Knowledge Products

Smart Patient Smart Money

Book Summary Not many books have a high probability of saving you hundreds of dollars quickly but Smart Patient - Smart Money - Financial Wellness for the Healthcare Consumer is simply one of those unique books. Disguised in an easy to read and, believe it not, funny format, you'll be pleasantly surprised by the creative solutions to common and frequently thorny issues experienced by nearly anybody who has paid a medical bill.

On reading the book one insurance executive commented, "Just finished the book. Informative and entertaining! Who would of thought, I'd be chuckling out loud reading an insurance book... I enjoy your insight and humor!

The books is the production of the Smart Patient Academy, the brainchild of author and health insurance consultant Jim Skinner, whose approach healthcare is imbued with his own experience with cancer as well as his 18 years experience training consumer how to use their health plans. As Jim likes to say, he has been "Your honorary test monkey in our healthcare system," which makes is approach both honest and practical.

Jim has carved out a unique voice in healthcare consumerism market place.

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Large Employers

Large Employers

The Essential Playbook for the New Healthcare Consumer. Get a copy of the complete SPA handbook. Full of Tricks and Tips about how to get the most out of your Healthcare.

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Industry Power Users

Industry Power Users

The Total Employee Engagement Blueprint! A program designed at getting the best possible return on your invest with respect to your employee's healthcare.

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Wingman Training

Learn about our Wingman Program. Coaching for healthcare professionals and individuals who would like to learn how to become leaders through the healthcare system.

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SPA - Who We Are: The Genesis of The Smart Patient Academy : Jim's Story

Have you ever felt that you were out of control, lost, fearful, or intimidated in our healthcare system? Well, that was me at age 42 with a stage three cancer diagnosis –of genetic, not lifestyle origin. I had just returned from surfing in Hawaii and felt pretty healthy with minimal symptoms, so you can imagine my surprise. I vividly remember my oncologist saying, "Jim, we only have one shot to cure this. You're otherwise a very healthy person, so I'm going to hit you as hard as I can." For me, those words were like being told you only get one pitch your first time at bat, and you have to hit a home run or you die.

My treatment started quickly with chemotherapy delivery around the clock for six weeks straight with no break –not even a shower– so as not to compromise the chemo-port in my clavicle. To that they added 26 rounds (a lifetime dose) of radiation to three locations in my hip area as I was held in place like a rotisserie chicken week after week. At the end of the 26 doses, I couldn't even walk. They then performed surgery, pulling out 22 lymph nodes that had been so destroyed by chemo and radiation that they couldn't determine the degree of cancer that had spread throughout my body. Just to play it safe, all five doctors agreed that it was best to simply assume the cancer was everywhere, and so they ordered more chemo for the remainder of the year. Again, this was akin to running a marathon of suffering, only to reach a finish line that turned out to be a cruel mirage.

Maybe some of you have taken a deep dive into a medical situation like this, where it's easy to see the two opposing faces of the healthcare system. While individual providers like doctors and nurses can be empathetic and caring, the system –or the rules and bureaucracy in which they operate –can be downright hostile and dangerous. So it's a pretty confusing place to be, even for someone who has spent nearly two decades as a health insurance expert. I was simply unprepared to manage the gaps in care, miscommunication, and high error rates, not to mention the intimidating complexity, egos, and unsustainable costs. In short, it seems to be a system that's about everyone but the patient. What's worse is that we "patients" are in a system that demands passivity. A good patient is a passive patient, and passive patients don't challenge care, doctors, or cost. I'm sure you realize this is a lethal combination.

I remember thinking to myself how ironic it was that my biggest fear in life had always been cancer and the prospect of being on chemo. I watched many of my parents' friends die from it, as well as my father who died in my arms, and I was never really sure if it was the cancer or the chemo that had killed him. Bear in mind that I have jumped out of planes, climbed dangerous mountains, and been in combat zones, but all of these situations paled in comparison to the fear I had going into the world of cancer and chemotherapy. It was a total loss of control, self-image, and confidence. The disease brought me down to the deepest levels of crisis and despair.

I recall my last day on chemo at the end of that year, sitting in the "infusion chair" with my Livestrong bracelet and a bank of TVs in front of me. Sitting next to me was the only other person in the room, a 14-year-old girl curled up in her chair under a blanket, motionless and quiet. We said nothing to each other at first, suffering in silence. Then three or four nurses came into the room to congratulate me for finally making it through my long year of suffering. The young girl turned to me after they left and said, "I'm so happy for you. Congratulations. You should feel proud for making it." A bit embarrassed, I thanked her and asked how long she had to go. "I really don't know how long I'll be on chemo," she said. "This is my second year like this. But you know what? I'm so grateful that this year I'll be able to hold my head up to watch the football games tomorrow on Thanksgiving. Last year I couldn't."

This girl was ten floors lower than I was, unlikely to survive, but grateful for what she had. She was braver, more humble, and more connected to what is important in life than I can ever hope to be. Even more, she had broken out of the box the healthcare system placed her in, ceasing to bring her down. It was a light-bulb moment for me. I realized just how lucky and blessed I really was. I got to walk out. She probably never would.

I remember my Thanksgiving Day Girl well, but I never saw her again. I thanked her and tried to say some encouraging words without crying. I don't think I did a good job. I thanked all the nurses for being so supportive during the year, and I hugged my wife who had slipped in to pick me up just as this scene concluded. As I left the building, I cried –a lot. But when I got to the car, I decided to sit in the driver's seat. I thought that if my young friend could hold her head up, I could certainly drive myself home.

Without actually knowing it at the time, my brief conversation with Thanksgiving Day Girl created a passion in my heart to transform the patient experience from a situation of fear, intimidation, and paralysis into one of confidence, power, and control. She showed me a uniquely human trait, one in which personal tragedy can be transformed into triumph. I have been using Thanksgiving Day Girl's gratitude tool for the past ten years, refining and studying it. With a brain tumor under my belt, and an autoimmune disease instigated by radiation to the brain, I have been able to transform my fear into action and make the system work for me. You can too.

In 2012 I created the Smart Patient Academy, a communications, training, and benefits enrollment company to guide people through the confusing and intimidating maze of healthcare and financial obstacles. This book is the first of several knowledge products produced by the Academy. I know my Thanksgiving Day Girl would approve.

So I'm here to tell you that:

  • You can take control of your healthcare situation.
  • You can make the healthcare system work for you, not against you.
  • You can conquer confusion, fear, and intimidation.
  • And you don't have to wait for a healthcare crisis.

What you'll learn in this book will change the quality of your life.

SPA - What We Do:

Our Goal:
Our Goal


Smart Patient Academy, the publisher of this book, is a communications and enrollment company that was created with a clear and simple vision: To transform the patient experience in a way that makes healthcare providers and insurance companies responsive to the consumer both financially and clinically.


In a word - EMPOWERMENT. We have a process for creating Expert Patients in all senses of the word.


It's all about making the healthcare marketplace responsive to consumers. Adoption of the strategies necessary to achieve this is the first and most crucial step to achieve that goal. As such, we are experts in all forms of Consumer Driven Health Care (Health Savings Accounts, Health Reimbursement Arrangements, and the like). When properly applied, consumer driven plans cause patients to become active, responsibility-sharing parties in their own healthcare. In short, healthcare consumers shift from being passive to active patients.

Active consumers vote their preferences in the healthcare marketplace with their money, time, and trust. Almost 19 million Americans are currently enrolled in some form of consumer driven healthcare plan today. Those numbers are growing rapidly and our financial strength and awareness is expanding as well. The cumulative effect of millions of Smart Patients flexing their collective financial muscle will cause the price of healthcare to drop. The market will shift to meet our demand, which is the way every other market operates. Why should we expect any less in the delivery of our healthcare?

At Smart Patient Academy we are experts in the application of behavioral psychology and behavioral finance principals to the world of healthcare and benefits communication. Our mission is to deal with the entire experience of the "consumer" – " patient" – " employee", both in the transaction of buying health insurance and the ultimate use of the insurance and navigation through the healthcare system. We live where the consumer/patient lives and understand how to bring meaning and value to a wide audience. The Smart Patient Academy portfolio of knowledge products and services is entirely unique and can be customized to fit a wide array of circumstances.

SPA - Who We Serve

The Smart Patient Academy Serves three major markets:

Large Employer Groups

Consumer Driven Health Care in all its various forms (HSAs & HRAs)&ndash holds great potential, but it falls short when not coupled with great communication and training how to extract value out of their healthcare system. I frequently see two groups of employees: the ones who picked a CDHC plan because they understood it, and those who chose it simply because it was cheaper than the alternative. I think you would agree that it's irresponsible to shift risk and cost to employees without teaching them how to manage that risk-without proper education, those employees will succumb to confusion and be inclined to avoid seeking care. In the world of CDHC, your communication procedure needs to evolve from the traditional (and let's face it, boring and obligatory) "enrollment meeting" to a whole new conversation about the Total Value of Healthcare (TVH).

With 18 + years of group enrollment meetings under his belt, Jim Skinner, decided to create a curriculum that teaches the TVH process in the form of a book. In 2013 The Smart Patient Academy created Smart Patient - Smart Money: The Essential Playbook for the New Healthcare Consumer in an effort to connect in a very tangible way with the consumer. The book is an effort to bridge a very large understanding gap, by transforming complexity into simplicity and the technical into the practical for employees. The book shows how patient/consumers can extract maximum value out of the healthcare system.

In our humble opinion, benefits communication today simply does not connect with the customer. Our discussion is all about money, analysis, all based on the old "carrots and stick" paradigm of rewards. Furthermore, we all know that only about 15% of decisions involving both health and money are logical. The other 85% of consumer decisions involve emotion, friendly recommendations, habits and mental shortcuts. Yet, nearly 100% of the insurance industry communication is left-brain, analytical, and rule-based thinking that has little relevance to the consumer. Is it any wonder why we don't connect to the end user? To make this illustrate this point, we created the following info-graphic which show why we don't connect and what actually does connect, engage and inspire.

When we apply all these behavioral psychology factors to the world of benefits and health insurance we get true employee engagement. Consumer driven health plan will not be well received over the long run without engagement. Our Total Employee Engagement Blueprint (TEEB) provides a systematic process for making such a transition successful. Using the proven behavioral science techniques and best practices from a variety of industries, our unique process will yield both high adoption and long term satisfaction rates.

In sum, any ROI on your "health insurance spend" requires the employees to appreciate what you give them, and the only way they can achieve that is to first understand the benefits themselves. Remember that employees assign the total value of an employer provided benefit not the employer. And that valuation process goes well beyond dollars and cents.

That said, here are some of the key messages embedded in this book that we know you as employers want your employees to embrace:

  • Understand that we are all in the same "claims boat" together.
  • Take control of your finances and your health by taking personal responsibility.
  • Huge changes are happening in the healthcare marketplace and you need to understand how to work in this new world.

Industry Power Users

Examples include but are not limited to:
  • Technology Companies that provide exchange infrastructure
  • Financial Institutions committed to the Health Savings Account industry
  • Enrollment Companies
  • Voluntary Benefits Companies
  • Insurance Companies
  • Wellness Companies
  • Health Population Management Providers

Over the past 10 years we collective learned as an industry that in order to get a long term ROI on consumer driven plans like H.S.A's, it is critical that some level of behavior change happen within the employee population that chooses these plans. Otherwise the plans are being selected only because they are less expensive, which is an incomplete and unsustainable reason for choosing them. Behavior change in this case is really defined as employee "engagement" &ndash i.e. participation, and personal responsibility. Consumer engagement is the best predictor of ROI for anyone in the industry. Driving engagement is what Smart Patient Academy (SPA) was created to do.

In addition, we see a huge demand to create a long term relationship with the end consumer. That relationship or "stickiness factor" for any industry power user is not achieved simply via an insurance sales transaction process. A human and emotional element is necessary to drive action, long term sustainability and relationships. Creating and understanding the human experience in healthcare is the necessary antidote to commoditization of product and delivery systems. How we get there is only through an in-depth knowledge of behavioral economics as applied to health insurance marketplace.

We have also learned from other industry how to measure the magnitude of change required by an organization looking to drive the engagement message. In some organizations this change is easy and in others it is much harder. I would describe this as a scale that measures the level of entitlement mentality that employees apply to their health plans. Other industries are a good 30 years ahead of the benefits industry in terms of driving large scale corporate behavior change. SPA has literally repurposed proven technology in other fields to drives behavior change for health plans. We can also use their a proven assessment process that precedes the roll-out of consumer driven plans that will predict the level of change and what to target within an organization

In addition to our trademark large employer process called the Total Employee Engagement Blueprint, SPA has a wide range of multi-media and communications capabilities that can be customized to any "power user" circumstance.

What is an example of what we can do for you? Here is one idea:

The Essential Smart Patient Smart Money -"Mini Book":)

(Private Labeled for Bulk Use)

Imagine a branded mini-book which engages your target audience with relevant and digestible content. Smart Patient Academy will customize a 32 page Mini book for you with customizable content that matches your target market and the specific problems your audience needs to tackle. The Essential Smart Patient Smart Money can be in both an EBook or paperback format. It can also include embedded QR codes that link to video shorts customizable to your audience.

Please contact Smart Patient Academy for more details

Wingman Training: Train the Trainers

At Smart Patient Academy we are experts in training consumers how to extract the maximum value out of the healthcare system. This is a much broader concept than simply doing annual product training. Consumer driven healthcare plans must be modeled from the top-down and that requires that key people in your organization know how to use the insurance and can train others. These internal leaders in your organization become the Wingmen to others.

Here is sample of how some of the narrative and training would begin:

Consumer driven plans are just a new way of saying that we're now going to apply all the simple, common-sense rules of frugal shopping to the world of healthcare. When shopping for food, cars, appliances, and electronics, what do we do?

  • We shop for both quality and price
  • We know the cost of something before we buy it
  • We take control of our wallets
  • We ask a lot of questions
  • We negotiate

If you've been introduced to a consumer driven plan, are trying to learn if it's right for you, or are hearing about it for the first time, you're in the right place! And even if you don't have a classic consumer driven health plan like an HSA, you'll still want to pay attention, because any health plan where you incur a large deductible expense is a big incentive to become a Smart Patient. In short, all the same principles will apply.

We as consumers are caught in a financial Twilight Zone, which has become a tug-of-war between government-controlled healthcare pricing and free-market forces battling it out for our money. It's not a conflict we become aware of until we have a big medical bill or an insurance policy that puts our money at risk up front. Then, and only then, do we tend to pay attention.


Costs drive our behavior. It's human nature to be more careful with our own money than we are with somebody else's. When our own hard-earned dollars are at stake, we tend to be a lot more cost conscious. When enough people become cost-conscious consumers, the prices for everybody go down. At the end of the day, it's only through the process of healthcare consumers flexing their muscles that the cost of care will decrease. The government is not coming to the rescue; it's you and I demanding change as consumers. Collectively, we have power!

Health insurance policies that adopt this "skin-in-the-game" philosophy are called "consumer driven." Any plan where you have to deal with lots of out-of-pocket cost requires you to be a good consumer. Why? Because you care about where the money goes. That said, there is a new generation of product:


Health Savings Accounts
High-deductible health plans that are attached to bank accounts.
We call them HSA plans for short.

Why would I want an HSA?

HSAs and other consumer driven insurance plans are quite different for most of us who have been in HMOs or rich "copay plans" that cover every sniffle. But here's the benefit:

Consumer Driven Plans are first and foremost Less Expensive. In addition, they put Responsibility and Control back in our hands.

How much less expensive? These plans can cost 30% less than traditional plans– 30% less! (and that could be the amount of a car payment for some of you!) Also, the rate of increase on these plans year after year is lower and less rapid as well, so our employer is going to promote these plans, too.

money knocks


How you think is key.

Why are these qualities important to you?

They allow you to:

  • Recognize a threat to your wallet exists
  • Take responsibility for your own health and finances
  • Use common sense and do your homework
  • Become your own best advocate
  • Form a team with those who can help you navigate the system

If you're not sure you're ready for all this, don't worry. By the time you graduate from Smart Patient Academy, you'll have the tools you need to be an empowered and educated healthcare consumer. And the best part is, I'm going to make it easy.

Here's to your health– both physical and financial.


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