Podcasts

Navigating Healthcare with CareGuides: A Conversation with Kristin Conti

Mike Rankin and Kristin Conti discuss how CareGuides is making healthcare more accessible by helping employees navigate the system, manage chronic conditions, and take control of their health.

In this episode of Relational Intelligence, Mike Rankin sits down with Kristin Conti, a family nurse practitioner and Program Director of CareGuides, to discuss how CareGuides is transforming the patient experience. With healthcare becoming increasingly complex, many employees struggle to navigate insurance claims, get enough time with their doctors, or fully understand their treatment plans. Kristin shares how CareGuides provides personalized healthcare navigation, coaching, and advocacy, helping individuals optimize their health, manage chronic conditions, and make informed decisions about their care. From tackling insurance claim denials to using food as medicine, this conversation sheds light on how small changes can create lasting health improvements.

Clips

The Challenges of Navigating Healthcare

Time: 1:35

Kristin Conti explains how limited doctor visits and insurance hurdles create barriers for patients seeking quality care.

How CareGuides Supports Patients Beyond the Doctor’s Office

Time: 4:45

From care navigation to chronic condition management, Kristin details how CareGuides helps individuals make informed health decisions.

The Role of Nutrition, Lifestyle, and Holistic Health in Patient Care

Time: 10:43

Kristin shares insights on using food as medicine, managing metabolic syndrome, and improving long-term health through lifestyle changes.

Claim Advocacy & How Employees Can Benefit from CareGuides

Time: 16:31

Kristin discusses how CareGuides helps employees resolve insurance claim issues and optimize their healthcare experience.

Transcript

Mike Rankin:
This is Mike with Relational Intelligence, and I have with me here today Kristin Conti of CareGuides. Kristin is a family nurse practitioner, and she’s here to talk to us today about her new project. So welcome, Kristin.

Kristin Conti:
Thank you, Mike.

Mike Rankin:
You’re welcome. How are you?

Kristin Conti:
I’m well, how are you today?

Mike Rankin:
I’m doing fantastic. So tell me a little bit about CareGuides. I guess I would maybe tee it up a little by saying that in my experience as a health insurance broker and advisor, what we’re experiencing with our clients and their employees is that an employer might be spending half a million, a million, or even two million dollars a year on health insurance premiums, and yet employees are having increasing difficulty navigating the healthcare system.

Whether it’s getting a claim approved from an insurance company or even just getting enough time with a doctor, it’s becoming a real challenge. So when we started talking about CareGuides, I thought, Wow, this is really powerful. But I’m not a practitioner. There’s only so much we can do on our end, and then there’s this opacity where I just can’t see beyond that. I’m really excited to hear about CareGuides, but maybe before we go there, just share a little bit about your background—how did you get into the field, and what’s your story?

Kristin Conti:
Yes, I’ve had similar experiences. I’ve been a nurse for almost 20 years. I started out in critical care and then for the last three years worked as a primary care provider for the Air Force.

Mike Rankin:
Thank you for your service.

Kristin Conti:
It was an honor. During that time, I think you see a lot of disparities that people are facing—even in your own clinic. Let’s say, for example, you come in, and we have 20 minutes from start to finish. That’s from the time you check in, to the time we take your vitals, ask you why you’re there, address your issue, put in the orders, and chart the note.

Mike Rankin:
Wow, that’s a lot.

Kristin Conti:
That’s a big ask in 20 minutes, and we’re all trying to do this because we have metrics and other factors—things that might determine, for example, in the civilian sector, whether or not you get reimbursed for the encounter. But it seems like it’s coming at the expense of the patient, right? You end up just using these quick checkboxes—How’s your sleep? How’s your diet? How’s your stress?—but you’re not really going into detail. And those details matter. I can write you a prescription, but really, the things that are going to change your life are lifestyle interventions—using food like medicine, talking about why you’re taking a prescription, or what your long-term health journey looks like. Because we don’t have time to discuss those things, there’s often a lack of understanding, which changes how engaged patients are and ultimately affects their overall health.

Mike Rankin:
Yeah, and it feels to me like we’ve reached a point where instead of Googling symptoms, people are just going straight to Instagram or social media to figure out what they need from their doctor.

Kristin Conti:
Yes!

Mike Rankin:
It almost feels symbiotic from a patient’s perspective—like, I don’t feel right, I have this symptom, I just want to get my prescription and leave.

Kristin Conti:
Yes.

Mike Rankin:
There’s this treadmill aspect of it. But I think there’s also growing awareness—at least in some popular media—that maybe we should be looking at things like food, sleep, alcohol intake, exercise, and all of those factors. But in that clinical environment, if I’m hearing you right, it’s almost impossible to get into that level of depth with a patient in a 20-minute appointment.

Kristin Conti:
It’s very hard to do. And if you have multiple issues you’d like to address, maybe it took you four to six weeks just to get that appointment, and now you’re faced with, Can I realistically address all of this in one visit? You don’t want to keep cutting someone off or deferring them out to a later date because those are priorities in their mind.

Mike Rankin:
Right.

Kristin Conti:
But to your point, we’re overly inundated with information, and we don’t always know how to use it to our advantage.

Mike Rankin:
Yes!

Kristin Conti:
What works for one person might not be right for someone else. So it’s our responsibility—not just to help people figure out what’s causing their issues—but to help them optimize the resources available to get what they need out of the healthcare system.

Mike Rankin:
So how do you envision CareGuides helping to solve that problem?

Kristin Conti:
Our primary focus is offering six different services.

One is care navigation—helping people determine when to get a second opinion, what to do after a diagnosis, or even something as simple as downloading their insurance app to understand what’s covered.

Then we offer personalized coaching. Instead of a long, 70-question survey, we ask things like, What are your healthcare goals? What would you like to share with me? How are you sleeping, eating, and exercising?

We also address preventative care, helping people stay healthy rather than waiting for them to get sick. And if they have chronic conditions, we focus on optimizing their care—because often, patients don’t fully understand why they’re on a particular medication or whether they need to be on it long-term.

Mike Rankin:
That’s a huge gap.

Kristin Conti:
Yes, and it’s where we can make a big impact.

We also provide holistic care, looking at the whole person—stress, work environment, barriers to exercise. It’s about meeting people where they are, rather than forcing generic recommendations that don’t fit into their lifestyle.

And finally, we offer claim advocacy, which helps patients when insurance claims are denied due to miscommunication between providers and insurers.

Mike Rankin:
Yeah, insurance claims are a nightmare sometimes.

Kristin Conti:
But because of the way it was coded, it looked like it was for a different condition, which is not the standard of care. So that part of the claim was denied. Yeah, so I think just making sure to go back through and figure out: okay, what condition do you have? Why was this recommended? What interventions have you done up until now? Would this be considered standard of care? What’s the likelihood of success if you have this intervention? Looking at the whole picture and figuring out where the breakdown in communication is—that’s generally the easiest way to solve that problem. Because our end goal is to get people the care they need. And I think that’s really everyone’s intention—whether it’s the caregiver, the insurance company, the surgeon, whomever it is.

Mike Rankin:
Yeah, and I think a lot of times—and I’m not defending the insurance industry here—but in many cases, it’s not just the insurance company’s fault. It might just be a miscommunication between the doctor’s office and the insurance company as to how something should be covered. And I think a lot of people might say, well, you should just cover everything. If the doctor writes it up, it should be covered. But you can’t do that. You can’t do that. I mean, really, it’s not realistic. Costs would go up like 40%—as a real practical number. So if we were to say, let’s cover everything no matter what, insurance premiums—which are already very expensive—would just skyrocket. And at the end of the day, those premiums are a direct reflection of claims activity and the underlying health of the population.

Kristin Conti:
Right.

Mike Rankin:
So if we want to try to chip away at ever-increasing healthcare costs, we really need to try to improve overall health. And that’s a big lift. We also have to be mindful of how we spend money. Not everybody needs an MRI. Because even if a test gives you a diagnosis, it’s not necessarily going to take away your pain or alleviate your symptoms. So I think we have to consider all these factors, and sometimes, offering a little education can go a long way.

The one thing that you said earlier really got me thinking—there are kind of two things that are on my mind in tandem. One is standard of care. And the other is liability and protection from lawsuits. And it strikes me that perhaps—I don’t know—but from your perspective, do you feel like there’s some level of medical activity that happens just to protect the doctor’s office or the hospital from potential lawsuits? Like, oh, I feel like I have this issue, so now we have to check all these boxes. Because if we don’t check those boxes, then we could be sued. We could be liable.

Kristin Conti:
Yes. That definitely happens. I think we’re all, to some degree, practicing defensively.

Mike Rankin:
Yeah.

Kristin Conti:
I wish that wasn’t the case. Because then you almost find yourself in a predicament where you’re ordering tests that wouldn’t normally be indicated, and you know you’re kind of going down a rabbit hole…But you have to do it—it’s kind of what they call CYA.

Mike Rankin:
Yes. And we do know what that stands for.

Kristin Conti:
Yes!

Mike Rankin:
Yeah. We’ll leave that one unspoken. (laughs)

Kristin Conti:
Right.

Mike Rankin:
So if we look into the future a little bit with CareGuides, what are some of the positive impacts that you hope to make on a broader scale over time?

Kristin Conti:
One thing I hope is that employees start to see that their employer purchasing CareGuides is an investment in them. It’s the employer saying, “We think of you as a priority, and we want you to be in a position to prioritize your own health.” Bigger picture, we want to drive down costs by making sure people truly understand their healthcare, are able to utilize it effectively, and optimize any treatment plans they’re currently participating in. We also want to introduce more education around lifestyle medicine—using food as medicine, making informed choices about supplements, and understanding that you don’t necessarily have to be sick in order to live better. Prevention is just as important.

Mike Rankin:
It’s amazing you say that because when I think about my morning ritual—right, I take my vitamin B, my fish oil, and my vitamin D. And as I’m taking those, I realize—I mean, I know what the label says, but I don’t really know the manufacturing process behind these supplements. They’re supposed to be good for me, I try to buy high quality, but I haven’t done the deep research. How does someone even go about making sure they have a supplement that’s actually high quality? Because supplements don’t go through an FDA approval process, right?

Kristin Conti:
Yeah, unfortunately, they don’t. When I say “they,” I mean general quality control studies—some independent organizations have done random testing where they take products off store shelves and analyze them. And they’ve found things like Prozac and even bits of crayons in over-the-counter supplements. What we forget is that, not only are supplements unregulated in many ways, but whatever else is being manufactured in that facility can end up in the product. That’s why looking for clean labels and gold-standard certifications is so important.

Mike Rankin:
Right.

Kristin Conti:
That’s one of the things we focus on with CareGuides—teaching people how to identify quality sources. What we used to say in the military was, “If the NCAA can take it, then so can you,” because they have strict drug testing standards. You don’t want to end up testing positive for something you never intended to take just because of cross-contamination in a supplement facility.

Mike Rankin:
Yeah, like your protein powder accidentally putting you on Prozac.

Kristin Conti:
Exactly.

Mike Rankin:
Although… I don’t know, maybe that would make fish oil even better! “Wow, I feel amazing today!”

Kristin Conti:
(laughs) Right?

Mike Rankin:
So let’s talk about the process. If I’m an employee and I get an email from CareGuides saying, “Hey, welcome, Mike, we’d like to invite you to do your wellness roadmap,” and I go through and fill it out—what happens next?

Kristin Conti:
From the participant’s perspective, they’ll receive a welcome email explaining who we are and what we offer. There’s a simple link that takes them to a brief survey, which helps us understand their healthcare goals, lifestyle, and any concerns they have. Once they submit the survey, I receive a notification. Then, I send a thank-you email with a second link, allowing them to book a one-on-one session with me. That’s the beginning of their CareGuides journey.

Mike Rankin:
Awesome, awesome. And then from there, it’s really dependent on what evolves in the conversation and what’s most relevant to them, right?

Kristin Conti:
Exactly. It really just depends on the individual.

Mike Rankin:
Well, hopefully, that’s exciting for you—to have the freedom to dig into real issues rather than just rushing through a typical clinical setting.

Kristin Conti:
Absolutely. It’s very exciting.

Mike Rankin:
Fantastic. Well, Kristin, thank you so much. This was really eye-opening, and I hope a lot of employees and participants get to experience it.

Kristin Conti:
Me too. Thank you for having me.

Mike Rankin:
Thank you for your time, Kristin.