In this episode, we’re joined by Ron Howrigon, President of Fulcrum Strategies, who specializes in guiding doctors through the complexities of insurance policies. Ron shares his unique journey from working on the insurance side to advocating for physicians and patients against unfair industry practices. We dive into the challenges of prior authorization, insurance denials, and their impact on physician burnout. Ron sheds light on the incentives driving insurance companies and the reasons behind coverage battles, while offering thoughtful solutions to improve the system for patients and health care providers alike.

Among the highlights in this episode:

01:17: Ron explains his career shift from working for major insurance companies to founding Fulcrum Strategies, motivated by his personal experience during his child's birth

03:15: Ron describes the main focus of his work: helping physicians negotiate fair reimbursement terms with insurance companies and address issues like prior authorization

06:04: Ron highlights common problems physicians face, including retroactive denials and patients being unable to afford out-of-pocket costs despite having insurance

08:14: Ron discusses the motivation behind insurance companies’ tactics, explaining the profit-driven nature of the industry and how it conflicts with patient care needs

09:49: The conversation shifts to the challenges of managing chronic disease within the insurance system, with Ron explaining the adverse selection and cost issues insurers face

11:01: Zoe Rothblatt, Director of Community Outreach at GHLF, shares her personal experience with biologic medication costs, highlighting the financial burden on chronically ill patients

13:46: Ron offers his perspective on potential solutions, including the possibility of universal health care and reforming the insurance industry's approach to prior authorization

15:29: The discussion addresses the need for accountability in the insurance industry, with Ron suggesting that medical directors be held to the same standards as prescribing doctors

18:49: Ron offers a message of resilience and hope, encouraging patients and physicians to continue advocating for policy change and better care

19:57: What our hosts learned from this episode

Contact Our Hosts

Steven Newmark, Chief of Policy at GHLF: snewmark@ghlf.org

Zoe Rothblatt, Director of Community Outreach at GHLF: zrothblatt@ghlf.org

A podcast episode produced by Ben Blanc, Associate Director, Digital Production and Engagement at GHLF.

We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to podcasts@ghlf.org

Catch up on all our episodes on our website or on your favorite podcast channel.

In this episode, we’re joined by Ron Howrigon, President of Fulcrum Strategies, who specializes in guiding doctors through the complexities of insurance policies. Ron shares his unique journey from working on the insurance side to advocating for physicians and patients against unfair industry practices. We dive into the challenges of prior authorization, insurance denials, and their impact on physician burnout. Ron sheds light on the incentives driving insurance companies and the reasons behind coverage battles, while offering thoughtful solutions to improve the system for patients and health care providers alike.
Among the highlights in this episode:
01:17: Ron explains his career shift from working for major insurance companies to founding Fulcrum Strategies, motivated by his personal experience during his child's birth
03:15: Ron describes the main focus of his work: helping physicians negotiate fair reimbursement terms with insurance companies and address issues like prior authorization
06:04: Ron highlights common problems physicians face, including retroactive denials and patients being unable to afford out-of-pocket costs despite having insurance
08:14: Ron discusses the motivation behind insurance companies’ tactics, explaining the profit-driven nature of the industry and how it conflicts with patient care needs
09:49: The conversation shifts to the challenges of managing chronic disease within the insurance system, with Ron explaining the adverse selection and cost issues insurers face
11:01: Zoe Rothblatt, Director of Community Outreach at GHLF, shares her personal experience with biologic medication costs, highlighting the financial burden on chronically ill patients
13:46: Ron offers his perspective on potential solutions, including the possibility of universal health care and reforming the insurance industry's approach to prior authorization
15:29: The discussion addresses the need for accountability in the insurance industry, with Ron suggesting that medical directors be held to the same standards as prescribing doctors
18:49: Ron offers a message of resilience and hope, encouraging patients and physicians to continue advocating for policy change and better care
19:57: What our hosts learned from this episode
Contact Our Hosts
Steven Newmark, Chief of Policy at GHLF: <a href="mailto:snewmark@ghlf.org">snewmark@ghlf.org</a>
Zoe Rothblatt, Director of Community Outreach at GHLF: <a href="mailto:zrothblatt@ghlf.org">zrothblatt@ghlf.org</a>
A podcast episode produced by Ben Blanc, Associate Director, Digital Production and Engagement at GHLF.
We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to <a href="mailto:podcasts@ghlf.org">podcasts@ghlf.org</a>
Catch up on all our episodes on our website or on your favorite podcast channel.

A podcast that breaks down major health news of the week to help you make sense of it all. Our goal is to help you understand what’s happening in the healthcare world to help you make informed decisions to live your best life.

A podcast that breaks down major health news of the week to help you make sense of it all. Our goal is to help you understand what&rsquo;s happening in the healthcare world to help you make informed decisions to live your best life.

The Health Advocates

A podcast that breaks down major health news of the week to help you make sense of it all. Our goal is to help you understand what’s happening in the healthcare world to help you make informed decisions to live your best life. The podcast is part of the Global Healthy Living Foundation Podcast Network and hosted by Steven Newmark, Chief of Policy at GHLF, and Zoe Rothblatt, Director of Community Outreach at GHLF.

A podcast that breaks down major health news of the week to help you make sense of it all. Our goal is to help you understand what’s happening in the healthcare world to help you make informed decisions to live your best life. The podcast is part of the Global Healthy Living Foundation Podcast Network and hosted by Steven Newmark, Chief of Policy at GHLF, and Zoe Rothblatt, Director of Community Outreach at GHLF.

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