#515 Health Plan Design - Struggles Shape Smarter Structures with David Contorno

The ShiftShapers Podcast

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

Chapters

1. Evolution of Plan Design Beyond RBP (00:00:00)

2. Scaling Direct Primary Care Solutions (00:03:47)

3. Cash Pay Pathways and Provider Access (00:07:11)

4. Fiduciary Duty in Healthcare Plans (00:11:36)

5. Mental Health Integration and Innovation (00:17:50)

6. Psychedelic Therapy and Future Treatments (00:24:45)