Ramesh Kumar of zakipoint Health on Podcasting, Innovation, and the Future of the Industry

The HCAA Executive Forum 2025 has been a hub of thought leadership and in-depth discussions on the future of self-funding. In this special interview series, John Lynn, Founder and Chief Editor of Healthcare IT Today, spoke with key industry leaders to explore the biggest challenges and opportunities in self funding today.

Previously, Rachel Strauss of PBM Princess shared insights on education, advocacy, and the evolving role of pharmacy benefits in self-funding. Now, we turn to Ramesh Kumar, CEO and Co-founder of zakipoint Health, to explore how podcasting has become a powerful platform for knowledge-sharing in self-funding and what trends are shaping the industry’s future.

The Power of Connection in Self-Funding

Ramesh has long been passionate about bringing transparency and engagement to healthcare, particularly in the self-funding space. His company, zakipoint Health, is focused on providing tools that enhance price transparency, navigation, and personalization of healthcare benefits.

“I see myself as an entrepreneur,” Ramesh shared. “We started zakipoint Health to tackle the massive issue of price transparency—because, honestly, most of us have no idea what healthcare services really cost.”

Beyond his work with zakipoint Health, Ramesh has extended his impact by partnering with HCAA to launch Voices of Self Funding, a podcast that has become a key resource for industry professionals seeking insight and discussion on major trends.

Why Podcasting Matters in Self-Funding

Podcasting has emerged as an influential tool for education and industry engagement. Ramesh sees Voices of Self Funding as more than just a discussion forum—it’s an opportunity to highlight the voices of brokers, TPAs, and other key players shaping the industry.

“The goal is simple: create an engaging space where professionals can share ideas, real-world challenges, and solutions,” he explained. “It’s not just about discussing trends; it’s about helping listeners walk away with tangible takeaways they can apply in their own businesses.”

What’s Trending in Self-Funding?

With numerous guests on the podcast, Ramesh has noticed several recurring themes that have dominated conversations in recent months. Among them:

• Cost containment strategies – How TPAs and brokers are navigating rising healthcare costs, particularly around high-cost claims and specialty medications.
• Mental health and behavioral health integration – Employers are increasingly prioritizing access to mental health services, and the industry is adapting to meet these needs.
• AI and automation in claims management – Leveraging AI to streamline processes, enhance efficiency, and reduce administrative burdens.
• Regulatory shifts and price transparency mandates – How new legislation is impacting self-funding and what it means for plan sponsors.

“These are the critical conversations shaping self-funding,” Ramesh said. “The more we talk about them and share knowledge, the better positioned the industry will be to tackle them effectively.”

The Expanding Audience for Self-Funding Conversations

While originally geared toward TPAs, Voices of Self Funding has gained a much broader audience, including brokers, employers, and even investors looking to understand where the industry is headed.

“We’ve seen growing interest from equity investors who want to understand self-funding better,” Ramesh noted. “That tells me that the industry is becoming more dynamic and attracting attention from all corners.”

Memorable Podcast Moments

Ramesh reflected on some standout episodes that have had a lasting impact on listeners.

“One of the most fascinating discussions we had was a debate between two CEOs on cost containment. It was an insightful back-and-forth that really showcased different perspectives on tackling rising costs,” he said. “Another great conversation was with Dr. Martin Makary on price transparency and the ways hospitals are responding to new regulations. These types of discussions really move the needle in terms of education and awareness.”

Looking Ahead: What’s Next for Self-Funding?

As self-funding continues to evolve, Ramesh sees several major themes taking center stage in the coming years:

• The growing impact of AI – From member engagement to claims processing, AI-driven tools are set to revolutionize how TPAs and brokers operate.
• More direct employer-provider contracting – Employers are looking for new ways to manage healthcare costs, and direct partnerships with providers could play a key role.
• Regulatory changes driving innovation – With price transparency and fiduciary rules evolving, businesses will need to stay agile to remain compliant and competitive.
• Explosion of point solutions – Employers and brokers should be selecting, integrating, tracking, and promoting point solutions like specialty meds and digital health products for a unified member experience.

“There’s a lot happening, and it’s an exciting time for the industry,” Ramesh said. “The key is staying informed and engaged—whether it’s through conferences, industry groups, or, of course, podcasts.”

Final Thoughts

Ramesh closed by encouraging self-funding professionals to continue learning and sharing knowledge.

“This industry thrives on connection and collaboration. Whether it’s through HCAA University, the CSFS program, or podcasts like Voices of Self Funding, the more we engage, the better we all become at delivering value.”

As the self-funding landscape continues to shift, leaders like Ramesh Kumar are helping to drive meaningful conversations that push the industry forward. Stay tuned for more insights from Executive Forum’s Leadership Series, featuring top voices in self-funding and healthcare innovation.

The HCAA Executive Forum 2025 continued its deep dive into self-funding’s most pressing topics through a series of interviews with industry leaders. In this ongoing series, John Lynn, Founder and Chief Editor of Healthcare IT Today, sat down with top experts to uncover insights shaping the future of self-funding.

Previously, Julie Wohlstein of Centrix Benefit Administrators discussed the evolution of self-funding, the importance of continuous learning, and how HCAA serves as a catalyst for industry collaboration. Now, we shift focus to Rachel Strauss, Founder of PBM Princess, to discuss how advocacy, education, and networking are shaping the self-funding space.

Building a Career in Pharmacy Benefits

Rachel has spent over two decades in the pharmacy benefits space, making a name for herself as an industry advocate and educator. Her passion for the field even led to the creation of her company, PBMP, where she focuses on education, advocacy, and finding innovative solutions in pharmacy benefits.

“I once got introduced at an event as the ‘PBM Princess,’” Rachel said with a laugh. “Instead of rejecting it, I embraced it because I truly am passionate about this space and the work we do.”

HCAA University: A Gateway to Industry Knowledge

The launch of HCAA University promises to play a critical role in the professional journeys of many self funding experts and newcomers to the field.

“We all tend to work in silos,” she explained. “Unless you're one of the architects of a health plan, it’s easy to stay focused on just your piece of the puzzle. HCAA University helps broaden that view and allows professionals to see how their role fits into the bigger picture.”

Rachel highlighted that HCAA University is particularly beneficial for those entering the industry or transitioning into self-funding. “It’s an invaluable tool for professionals looking to upskill and understand the ecosystem beyond their niche.”

CSFS Certification: Removing Barriers to Access

Rachel has long been a supporter of the Certified Self-Funding Specialist (CSFS) program, though she admitted that time constraints had kept her from completing it in the past.

“For years, I’ve wanted to go through the certification process, but there was always something in the way,” she said. “Now, with the digital updates, it’s more accessible than ever, and I have no excuse not to do it.”

She sees the updates as a game-changer for professionals looking to deepen their industry knowledge without disrupting their busy schedules.

Why HCAA Membership and Conferences Matter

HCAA has been a cornerstone of Rachel’s career, offering a supportive and collaborative environment where professionals can grow.

“What sets HCAA apart is its inclusivity,” Rachel said. “Even when I was new to the organization, they found ways to get me involved. Whether through committees, networking events, or mentorship, there’s a real effort to welcome and integrate new voices.”

She also emphasized that HCAA events go beyond just networking. “At many conferences, people show up to collect business cards. But at HCAA, it’s about education and meaningful discussions that help advance the industry.”

Pharmacy Benefits and the Regulatory Landscape

One of the most exciting trends in the industry, according to Rachel, is the increased focus on pharmacy benefit management (PBM) regulation.

“For years, I’d tell people I worked in pharmacy benefits, and they had no idea what a PBM was,” she said. “Now, with new legislation and regulatory attention, PBMs are finally part of the national healthcare conversation.”

She sees this as an opportunity to drive meaningful change and improve cost transparency, patient access, and plan sustainability.

Looking to the Future

Rachel is optimistic about the future of self-funding and believes that continued education and advocacy will be critical to the industry’s evolution.

“The more we educate ourselves and advocate for change, the better the outcomes will be—not just for employers and plan sponsors, but for the members who rely on these benefits.”

She encourages professionals to take full advantage of resources like HCAA University, CSFS certification, and industry events to stay ahead of the curve.

Final Thoughts

Rachel closed by reiterating the importance of community and education in self-funding.

“HCAA has been an incredible resource, and I encourage anyone in this industry to get involved. Whether you're new to self-funding or a seasoned professional, there’s always something to learn and someone to connect with.”

Stay tuned for the next installment in our Executive Forum’s Leadership Series, featuring another leading voice in self-funding.

The HCAA Executive Forum 2025 brought together some of the most respected voices in self-funding, offering a platform to discuss the industry's challenges, innovations, and opportunities. In this special interview series, John Lynn, Founder and Chief Editor of Healthcare IT Today, sat down with four leaders in self-funding to explore the issues shaping the industry today.

In our previous installment, Caryn Rasnick shared insights into HCAA University, the importance of the Certified Self-Funding Specialist (CSFS) designation, and how education is shaping the future of self-funding. Now, we turn our attention to Julie Wohlstein, MAS, CSFS, President and CEO of Centrix Benefit Administrators, to discuss the evolving landscape of self-funding, the role of continuous learning, and how HCAA serves as a catalyst for industry collaboration.

A Career Rooted in Healthcare Leadership

Julie brings more than four decades of experience to the table, having worked on both the TPA and brokerage sides of the industry. Her background in gerontology and a master’s degree in leadership of healthcare organizations give her a broad and well-rounded perspective.

"I’ve been in the industry for 43 years," Julie explained. "I started in gerontology, so I’ve always been in healthcare in some form. Being on both the TPA and brokerage sides has given me a deep understanding of the intricacies of self-funding."

HCAA University: A Critical Tool for Onboarding and Upskilling

One of the major challenges facing self-funding organizations today is ensuring that new hires—many of whom come from outside the industry—gain the necessary foundational knowledge. Julie sees the newly unveiled HCAA University as a key resource in this effort.

"I employ new hires from a variety of industries," she shared. "You can teach a skill set, but you can’t teach extreme ownership and accountability. HCAA University gives new employees the foundational tools they need to understand self-funding and contribute meaningfully to their organizations."

Julie emphasized that onboarding and upskilling employees efficiently is critical for business success. "This industry is complex, and the ability to quickly orient new professionals ensures they have the best chance for success in their roles."

CSFS Certification: A Deeper Understanding of Self-Funding

For Julie, earning her Certified Self-Funding Specialist (CSFS) designation was about more than professional development—it was about deepening her expertise to better serve clients and employees.

"Self-funding is highly specialized. The more you understand the different components—risk transfer, actuarial science, and compliance—the better you can serve your clients. The CSFS designation gave me a comprehensive understanding of the entire ecosystem."

The CSFS certification has evolved significantly over the years, incorporating regulatory updates and digital enhancements. Julie highlighted the importance of HCAA’s commitment to continuous updates, ensuring that certification holders remain at the forefront of industry changes.

The Value of HCAA Membership and Conferences

For Julie, HCAA is more than an association—it’s a lifeline that keeps industry professionals connected and informed.

"HCAA provides a wealth of resources that allow me to keep up with the latest regulatory and compliance requirements. There’s so much complexity in administering self-funded plans, and HCAA ensures that I have access to the latest insights and best practices."

Beyond compliance, Julie values the networking and collaboration opportunities that HCAA fosters. "The industry is evolving, and we’re seeing a shift where brokers are approaching TPAs with vendor partnerships instead of the other way around. That dynamic makes events like the HCAA Executive Forum even more critical for fostering connections and learning from industry leaders."

She also highlighted the collegial atmosphere of HCAA, noting that it feels like a family-oriented association where members can engage openly, ask questions, and share knowledge without hesitation.

Embracing AI and Innovation in Self-Funding

Looking ahead, Julie is most excited about how artificial intelligence (AI) and automation will reshape self-funding. "I’m not a tech person—I’m a people person," she admitted. "But I recognize how AI can improve administrative efficiency, workflow automation, and client engagement."

She sees AI as a powerful tool for reducing administrative burden and allowing professionals to focus on high-value decision-making. "The ability to leverage AI for claims processing, compliance monitoring, and data analysis will allow us to be more proactive and strategic in serving self-funded clients."

Final Thoughts

Julie closed with a reflection on the importance of continuous learning and industry engagement. "The self-funding industry is constantly evolving. Whether it’s through HCAA University, CSFS certification, or industry conferences, staying informed is essential for success."

For professionals looking to deepen their expertise and expand their network, HCAA remains an invaluable resource. As the industry faces new technological, regulatory, and market-driven challenges, the ability to adapt and collaborate will be key.

Stay tuned for the next installment in our Executive Forum’s Leadership Series, featuring another leading voice in self-funding.

As we look ahead to the next 12–24 months, the healthcare landscape is poised for significant changes driven by both political and economic forces. With a new administration in office, the stage is set for a series of regulatory shifts and market adjustments that will impact every corner of the healthcare industry. Understanding the historical context and anticipating the administration’s strategic priorities will be key to positioning ourselves for success in this evolving environment.

During his last term, President Trump made significant changes in the healthcare space.  These included No Gag Clause provisions, hospital price transparency and shoppable tools, the No Surprise Act, RxDC reporting requirements, Qualifying Payment Amount and Independent Review Processes as part of the price transparency initiative, MRF requirements, privatization of healthcare through the expansion of Medicare Advantage Plans, and expansion of Associated Health Plans. 

In addition to this, the unemployment rates (pre-Covid) were the lowest they had been in generations.  This created more competition within our industry to snag any talent with any training or industry knowledge.  In doing so, wages for roles like account managers, eligibility specialists, and claims examiners skyrocketed.  Furthermore, most TPAs were not equipped with the appropriate resources (technology or human) to address the legislative requirements.

Now, we need to factor in RFK Jr. who is a strong advocate for reversing the chronic disease epidemic in our country.  He will be eager to prove his hypothesis here using data and science.  He believes that the industry has too much influence and will likely stay focused on PBM regulations, disease management mandates, wellness incentives, and removal of vaccine mandates.

Given what we know, what should we expect from this administration?

• Expansion of price transparency regulations. Trump believes healthcare requires price tags just like any other item we purchase to create competition, reduce prices, and improve quality. In fact, on February 25, 2025, he signed an Executive Order to further the goal of price transparency. This Order aims to move from price estimates to Actual Prices and indicates action may be taken to make ricing comparable between hospitals and insurers. Could this be the beginning of the end for the hospital charge master as we know it?
• Expansion of No Surprise Act to include an increase in the dollar threshold that can be reported to credit agencies which will increase the number of Open Negotiations and Independent Reviews. There is significant uncertainty around how the increased number may be managed given the cuts to government spending. However, I would not expect this to stop the momentum. A combination of increased dollar thresholds or no dollar thresholds along with the expansion of price transparency will serve to meet a significant portion of his stated goals.
• Continued efforts to privatize the healthcare sector. This could include further expansion of Medicare Advantage Plans.
• Expansion of the regulations for Associated Health Plans.
• Heavy focus on expanding the RxDC reporting requirements in an effort to regulate pharmaceutical pricing.
• Less likely but possible given leaning of RFK Jr. – Disease Management Mandates. I would expect this to come in the form of a requirement to report based on chronic disease state. Similar to MRF requirements but leaning toward demographic data, diagnostic data, and geographic data.
• RFK Jr. has historically been vocal in his opinion of GLP-1s.This “new” weight loss remedy likely has a pretty big target on its back.
• Removal of gender affirming care requirements for minors.
• Federal subsidy for in vitro fertilization.
• Increase to minimum wage and significant reduction in unemployment numbers.

If there is one thing that we know about this administration, it is packed full of people who do hesitate to act.  The economy will remain at the forefront of the discussion, but we are not likely to see a reprieve from significant changes to the healthcare sector.  We certainly have some challenges ahead but should not lose sight of the significant opportunities these changes may create for our industry.  What can we do to prepare ourselves to be in a position to take full advantage of the possible opportunities? 

Here is some food for thought:  

• Shore Up Your Processes on Existing Reporting Requirements Now. The first several rounds in transparency regulations created a very heavy burden for the industry. TPAs were often ill equipped to gather the information required from their systems and did not have the technical capabilities to report the information within the scope of the regulations. RxDC reporting was particularly difficult and is still being pieced together between the TPA and the PBM in many instances. This second round of transparency will have a heavier focus on pharmacy data and actual costs. It is even probable that we may see the addition of diagnostic reporting requirements.
• Open Negotiations and Independent Reviews will increase. Currently, many in our industry have not given full consideration to how they track and report on open negotiations. This means that many TPAs are not doing nearly enough to defend the allowable charge. As a result of this, most IDRs rule in favor of the provider. This fact alone will likely be ammo used by the opposition to indicate that hospital pricing is not excessive. The new administration is not likely to accept this at face value. We should expect that this will come to light and garner significant scrutiny. Any administrator who is not conducting the open negotiations or independent reviews at the highest level may find themselves in hot water very quickly. The administration will be looking for fraud, waste, and abuse here. Make sure that you have created criteria and processes on open negotiation based on bill type that can be followed and documented. This will allow an administrator to prove that they followed a clear and clean process for defending the amount paid.
• Under his first term, Trump brought monthly premiums for Medicare Advantage to the lowest they had been in 13 years. He credits this, in large part, to expanding these plans in the private sector, creating more plan options and better pricing. These same premiums have increased back up to where they were 8 years ago. There may be significant opportunities to offer and administer these plans in the coming months.
• Expansion of Associated Health Plans similar to MEWAs but with a lot less regulation and a lot more flexibility. This will allow for multiple employers to join together under an association to achieve the same buying power as larger employers.
• Document All Institutional Knowledge and Processes. Increases in minimum wage and lower unemployment rates created disruption in our industry during his last term. Luckily, the increased opportunities and reduction of taxes helped offset this.The TPA industry is a pretty small bubble. We have a finite number of people who have been working in the industry for 5+ years. Those people, particularly in claims, eligibility, and account management, will remain in high demand. This will become more difficult given that those people with 5+ years of experience are largely over the age of 50 right now. We are in an industry in which experienced claims examiners, enrollment specialists, and account managers are becoming difficult to find and even more difficult to keep. For example, the average salary for a medical claims examiner in 2018 was showing around $47,523.Compare that to the average salary for this same position in 2023 which is listed at $75,050.

The next two years promise to be pivotal for the healthcare industry, with increased regulation, shifting market dynamics, and evolving political priorities shaping the path forward. While these changes present undeniable challenges, they also open the door to new opportunities for those prepared to adapt. By strengthening internal processes, staying ahead of reporting requirements, and anticipating regulatory shifts, industry leaders can position themselves to thrive in a rapidly changing landscape. Now is the time to prepare, strategize, and seize the opportunities that lie ahead.

This installment features Caryn Rasnick, CSFS, CEBS as she shares insights into HCAA University, the importance of the Certified Self-Funding Specialist (CSFS) designation, and how the self-funding industry is evolving.

A Legacy in Self-Funding

Caryn’s connection to the industry runs deep—her father, Steve Rasnick, was a pioneer in self-funding and a former president of HCAA.

“I got involved when I was 13,” Caryn shared. “I am officially 56 years old, so I’ve been in the industry for a very long time. I’ve had the unique experience of learning from the ground up, which gives me a passion for watching this industry evolve.”

The industry has changed significantly over the years, particularly in the areas of regulatory oversight and compliance. “The amount of regulatory oversight and compliance requirements we deal with today is a major shift,” Caryn explained. “But beyond that, the way technology has influenced claim processing, auditing, and member engagement has been a game-changer. It’s a much more complex landscape than when I first started.”

HCAA University: Addressing a Critical Industry Need

HCAA University was developed just recently by the HCAA to meet a major educational gap in the industry. “New hires entering the self-funding space often don’t have any idea what a TPA is or how self-insurance works,” Caryn said. “We needed an entry-level program to give them a foundational understanding of the industry.”

The digital rollout of program is extremely accessible to newcomers. “With this intuitive format, the platform is easier than ever for learners to access. It provides a structured introduction to self-funding, so new employees can understand how they fit into the bigger picture of their employer’s healthcare strategy.”

CSFS Certification: Elevating Industry Credibility

The Certified Self-Funding Specialist (CSFS) certification has also played a major role in professional development. “As a CSFS, I have an extra level of credibility when speaking with brokers and clients,” Caryn explained. “Back when we first launched the Emerging Leaders Program, CSFS certification was a requirement. But I didn’t fully appreciate its value until I was in my mid-40s and realized how much it enhanced my confidence and professional standing.”

The CSFS program has been modernized with digital resources and is now reviewed on a biannual basis to stay current with industry changes. “The regulatory environment, funding models, and compliance requirements are constantly shifting. We’ve committed to keeping the CSFS program updated so that professionals stay informed and ahead of the curve,” she said.

Why HCAA Membership and Conferences Matter

HCAA membership and conferences like the Executive Forum provide a crucial platform for education and networking. “HCAA is the educational arm of the self-funding industry,” Caryn said. “It helps professionals stay on top of compliance changes, plan design strategies, and best practices. These conferences are an incredible opportunity to build relationships and learn from others who are dealing with the same challenges.”

The industry has also seen a shift in dynamics, with brokers now approaching TPAs with vendor partnerships rather than the other way around. “That shift makes it even more important for brokers, TPAs, and vendors to collaborate at conferences like this. It’s how we find best-in-class partners and stay competitive.”

AI and the Future of Self-Funding

One of the most exciting trends in self-funding is AI and automation. “As much as we focus on high-level industry trends, the success of a TPA still comes down to getting the basics right—processing claims correctly, answering phones properly, and ensuring a positive member experience,” Caryn said. “That’s where AI can make a huge impact. If we can leverage automation for routine tasks, we free up people to focus on higher-value work that requires critical thinking.”

AI’s role in compliance and auditing is particularly exciting. “If we use AI to automate regulatory compliance and claims audits, we can improve efficiency and accuracy while allowing human talent to focus on strategic decision-making. It’s an exciting time for the industry.”

Final Thoughts

As the conversation wrapped up, Caryn emphasized the importance of ongoing education and industry engagement.

“For those looking to stay ahead in self-funding, HCAA University and CSFS certification offer invaluable tools for professional growth. And with AI and automation poised to reshape the industry, there has never been a more important time to stay informed.”

Stay tuned for the next installment in our Executive Forum’s Leadership Series, featuring another leading voice in self-funding.