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Relocalizing Health with Dave Chase

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While Washington argues and Wall Street profits, a quiet transformation is reshaping healthcare: one community at a time.

Relocalizing Health takes you inside this movement with Dave Chase, founder of Health Rosetta, as he talks with the people leading healthcare's ground-up transformation. Their approach? Keep care local, rebuild trust, and redirect healthcare wasted spending into something that actually serves people.

You'll hear real-world stories from employers, clinicians, and civic leaders who are designing health plans and ecosystems that work, and strengthening their local economies in the process.

Featured guests include:

- Public sector leaders who've redesigned employee health benefits to free up millions for essential services.

- Physicians who've left corporate systems to practice relationship-based care.

- Manufacturing executives using healthcare as a competitive advantage - not a cost burden.

- Civic leaders helping communities reclaim control of their healthcare destiny.

If you care about your community's future and want to see what's actually working in healthcare transformation, this show offers a clear-eyed look at proven models and how to implement them.

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20 episodes
Updated July 30
26 min on average

Episodes 20

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S1 · E27July 30 · 38 min
How Employer Cooperatives Are Fixing America's Healthcare Cost Crisis
Welcome to Relocalizing Health, where we explore the transformative power of community-driven healthcare reforms. In today’s episode, guest Lee Lewis and host Dave Chase challenge long-held beliefs about healthcare being an uncontrollable cost and reveal how employers, by banding together in cooperatives, are not just cutting expenses but improving care quality and outcomes. Drawing inspiration from the historic rise of rural electric cooperatives, Dave Chase introduces us to the Health Transformation Alliance, a pioneering employer-owned cooperative reshaping health benefits for millions. Lee Lewis, Chief Strategy Officer of the Health Transformation Alliance (HTA), shares behind-the-scenes stories and actionable insights on how organizations can pool resources, break industry dogmas, and unleash innovations that empower individuals and whole communities. Tune in to hear inspiring case studies, practical strategies for change management, and a powerful call to action for every employer, community leader, and clinician ready to take back control of healthcare and make a real difference for the people they serve. Timestamps: 00:00 Building a healthcare co-op 03:39 Saving for Employee Nursing Stations 08:35 Misconceptions about saving on healthcare 10:25 Identifying motivated benefits team members 15:23 Highlighting hospital cost and risk issues 19:03 Collaborating with local employers 20:42 Scaling innovation with initial partnerships 26:03 Improving patient care navigation 29:39 Improving employee benefits and savings 31:55 Economic impact of technology in workplaces 34:40 Healthcare crisis and hero benefits leaders Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E9July 29 · 12 min
What Advisors, Employers, and Community Leaders Will Actually Find in This Book
This episode is for the person who has been following this series and wants to know what is actually inside Relocalizing Health before they read it, and what they will walk away able to do differently. Dave Chase addresses three specific audiences directly. For advisors: the book is a field manual for building fiduciary-grade plans that hold up under scrutiny. It covers the contractual language that separates a plan built to perform from one built to produce revenue for intermediaries, the data access requirements that give employers genuine visibility into how their money is being spent, and the selection and evaluation frameworks that let advisors build accountability into every vendor relationship. For employers: the book shows what it looks like when a health plan is treated as a line of business an organization is actually willing to manage. Not a cost center that absorbs annual increases and passes them to employees. A strategic asset that generates a real dividend and reinvests it in the workforce. For community leaders: the book makes the case that healthcare cost is an economic development problem with a documented solution. The communities that get this right do not just save money. They redirect those savings into schools, workforce development, housing, and the kinds of local investments that build durable economies. Dave also addresses the AI Catalyst section specifically: as artificial intelligence displaces workers at scale, the communities that have figured out how to generate and redirect healthcare savings will have the resources to invest in workforce transition. The ones that have not will face a compounding crisis. The book launches July 29. Every attendee at RosettaFest gets a copy. Key Takeaways: The book is written for three distinct audiences with three distinct entry points: advisors, employers, and community leaders For advisors: fiduciary-grade plan building, contractual language, data access requirements, vendor evaluation frameworks For employers: treating the health plan as a strategic asset that generates and reinvests a real dividend, not a cost center absorbing increases For community leaders: healthcare cost is an economic development problem with a documented solution and the communities that solve it build durable economies The AI Catalyst section: communities that redirect healthcare savings into workforce development will have resources for the transition that AI displacement is accelerating The Nautilus Health Institute has democratized the tools so this is no longer locked behind expensive consultants or proprietary frameworks The book is a field manual, not a manifesto. The playbook exists. What is left is the will to use it. Resources Mentioned: Relocalizing Health by Dave Chase: pre-order on Amazon now RosettaFest 2026: RosettaFest.org Health Rosetta: healthrosetta.org Nautilus Health Institute: open-source tools and frameworks Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E8July 28 · 10 min
The Employers Who Cracked the Code, And Why Their Stories Are in the Book
This episode walks through the Rosie Award winners and the case studies that make up the appendix of Relocalizing Health — the documented proof that the model described in this book is not theoretical. Dave Chase walks through what the Rosie Awards actually represent: employers and public sector organizations evaluated on real Plan Grader scores and real reinvestment of savings through the Health Rosetta Dividend. The awards are not given for good intentions. They are given for results, for documented outcomes that show up in the numbers. The episode covers the kinds of results that have earned organizations a place in the appendix and on the Rosie Award stage: school districts that saved millions and kept teachers in classrooms, municipalities that redirected healthcare savings into community infrastructure, employers that eliminated deductibles and copays while reducing total cost, and health systems that demonstrated what direct contracting with employers actually looks like in practice. Dave is direct about why these stories matter: because the standard objection to everything in this book is that it sounds good in theory but would never work at scale or in a normal organization. The appendix is the answer to that objection. These are normal organizations. They are not wealthy. They are not in major metropolitan areas. Many of them are in the same kinds of communities that have been told this is too hard, too risky, or too far outside the status quo to be worth trying. The book launches July 29 at RosettaFest in Nashville. Every attendee gets a copy. Key Takeaways: The Rosie Awards evaluate real Plan Grader scores and real reinvestment of the Health Rosetta Dividend, not good intentions The appendix of Relocalizing Health is built from Rosie Award case studies, documented proof that the model works in normal organizations The organizations in the appendix are not wealthy, not in major metros, and not operating with special advantages. They are the answer to the objection that this would never work at scale. Results documented across Rosie Award winners include eliminating deductibles and copays, saving millions while keeping public sector budgets intact, and building direct contracting relationships with providers The people behind these results are at RosettaFest 2026 in Nashville, ready to share everything they built Resources Mentioned: Relocalizing Health by Dave Chase: pre-order on Amazon now RosettaFest 2026: RosettaFest.org Health Rosetta Plan Grader: healthrosetta.org Rosie Award winners PDF: available at RosettaFest.org Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E7July 27 · 16 min
What Relocalizing Health Actually Means
When people hear the phrase relocalizing health, a lot of them assume it is a slogan, a policy proposal, or someone's political talking point. This episode explains what it actually means. Dave Chase defines it plainly: treating your community's healthcare dollars as a community resource instead of an extractive expense that leaves town the moment it is spent. Most communities, healthcare is the biggest industry. Most companies, it is the second biggest cost item. And most of the money flows straight out to distant corporations and shareholders. Dr. Michael Fine calls it medicine as colonialism. Dave calls it extraction dressed up as care. In Ashtabula County, Ohio, roughly $450 million leaves the county every year. That is not a healthcare problem. That is an economic development catastrophe. Relocalizing means keeping that money home. But this episode goes deeper than a definition. Dave explains why every major reform effort has failed, regardless of ideology, and why they will keep failing until two structural flaws are addressed. The first: healthcare and social care are funded and governed in entirely separate silos, even though 80 to 90 percent of health outcomes are determined by things outside of the healthcare setting, like food, education, housing, and transportation. The second: healthcare decisions are made at the wrong scale, either way too large at the federal or state level, or way too small at the individual provider level, missing the Goldilocks zone of roughly 25,000 to 700,000 people where community-scale governance actually works. He then shows what right-sized governance looks like in practice. Jonkoping County in Sweden. The Nuka System of Care in Alaska. Rosen Hotels in Orlando. Ashtabula County in Ohio. Different politics, different governance structures, different geographies. Identical in two things: integrated funding and right-sized governance. And he closes with the most American story he knows. Rural electrification. A century ago, less than 10 percent of rural America had electricity. Private utilities said serving rural America was impossible. Communities formed electric cooperatives and did it themselves. By the 1950s, 90 percent of rural America had power. Today almost 900 cooperatives serve 42 million Americans across 56 percent of the US landmass. That is the playbook. The pioneers in this book are the farmers laying line before anyone in Washington figured it out. Key Takeaways: Relocalizing health means treating your community's healthcare dollars as a community resource instead of an extractive expense Dr. Michael Fine frames the status quo as medicine as colonialism: colonial powers extracting both money and wellbeing from communities through the healthcare system Ashtabula County: $450 million extracted annually from a county of 100,000 people. That is not a healthcare problem. That is an economic development catastrophe. Two structural flaws explain why all reform fails regardless of ideology: (1) healthcare and social care are funded and governed in separate silos even though 80 to 90 percent of health outcomes are determined by social factors, and (2) governance operates at the wrong scale The Goldilocks zone for right-sized governance is roughly 25,000 to 700,000 people. County scale. District scale. The size of Iceland. The master key: when one entity invests in prevention but a different one reaps the savings, no one has a reason to invest upstream Jonkoping County, Sweden: unnecessary hospital days for complex patients fell over 90 percent. One hospital cut staff beds by 30 percent. Cost of care in the last two years of life cut nearly in half. Population: 120,000. Nuka System of Care, Alaska: ER visits down 43 percent, hospital admissions down 53 percent. Went from worst health outcomes in America to some of the best. Rosen Hotels, Orlando: cut healthcare cost inflation to match regular inflation. Savings poured back into employees and the surrounding community. Sweden used a county council. Alaska used a tribal council. Ohio used public and private employers. Florida used a hotel company. Different every way except two things: integrated funding and right-sized governance. Multi-stakeholder cooperatives serve 12 percent of the population in Italy and provide 85 percent of care services for elders, children, and the disabled in Bologna Rural electrification: by the 1950s, 90 percent of rural America had power through cooperative ownership. Today 900 cooperatives serve 42 million Americans across 56 percent of US landmass. Father José María Arizmendiarrieta built Mondragón from a technical school in a war-scarred Basque town under Franco's dictatorship into the largest cooperative complex in the world. If it could be done there, American communities reclaiming their healthcare is not idealistic. It is almost modest by comparison. Ronald Reagan praised cooperatives as people's capitalism. Bernie Sanders praises them as democratic institutions. Cooperatives are genuinely post-political. Resources Mentioned: Relocalizing Health by Dave Chase: pre-order on Amazon now On Medicine as Colonialism by Dr. Michael Fine RosettaFest 2026: RosettaFest.org Health Rosetta: healthrosetta.org Nautilus Health Institute Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E6July 26 · 11 min
Why I Spent Ten Years Writing This Book: Relocalizing Health Taking Back Healthcare. Rebuilding Communities.
The short version is that a close friend died from a preventable medical error and left behind a ten-year-old daughter. That is where this started. But the longer version, the one Dave tells in this episode, is about what that loss made him unable to stop noticing. How the system he had spent his career inside, building technology for health systems and working at the intersection of healthcare and innovation, was not broken by accident. It was built this way. And the people inside it, the physicians, the administrators, the insurers, were not villains. They were operating exactly as the incentives demanded. What changed for Dave was not discovering a new problem. It was deciding to stop optimizing inside a broken model and start documenting the communities, employers, advisors, and clinicians who had already figured out how to build something better. This book is that documentation. He also talks about what the title actually means. Relocalizing health is not a policy idea. It is not a theory. It is something that is already happening in Alabama, Alaska, Ohio, Wisconsin, and Florida, the communities that anchor this book. It is what happens when healthcare dollars stop leaving a community and start building it instead. The book launches July 29 at RosettaFest in Nashville. Every attendee gets a copy. You can pre-order on Amazon now. Key Takeaways: A close friend's death from a preventable medical error left behind a ten-year-old daughter. That loss is where the decade of work started. The system is not broken by accident. It was built this way. But the people inside it are largely operating exactly as the incentives demand, not as villains. Dave spent years inside healthcare technology, building software for health systems, working at the intersection of innovation and care delivery. That proximity made the dysfunction visible in a way it might not have been from the outside. The turning point was deciding to stop optimizing inside the broken model and start documenting the places where people had already built something better. Relocalizing health is not a policy idea. It is not a theory. It is something that is already happening in the communities in this book. The Health Rosetta Dividend is the financial expression of this: when employers build the right kind of plan, they generate real savings that can be reinvested into people and communities. The communities in the book prove this over five, ten, twenty, and thirty-year timelines. The book is a field manual, not a manifesto. It is written for employers who are done overpaying, advisors who want to build plans they can stand behind, and community leaders who understand healthcare cost as an economic development problem. With AI displacing workers at scale, the communities that capture the AI Catalyst by redirecting healthcare savings into workforce development will be the ones that build durable economies. The communities that do not will pay what Dave calls the AI Tax. The tools are now democratized through the Nautilus Health Institute. The playbook exists. What is needed is the courage to act, community by community. Resources Mentioned: Relocalizing Health by Dave Chase: pre-order on Amazon now RosettaFest 2026: RosettaFest.org Health Rosetta: healthrosetta.org Nautilus Health Institute: nautilushealthinstitute.org Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E5July 25 · 14 min
Case Study: A Secretary Died Avoiding a $1,500 Deductible. Wisconsin Built Something So It Would Never Happen Again.
In 2011, Patrick Blackholder was the CFO and COO at Rice Lake Area School District in northwest Wisconsin. Facing a mandated budget cut, he built a $1,500 deductible into the health plan. It seemed reasonable. It seemed responsible. A secretary came to his office. Her husband was out of work. Bills had stacked up. She said plainly: I cannot afford $1,500. I will not use it. Two years later, she died of cancer. She had avoided care until it was too late. Patrick said it as directly as a person can: that had a massive impact on me and how I thought about healthcare. I did not want this to happen again. That moment grew into the Employers Healthcare Cooperative of Wisconsin, which now covers 23,000 lives across the state. This episode is the story of how it got there. How Patrick rebuilt the plan around one insight: the answer was never to make expensive care more expensive for people who cannot afford it. The answer was to make the right care available for free. How one broker named Sarah Paints said yes when almost no broker in Wisconsin would touch it. How in year one Patrick called it a dumpster fire, working 40 extra hours a week on top of his actual job, fighting a hospital CEO who summoned him to an office to deliver ultimatums. How he looked that CEO in the eye and said: go ahead, balance bill every member. How the VP of contracting stepped in immediately and they got a direct deal. How a surgeon who lost a $59,000 procedure to a direct contract called Patrick to find out why. How they talked. How the surgeon discovered how little of that $59,000 he was actually seeing. How he went out and built his own surgery center and now collaborates with the cooperative. How some groups cut their costs 45 percent in year one. How others held their costs flat for eight years while comparable groups rose more than 80 percent. How an independent actuary found cooperative groups running 22 percent better than comparable groups overall. And how Rice Lake, which built all of this a decade ago without a playbook and without ever finding the Health Rosetta community until 2023, is now an active part of that community, and is coming to RosettaFest 2026 with at least 15 of their members. Patrick Blackholder will be in the room in Nashville. Key Takeaways: Patrick Blackholder built a $1,500 deductible into the plan in 2011 during a mandated budget cut. A secretary who said she could not afford it died of cancer two years later after avoiding care. That moment became the reason everything else happened. Wisconsin is one of the most expensive states for healthcare with some of the most egregious price gouging hospitals in the country Patrick's core insight: the answer is never to make expensive care more expensive for people who cannot afford it. The answer is to make the right care available for free. Sarah Paints was the one broker in Wisconsin who said yes. She later left her firm when it would not support the model and still serves cooperative groups today Year one was a dumpster fire — Patrick's own words. Reference-based pricing with almost no contracts, less than two months to launch, a workforce that mostly disappeared for the summer A hospital CEO summoned Patrick and the superintendent to his office, spent ten minutes making threats, and told them to pay the billed charges or he would start balance billing employees. Patrick told him to go ahead. The VP of contracting stepped in immediately. They got a direct deal. Three of nine school board members lobbied to fire Patrick. The superintendent held the line. Patrick drove across northwest Wisconsin negotiating contracts procedure by procedure. Every place an employer could not get good access became the next stop. Walker Forge president Brian Adesso proposed the cooperative in 2021 with beautifully simple logic: schools already cooperate on things they cannot afford alone. Why not this? The cooperative now covers 23,000 lives. Member pitch: we have more than 20,000 belly buttons. Two cancer cases caught early because members came in for routine physicals that were free. A provider said flat out: without the free clinic, these would not have been caught. A $59,000 procedure moved to a direct contract alternative. The surgeon called to ask why he lost the case, discovered how little of $59,000 he was actually seeing, and went out and built his own surgery center. He now collaborates with the cooperative. Some groups cut costs 45 percent in year one. Others held flat for eight years while comparable groups rose more than 80 percent. Independent actuary found cooperative groups running 22 percent better overall. Rice Lake built all of this from scratch without a playbook nearly a decade ago and did not find the Health Rosetta community until 2023. They are now active members and coming to RF26 with at least 15 member employers. Resources Mentioned: Relocalizing Health by Dave Chase: pre-order on Amazon now RosettaFest 2026: RosettaFest.org — Patrick Blackholder and at least 15 cooperative members are attending Health Rosetta: healthrosetta.org Nautilus Health Institute: open-source tools and frameworks Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E4July 25 · 14 min
Case Study: The Poorest County in Ohio Kept $450 Million Home and Changed Everything
Ashtabula County, Ohio. One of the poorest counties in the state. A medical desert. One primary care doctor for every 3,500 residents against a national average of one per 1,300. At least 30,000 people living in medical debt. And $1.4 billion flowing through that county every year, with at least $450 million of it being extracted out to distant corporations. This is the story of what happened when a benefits advisor named Bryce Heimbach, a concierge nurse navigator named Casey Billington, a direct primary care physician named Dr. Brad Schneider, and a pharmacist named Maria Fowler decided to stop accepting that as inevitable. It started with a school district. Ashtabula Area Schools, the 8th poorest district in Ohio, was spending more than 20 percent of its general fund on healthcare. In July 2020, they put in a new plan. By May 2021, less than a year later, a school levy failed that would have meant teacher layoffs, cut programs, and gutted transportation. Except it did not matter because in less than a year, the plan had already saved $2.4 million, more than the entire levy would have raised. The story did not stay in the school district. A teacher married the city manager. The city of Ashtabula tried it. Saved $360,000 in year one. The county followed. Private employers followed. Crystal Clinic, the number one surgical facility in Ohio, started getting so much volume from Ashtabula members driving an hour or two for zero cost share that they opened a clinic right in the county. A medical desert started getting its doctors back. A police detective's daughter broke her ankle out of town. He called the concierge nurse. By the time he was on the interstate, everything was handled. A teacher named Maureen Cerbella stopped paying for her life-saving medications. She said it felt like a $3,000 raise. And a funeral home director named Mike Chupp, who had spent his career noticing that every fourth body he prepared had not even reached his own age, started seeing something different in his community. Bryce Heimbach is at RosettaFest 2026 in Nashville, July 29 to 31. He will be in the room. Key Takeaways: Ashtabula County is one of the poorest counties in Ohio with one primary care doctor for every 3,500 residents and at least $450 million extracted annually to distant corporations Bryce Heimbach joined Health Rosetta in 2018 at the very first gathering in Chicago after nearly leaving the industry The football team metaphor: nurse navigators are the fullbacks, primary care is the running back, and what wins is constant communication and alignment across the team Casey Billington co-founded Concierge Nurse Navigators bringing oncology-style navigation to the broader population for the first time Dr. Brad Schneider left a hospital where he was seeing 30 patients a day in 15-minute visits and drove 45 minutes each way to practice medicine the way he was trained Maria Fowler at Hoffman's Pharmacy, one of the last independent pharmacies standing, became the preferred pharmacy with generic medications free for members Ashtabula Area Schools, the 8th poorest district in Ohio, saved $2.4 million in less than a year, more than an entire school levy The city of Ashtabula saved $360,000 in year one The dominant regional hospital system pushed back hard on price transparency, which Bryce said was proof they were over the target Unions became the strongest advocates after asking: you're telling me this can be free and you'll validate the physicians are highest quality? Yes Crystal Clinic, the number one surgical facility in Ohio, opened a clinic in Ashtabula County after receiving so much volume from cooperative members Bryce and partner Frank Stichter took the model west and helped launch a community-owned health plan on the Western Slope in Colorado The model works in the 8th poorest county in Ohio with a single hospital town. The excuse that anyone else cannot do it is wearing thin. Resources Mentioned: Relocalizing Health by Dave Chase: pre-order on Amazon now RosettaFest 2026: RosettaFest.org — Bryce Heimbach is part of the Employer Track Health Rosetta: healthrosetta.org Nautilus Health Institute: open-source tools and frameworks Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E26July 16 · 29 min
How Can Community-Driven Healthcare Transform Costs and Outcomes?
Welcome to Relocalizing Health! In this episode, Dave Chase sits down with Claire Brockbank, a trailblazer in transforming healthcare costs and outcomes through community-driven strategies. From helping Colorado’s mountain towns slash exorbitant insurance prices with Peak Health Alliance to leading one of the largest union health funds in the nation at 32BJ, Claire Brockbank has proven that local communities, armed with the right data and determination, can take back control from hospital monopolies and insurance giants. Together, they explore the power of direct contracting, the critical role of transparency and accountability, and innovative programs like 32BJ’s $40 baby initiative. Listen in for practical lessons and inspiration on how you, your organization, or your community can challenge the status quo and drive real, measurable healthcare change. Timestamps: 00:00 Addressing High Health Care Costs 04:17 Fair pricing for hospital negotiations 09:40 Using data in negotiations 12:47 Direct health care negotiations 16:13 Overcoming Challenges with Claire and 32BJ 18:37 Launching the maternity program 22:01 Addressing healthcare inequalities 23:43 Negotiating healthcare savings and impacts 26:59 Claire's leadership in health cooperatives Claire BrockBank - https://www.linkedin.com/in/claire-brockbank-17b7901/ 32BJ Health Fund - https://health.32bjfunds.org/ Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E3July 14 · 16 min
Case Study: The Clinic That Started in an Accounting Office and Saved $570 Million - Rosen Hotels, Orlando
Rosen Hotels & Resorts is a family hospitality company in Orlando, Florida, built by Harris Rosen, the son of immigrants who grew up on New York's Lower East Side. During the oil crisis in the 1970s, he bought a bankrupt Quality Inn on International Drive with a modest down payment and a lot of nerve. By the early 90s he had built a real company. And like every other employer in America, he was getting hammered by healthcare increases. His workforce reflected the hospitality industry in Central Florida: a lot of immigrants, many of whom had never had access to a modern healthcare system. The traditional insurance model was punishing them with high deductibles, rising premiums, and surprise bills, in an industry where people live paycheck to paycheck. So Rosen and his CFO, Frank Santos, now the company's CEO, asked a question almost nobody asks: what if the hundreds of millions going into bureaucracy went to caring for people instead? They converted part of an accounting office into a clinic with one part-time doctor. Their broker told them to stay in the insurance pool. Industry veterans said an employer couldn't deliver care without going broke or going substandard. Three decades later, that accounting-office clinic is a 12,000-square-foot medical center. Rosen employees see a doctor on the clock, not on their own time. Deductibles and co-pays went down while the rest of the industry raised them. Per-employee healthcare costs run 55 percent below industry norms, sustained for thirty years. Total savings: $570 million and counting. Rosen never kept the savings. They poured them into Tangelo Park: free preschool, free daycare, fully funded college scholarships for an entire neighborhood. High school graduation rates that used to be unacceptably low now sometimes hit 100 percent. Crime dropped 80 percent. If a mid-sized hotel company in Orlando can build this, "we're not a healthcare company" stops being an excuse. It is just a story we tell ourselves. Kenneth Aldrich, Rosen's clinical leader since 1998, and Carolyn Grant from Rosen's care team will be at RosettaFest 2026, July 29 to 31 in Nashville at the Gaylord Opryland. They will be in the room. So will the playbook. Key Takeaways: Harris Rosen bought a bankrupt Quality Inn on International Drive in Orlando during the 1970s oil crisis and built Rosen Hotels & Resorts from it Facing a steep renewal increase in the 1990s, Rosen and CFO Frank Santos converted part of an accounting office into a clinic with one part-time doctor, against their broker's advice That clinic is now a 12,000-square-foot medical center, built in part on fully functioning used equipment bought at 10 cents on the dollar Employees see their doctor on the clock, get free rides to appointments, and complex health needs (60 to 72 percent of pregnancies now classified high risk) are treated as a design problem, not a liability Rosen's opioid prescription rate runs at one-sixth the typical US employer rate, a pattern Dave Chase investigated for his book The Opioid Crisis Wake-Up Call Healthcare costs have stayed essentially flat at the rate of inflation for three decades; per-employee costs run 55 percent below industry norms Total savings: $570 million and counting, benchmarked against comparable Orlando hospitality employers Employee weekly contribution is about $16.66; turnover runs at one-sixth the industry rate; workers' comp costs were cut in half The Tangelo Park Program funds free preschool, daycare, after-school care, and fully funded college scholarships for an entire neighborhood; economist Lance Lochner measured a 7-to-1 return on the investment The model has since spread into Parramore and the historic Eatonville neighborhood, and other Orlando employers have followed, including Second Harvest Food Bank and the School District of Osceola County, which saved $21 million in its first two years Resources Mentioned: The Opioid Crisis Wake-Up Call by Dave Chase Relocalizing Health by Dave Chase: pre-order on Amazon now RosettaFest 2026: RosettaFest.org - Rosen's clinical and care leadership will be in Nashville Subscribe and Follow: Relocalizing Health Podcast, available on all major platforms. Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E2July 7 · 15 min
Case Study: From the Worst Health Outcomes in America to the Best System in the World: The Nuka Story
In the late 1990s, the Alaska Native Medical Center was a tuberculosis sanatorium turned healthcare facility where elders described themselves not as people, but as numbers. One elder remembered it clearly: "I was number 24601. My newborn daughter was 24602. When my aunt passed, they gave her number to another baby." That was the system April Kyle grew up in. She avoided that hospital as a child because going was a horrible experience. Six-hour waits were normal. Six-week appointment backlogs were standard. The worst health outcomes in the United States. April Kyle now runs it. What happened between those two realities is one of the most documented, most studied, most awarded healthcare transformations in the world. People fly in from Singapore, Sweden, and across the globe to understand how the Southcentral Foundation and the Alaska Native community it serves built the Nuka System of Care, a model so far ahead of conventional medicine that it has won the Malcolm Baldrige National Quality Award twice. The only healthcare organization in America to do so. This episode tells that story. Not the awards. The ownership. The decision to stop calling people patients and start calling them customer-owners. The moment a new nurse leader said we were going to see anyone who needs care the same day and her colleagues thought leadership had lost their minds. Within six months it was just how things worked. Emergency room visits down 45 percent. Hospital admissions down 53 percent. Specialist use down 65 percent. Quality scores went from the bottom fifth percentile to the 75th and often the 90th percentile. Childhood immunization at 93 percent. Diabetes complications down 25 percent. Customer-owner and employee satisfaction both hovering around 95 percent. Total cost running 20 to 30 percent below national averages. In Alaska. In one of the most expensive geographies in the country. And over half the employees are now Alaska Native people. The health system became an engine of community wealth building. April Kyle is flying from Alaska to RosettaFest 2026 in Nashville, July 29 to 31, to share this story in person. She will be in the room. Key Takeaways: South central Foundation serves 70,000 Alaska Native people across an area the size of Sweden The transformation began when the community took ownership of a system that had been poorly serving them The single most powerful shift: they stopped using the word patient and started calling everyone a customer-owner Dr. Douglas Eby, Chief Medical Officer: "When you're a patient, things are done to you. When you're a customer, you have a choice. When you're an owner, you have control." April Kyle's leadership philosophy: "I'm not the expert at what services should be delivered. I need to be an expert at how to be driven by the community." Same-day access for anything achieved within six months of committing to it, from a six-week waitlist They spend 10 times the usual amount on training, coaching, and mentoring ER visits down 45 percent, hospital admissions down 53 percent, specialist use down 65 percent Quality scores from the bottom fifth percentile to the 75th to 90th percentile Total cost 20 to 30 percent below national averages despite Alaska's high-cost geography The community decides: mammogram scheduling was moved from fall to February because the women of one island community said so, and they were right Copying the tactics is easy. Copying the ownership model is what most systems cannot do. April Kyle joins the main stage at RosettaFest 2026 in Nashville Resources Mentioned: Relocalizing Health by Dave Chase: pre-order on Amazon now South central Foundation and the Nuka System of Care: southcentralfoundation.com RosettaFest 2026: RosettaFest.org April Kyle joins the main stage Previous Relocalizing Health podcast interview with April Kyle: search the feed Subscribe and Follow: Relocalizing Health Podcast — available on all major platforms. Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E5July 4 · 14 min
Case Study: A Secretary Died Avoiding a $1,500 Deductible. Wisconsin Built Something So It Would Never Happen Again.
In 2011, Patrick Blackholder was the CFO and COO at Rice Lake Area School District in northwest Wisconsin. Facing a mandated budget cut, he built a $1,500 deductible into the health plan. It seemed reasonable. It seemed responsible. A secretary came to his office. Her husband was out of work. Bills had stacked up. She said plainly: I cannot afford $1,500. I will not use it. Two years later, she died of cancer. She had avoided care until it was too late. Patrick said it as directly as a person can: that had a massive impact on me and how I thought about healthcare. I did not want this to happen again. That moment grew into the Employers Healthcare Cooperative of Wisconsin, which now covers 23,000 lives across the state. This episode is the story of how it got there. How Patrick rebuilt the plan around one insight: the answer was never to make expensive care more expensive for people who cannot afford it. The answer was to make the right care available for free. How one broker named Sarah Paints said yes when almost no broker in Wisconsin would touch it. How in year one Patrick called it a dumpster fire, working 40 extra hours a week on top of his actual job, fighting a hospital CEO who summoned him to an office to deliver ultimatums. How he looked that CEO in the eye and said: go ahead, balance bill every member. How the VP of contracting stepped in immediately and they got a direct deal. How a surgeon who lost a $59,000 procedure to a direct contract called Patrick to find out why. How they talked. How the surgeon discovered how little of that $59,000 he was actually seeing. How he went out and built his own surgery center and now collaborates with the cooperative. How some groups cut their costs 45 percent in year one. How others held their costs flat for eight years while comparable groups rose more than 80 percent. How an independent actuary found cooperative groups running 22 percent better than comparable groups overall. And how Rice Lake, which built all of this a decade ago without a playbook and without ever finding the Health Rosetta community until 2023, is now an active part of that community, and is coming to RosettaFest 2026 with at least 15 of their members. Patrick Blackholder will be in the room in Nashville. Key Takeaways: Patrick Blackholder built a $1,500 deductible into the plan in 2011 during a mandated budget cut. A secretary who said she could not afford it died of cancer two years later after avoiding care. That moment became the reason everything else happened. Wisconsin is one of the most expensive states for healthcare with some of the most egregious price gouging hospitals in the country Patrick's core insight: the answer is never to make expensive care more expensive for people who cannot afford it. The answer is to make the right care available for free. Sarah Paints was the one broker in Wisconsin who said yes. She later left her firm when it would not support the model and still serves cooperative groups today Year one was a dumpster fire — Patrick's own words. Reference-based pricing with almost no contracts, less than two months to launch, a workforce that mostly disappeared for the summer A hospital CEO summoned Patrick and the superintendent to his office, spent ten minutes making threats, and told them to pay the billed charges or he would start balance billing employees. Patrick told him to go ahead. The VP of contracting stepped in immediately. They got a direct deal. Three of nine school board members lobbied to fire Patrick. The superintendent held the line. Patrick drove across northwest Wisconsin negotiating contracts procedure by procedure. Every place an employer could not get good access became the next stop. Walker Forge president Brian Adesso proposed the cooperative in 2021 with beautifully simple logic: schools already cooperate on things they cannot afford alone. Why not this? The cooperative now covers 23,000 lives. Member pitch: we have more than 20,000 belly buttons. Two cancer cases caught early because members came in for routine physicals that were free. A provider said flat out: without the free clinic, these would not have been caught. A $59,000 procedure moved to a direct contract alternative. The surgeon called to ask why he lost the case, discovered how little of $59,000 he was actually seeing, and went out and built his own surgery center. He now collaborates with the cooperative. Some groups cut costs 45 percent in year one. Others held flat for eight years while comparable groups rose more than 80 percent. Independent actuary found cooperative groups running 22 percent better overall. Rice Lake built all of this from scratch without a playbook nearly a decade ago and did not find the Health Rosetta community until 2023. They are now active members and coming to RF26 with at least 15 member employers. Resources Mentioned: Relocalizing Health by Dave Chase: pre-order on Amazon now RosettaFest 2026: RosettaFest.org — Patrick Blackholder and at least 15 cooperative members are attending Health Rosetta: healthrosetta.org Nautilus Health Institute: open-source tools and frameworks Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E27July 2 · 40 min
What If Communities Were the Key to Better Birth Outcomes?
Welcome to another episode of Relocalizing Health! This week, Dave Chase sits down with Allison Duncan, founder of Anau Health and architect of transformative maternal health models, to explore why the current U.S. maternity system is failing women by design and how we can radically improve it. From her eye-opening journey mapping world-class maternal care in Brazil to building community-driven solutions in Pickens County, South Carolina, Allison Duncan shares powerful insights about the cost, human toll, and missed opportunities in our current system. Together, they discuss how integrating social care with clinical support, rethinking payment structures, and harnessing local leadership can revolutionize birth outcomes and create brighter futures for mothers, babies, and communities everywhere. If you care about the future of healthcare and want to learn what it takes to reclaim maternal health from the ground up, you won’t want to miss this conversation! Timestamps: 00:00 Exploring maternal care issues 07:15 Challenges in Indigenous Maternal Healthcare 09:17 Innovative maternity care in Brazil 11:55 Rising Risks in Pregnancy and Birth 16:51 Addressing maternal mortality causes 20:00 Cost of NICU and preterm births 22:01 Reducing preterm birth costs 26:09 Finding a local design partner 27:55 Helping women achieve economic independence 33:37 Redesigning healthcare payment models 35:34 Introducing Strong Mama, Strong Babies 38:01 Issues in Payment Model Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E1June 26 · 13 min
Case Study: How a Screen Manufacturing in Alabama Cracked Healthcare Before Anyone Was Watching
Welcome to a special series within Relocalizing Health as we count down to RosettaFest in Nashville, July 29 to 31. Each one of these is a quick look inside the book and the communities that inspired it. Real places, real numbers, real people who decided to stop waiting for someone else to fix healthcare and just built something better themselves. If you don't have your ticket to Nashville yet, go grab it at RosettaFest.org. This is where the people in these stories will actually be in the room with you. Here's more about today's special episode Phifer Incorporated is a family-owned manufacturing company in Tuscaloosa, Alabama. About 1,200 employees. They make aluminum, fiberglass, and polyester screening — the window screens in your home, the sun-shading fabric on your lawn furniture. They are also the last remaining made-in-USA manufacturer in their category. And they figured out something most Fortune 500 companies still have not figured out about healthcare. This episode is the story of Russell DuBose, VP of HR at Phifer, who refused to treat healthcare like a force of nature he could not touch. He looked at the glide path the company was on in the mid-2010s and saw a future where benefits became unaffordable to the plan and the people on it. So he did what any manufacturing leader would do. He treated it like a supply chain problem and applied the same lean six sigma rigor he would to any production deficit on the factory floor. What followed was a seven-year roadmap, a zero-cost-share on-site clinic, direct contracts with the best providers, a transparent pharmacy, nurse navigation, scholarships for employees' kids, summer enrichment programs, childcare support for working families, and five straight years of essentially flat healthcare spending. The Plan Grader score went from 37 to 74. Retirement readiness climbed more than 20 points. And then a benefits decision at a screen manufacturing plant in Tuscaloosa turned into a national voice. Russell testified before the House Energy and Commerce Committee on ERISA and chairs the Alabama Employer Healthcare Consortium, helping spread the model to other employers across his region and state. If a 1,200-person manufacturer in Alabama can do this, the excuse that you are not big enough stops being a reason. It is just a story we tell ourselves. Russell DuBose is a co-leader of the Employer Track at RosettaFest 2026, July 29 to 31 in Nashville at the Gaylord Opryland. He will be in the room. So will the playbook. Key Takeaways: Phifer Inc. is the last remaining made-in-USA manufacturer in their screening category Russell DuBose reframed healthcare as a supply chain problem and applied lean six sigma rigor to it The 2017 read of The CEO's Guide to Restoring the American Dream gave him the blueprint First Plan Grader score was 37 out of 100. Most employers start between 5 and 17. The Phifer Cares Clinic opened in 2019 with zero cost share for advanced primary care. Within months it was running at 88 percent daily capacity with 58 percent of eligible members actively using it Five straight years of flat healthcare spending through inflation and high-cost cancer claims Savings reinvested: scholarships for employees' kids (100-plus students to college), summer enrichment for hundreds of children, eliminated pharmacy co-pays for 1,700-plus patients, childcare support for 250-plus working families Plan Grader improved from 37 to 74 Russell testified before the House Energy and Commerce Committee on ERISA He chairs the Alabama Employer Healthcare Consortium Resources Mentioned: Health Rosetta Plan Grader: healthrosetta.org Nautilus Health Institute: open-source tools and frameworks Relocalizing Health by Dave Chase: pre-order on Amazon now RosettaFest 2026: RosettaFest.org — Russell DuBose is a co-leader of the Employer Track Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E25June 23 · 48 min
Redesigning Health and Wealth in Our Communities
Welcome to Relocalizing Health. In today’s episode, host Dave Chase sits down with Kevin Bayuk, a partner at Lift Economy and a pioneer in redefining how communities can thrive by redesigning local systems. With over 20 years of experience questioning why wealth leaves local communities and how to rebuild systems that circulate, compound, and benefit all, Kevin Bayuk shares his journey from Silicon Valley tech entrepreneur to advocate for regenerative enterprise and bioregional self-reliance. Together, they explore the root causes of ill health in society, including the “loneliness epidemic,” and discuss the vision and practicality of economies and healthcare systems that put well-being, community connection, and ecological thriving at the center. Through stories drawn from permaculture, multi-stakeholder co-ops, and innovative healthcare models like direct primary care, Kevin Bayuk and Dave Chase challenge business-as-usual approaches and invite us to imagine what is possible if we reclaim agency over health, wealth, and the future of our communities. Whether you’re leading a business, a school district, or simply curious about holistic approaches to community health, this episode will inspire you to see that the tools and models for transformation already exist; you just have to look a little closer. Timestamps: 00:00 Early Silicon Valley entrepreneurship 06:04 Rethinking healthcare and wellbeing 10:01 Imagining a future economy 13:42 Community-focused motivation and cooperative structures 15:52 Workers owning the farm 18:40 Community-owned farming cooperatives 21:48 Direct primary care model explained 24:52 Community-driven profit reinvestment 29:01 Structural flaws in healthcare systems 33:37 Anna O'Malley's community medicine circles 35:28 Story of health intervention success 39:14 Future of Work and AI Automation 42:20 Slowing down for sustainability 46:00 Closing thoughts and action steps Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E24June 2 · 40 min
Trust, Compassion, and Results: The Rosen Way to Better Healthcare
Welcome to Relocalizing Health, the podcast about taking back healthcare and rebuilding communities. In today’s episode, host Dave Chase sits down with Kenneth Aldridge, the long-time clinical leader at Rosen Medical Center in Orlando, Florida. Together, they explore how Rosen Hotels has built the nation’s longest-running and most comprehensive employer-sponsored advanced primary care model, one that delivers exceptional outcomes for a diverse workforce, including a high percentage of high-risk pregnancies, while spending less than half the national average on healthcare. Kenneth Aldridge shares stories from nearly three decades of transforming care: from breaking down barriers to access for associates from third-world countries, to innovative programs like free transportation, on-the-clock appointments, medication support, and comprehensive case management throughout pregnancies. The conversation goes deep into the practical steps that have built lasting trust, improved health outcomes, and freed up resources for broader community well-being, including scholarships and neighborhood revitalization. If you’re curious about what a truly high-performing health system looks like, how love and common sense can upend toxic industry norms, and why Rosen’s model is being replicated across the country, this episode is for you. Join us as we reveal the playbook behind America’s healthcare “OGs” and offer hope for clinicians, employers, and communities everywhere. Timestamps: 00:00 Introduction to Relocalizing Health Podcast 06:17 Supporting employees with healthcare access 07:38 Helping patients manage diabetes 12:43 Creating a pregnancy management program 13:22 Prenatal care and pregnancy support 18:43 Bringing medical services in-house 21:13 Concerns about healthcare quality and costs 23:53 Rosen Medical Center health services 26:59 Commitment to supporting patients 31:51 Healthcare system challenges and solutions 35:09 The rewarding challenge of hard work 36:43 Reducing waste in healthcare spending Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E23May 13 · 42 min
Cancer Survivorship and the Push for Collective Patient Power
Welcome to another episode of Relocalizing Health, the show about reclaiming healthcare and strengthening our communities. I’m your host, Dave Chase, author of Relocalizing Health: Taking Back Healthcare, Rebuilding Communities. Today, we dive into the realities of being a patient in America, a system where too often, getting sick can mean financial ruin, emotional devastation, and feeling invisible. Our guest, Matthew Zachary, survived brain cancer as a young concert pianist and went on to do something even rarer, turning his experience into a national movement. As the founder of Stupid Cancer, host of the Out of Patients podcast, and cofounder of We The Patients, Matthew Zachary has spent nearly three decades fighting to give patients a real collective voice in a healthcare maze designed to isolate and overwhelm. In this conversation, we explore what it means when patients stop being statistics and start becoming a civic force, the power of collective activism, and how something as simple as a patient navigator can be the “seatbelt” we all need on our healthcare journey. We’ll talk about fighting denial engines, rethinking industry incentives, and why the revolution in healthcare might just be led by people who never wanted to be activists in the first place. Let’s dive in. Timestamps: 00:00 Empowering patient advocacy 05:32 Financial strain of cancer care 09:29 Discussing healthcare affordability issues 12:08 Concerns over AI in healthcare 14:24 Understanding healthcare appeals process 18:20 Understanding patient needs vs. system assumptions 21:08 Discussing product design flaws 23:14 Using nurse navigators for better care 27:11 Discussing civic power in healthcare 31:56 Audrey Tang and gov0 initiative 35:26 Discussing waste in healthcare spending 37:20 Challenging powerful hospital systems 40:02 Discussing Matthew's impact and achievements Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E22May 1 · 21 min
From Farm Lights to Healthcare Heights: How Cooperatives Solve America's Toughest Challenges
Welcome to another episode of Relocalizing Health, where host Dave Chase draws a bold parallel between America’s rural electrification revolution and the grassroots transformation happening in healthcare today. In this episode, Dave Chase unpacks the inspiring story of Iowa farmers who built miles of power lines before they even had a power source, showing how local ingenuity can spark nationwide change. He introduces his “three, two, one” framework, a blueprint where pioneering communities prove what’s possible, their success spreads, and smart policy amplifies the impact. You’ll hear real-world examples of how forward-thinking communities and cooperatives are reclaiming healthcare, like employer health plans in Wisconsin, a transformative effort in Ashtabula, Ohio, and successful models from Alaska Native tribes. Dave Chase shares actionable steps for employers, cooperatives, and policymakers to join the movement, and unveils his new book, "Relocalizing Health." Whether you’re a healthcare professional, policymaker, or simply passionate about your community’s wellbeing, this episode offers hope, practical guidance, and a reminder that American ingenuity is alive and ready to reinvent healthcare from the ground up. Timestamps: 00:00 "Farmers' Power Revolution" 04:23 "Cooperatives: Community-Driven Solutions" 09:05 "Localized Care vs. Distant Decisions" 10:10 "From Worst to Best Healthcare" 16:15 "Empowering Community Health Innovation" 17:03 "Transforming Healthcare at Rosetta Fest" 20:18 "Transforming Communities, Reclaiming Healthcare" Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E21April 21 · 42 min
How Plainfield Eliminated Deductibles, Cut Payroll Costs & Invested Savings Back Into Its Own People
Welcome to Relocalizing Health. In this episode, we shine a light on Plainfield, Indiana, a town just west of Indianapolis, where public sector employees like police officers, firefighters, and public works staff were once priced out of their own healthcare. Nate Thorne, assistant town manager, joins us to share how Plainfield broke free from years of rising premiums and shrinking paychecks, fundamentally transforming its approach to employee health benefits. Instead of accepting sky-high insurance costs as an inevitable “healthcare trend,” Plainfield’s leadership took courageous steps: moving to a self-insured health plan, forging a direct contract with their local hospital, and reimagining benefits so workers now pay zero deductibles and co-pays, with real dollars flowing back into their households. These savings built meaningful new programs like mental health support and childcare assistance, and Nate Thorne and his team are on a mission to show other cities and counties that there is a better way. Whether you manage a city, run HR for a school district, or just want a behind-the-scenes look at how local governments can invest in their people and communities, this episode brings you the story, the lessons, and the playbook, direct from a Rosie Award finalist, on how to take back control of your health plan and rethink what’s possible for your workforce. Timestamps: 00:00 Challenges of municipal worker benefits 04:21 Facing rising insurance costs 07:24 Challenge of risk in public policy 11:46 Implementing a Self-Insured Program 16:10 Managing healthcare spending changes 18:07 Cost-saving strategies for healthcare plans 22:02 Creative funding for employee benefits 26:18 Leadership and gradual progress advice 28:52 Challenges in the public sector 32:02 Managing retiree health benefits 35:13 Employee survey results on premiums 37:25 Annual employer gathering details 40:11 Plainfield's health plan changes Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E20April 15 · 38 min
How a Food Bank Beat Rising Health Costs to Deliver Thriving Coverage for 170 Staff
Welcome to Relocalizing Health. In this episode, we take you behind the scenes at Second Harvest Food Bank of Central Florida, where an organization fighting hunger is revolutionizing health benefits for its employees. Join Dave Chase as he sits down with Amy Lein, Chief Human Resource Officer at Second Harvest, to uncover how this nonprofit broke away from the broken health insurance model, creating one of the nation's highest-quality, most accessible benefit plans. Learn how every employee at Second Harvest pays zero in premiums, deductibles, and co-pays, translating into real quality of care and tangible support like paid leave and grocery assistance. Hear firsthand stories of transformation as employees, for the first time, can actually afford and access the care they need. This episode is a must-listen for nonprofit leaders, city managers, and anyone who has ever looked at a health insurance renewal and thought, “We can’t afford anything better.” As Dave and Amy reveal, a better way is not only possible, it’s already here. Timestamps: 00:00 Making healthcare affordable for employees 05:41 Improving employee healthcare access 09:14 The concierge nurse navigator 10:01 Affordable access to top doctors 14:32 How the gift card program works 19:35 Offering paid parental leave 22:37 Having access to quality healthcare 26:07 Rising healthcare costs and solutions 30:02 Vision for what's next 30:43 Creating a great workplace culture 34:38 Wrapping up with final advice Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/
S1 · E19April 6 · 39 min
How Spooner Physical Therapy Relocalized Health Plans and Reduced Costs for Employers and Employees
Welcome to Relocalizing Health with Dave Chase. In this episode, we explore what happens when a clinical leader takes health care into their own hands for both their patients and their employees. We'll meet Tim Spooner, a physical therapist who, in 1990, opened a single clinic in Scottsdale, Arizona with the conviction that the right care, at the right time, can transform lives. Thirty-five years later, Tim leads Arizona's largest private PT practice, operates clinics across Arizona and Texas, and runs Solve Global, a company that's reshaping how employers nationwide address musculoskeletal health. But Tim's story doesn't stop with clinical excellence. Frustrated by skyrocketing premiums, opaque data, and decreasing reimbursements, he set out to redesign his company's health plan from the ground up. In the process, he redirected money typically lost to the old system back into his people, offering benefits like tuition reimbursement, direct primary care memberships, and robust musculoskeletal solutions. His efforts not only earned national recognition but also inspired other PT practices to follow suit. Today, we'll dive into Tim's journey of leadership and innovation, the challenges he faced, and how his blueprint for change is empowering others to reclaim health care, making it more transparent, effective, and people-focused. Stay tuned as we learn what it truly means to "walk the talk" in health care and why the proof is in the room. Timestamps: 00:00 How Tim Spooner got started 03:28 Discovering rising healthcare costs 08:06 High hospital markup example 13:14 Regenerative medicine success stories 15:36 Proactive healthcare and early intervention 19:57 Challenges for healthcare professionals 22:48 Transitioning to self-insured healthcare 24:12 Leadership and driving results 26:59 Medical costs and MRI findings 30:43 Navigating healthcare payment models 36:11 Closing advice for key audiences 36:49 Partnering with clinical practice leaders Learn More: RosettaFest 2026 - https://rosettafest.org/ Health Rosetta - http://healthrosetta.org/ Nautilus - https://www.nautilushealth.org/ Kynexions - https://kynexions.com/ Dave Chase - https://www.linkedin.com/in/chasedave/ Podcast Website - https://relocalizinghealth.com/

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