Retrieval Augmented Generation (RAG) allows businesses to prioritize their own data when generating AI responses
• AI agents can perceive environments, make decisions, and take actions toward specific goals like searching and organizing data
• New business models like "service as software" are emerging, where AI handles operations behind traditional services
• Four principles for effective AI: treat it like a human, include it in brainstorming, expect continuous improvement, and keep humans in oversight roles

Diana Miller, a Benefits Pro 2025 Advisor of the Year finalist, shares her remarkable journey from growing up in Bogotá, Colombia to becoming one of America's top five benefits advisors through grit, analytical thinking, and cultural perspective.

• Benefits advising requires wearing multiple hats to serve employers, HR professionals, and employee populations
• An advisor's true value is revealed during challenging times when problems need solving
• Diana's "secret sauce" includes grit developed through childhood adversity, strong analytical skills, and cultural empathy
• Growing up in Bogotá during the drug cartel wars required constant security protection from armed guards
• Attended an English immersion school that prepared her for global opportunities
• Earned a scholarship to study in the US, choosing Dubuque, Iowa primarily based on weather expectations
• Experienced culture shock including a memorable incident trying to bribe a police officer
• Transitioned from marketing representative to advisor by going beyond expectations and providing strategic input
• Frustrated by seeing employees walk out of enrollment meetings due to poor benefits, sought better healthcare solutions
• Motivated by creating positive healthcare experiences for her community and designing better systems for future generations

Nelson Griswold, founder and chairman of the NextGen Benefits Network, joins us to discuss his mission to revolutionize employer-sponsored benefits and protect America's private healthcare system through innovative supply chain management strategies.

• Passionate about preserving private healthcare to maintain innovation and avoid government-run systems like those struggling in the UK and Canada
• Helping employers manage their healthcare supply chain by steering employees to highest quality providers
• Counterintuitively, highest quality care often costs less because good surgeons don't make mistakes requiring additional procedures
• Many NextGen plans eliminate out-of-pocket costs for employees who use recommended high-quality providers
• Transitioning from selling insurance to managing healthcare risks, just like employers manage other business expenses
• Creating an "open source" collaborative environment where advisors share strategies and innovations
• Emphasizing the importance of population health management to address health risks before they become serious conditions
• Challenging the traditional broker model that's incentivized to place business with insurance companies rather than lower costs
• Combining the triple approach of skill set, tool set, and mindset to create meaningful healthcare change

Visit NextGenBenefits.com to learn more about our mission to make the highest quality healthcare accessible and affordable for all Americans, starting with the employees of our clients.