Relentless Health Value

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Healthcare value, stripped of polite fiction.

The gist

Relentless Health Value is a brisk interview show about healthcare value, especially where contracts, incentives, networks, and prices quietly decide outcomes. It suits listeners who want plainspoken analysis of how money, care quality, and operational decisions collide.

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About Relentless Health Value

Relentless Health Value is a fast, practical show about the business side of American healthcare. Its center of gravity is value: who defines it, who pays for it, who proves it, and who gets away with pretending. Recent episodes spend a lot of time with plan sponsors, self-insured employers, unions, clinics, independent practices, specialists, and clinical leaders. That focus gives the show a buyer's-eye view of healthcare without losing sight of patients. Price transparency data is not treated as a compliance artifact. It becomes a way to compare rates, identify hidden friction, challenge assumptions, and ask why the same service can carry wildly different prices. The show is especially sharp when it talks about lazy networks. A network that includes everyone but guides no one is not allowed to hide behind comforting language. Advanced primary care gets similar treatment. The show separates meaningful risk management from short visits, thin referrals, and models that sound better than they work. Direct-to-employer specialty care brings another recurring concern into view: the distance between the people buying care and the physicians delivering it. Outcomes matter here. So do baseline measures, patient-reported results, comorbidities, payment models, and the operational effort required to prove quality instead of merely claiming it. Fraud and waste are handled with the same bluntness. Episodes on Medicare billing schemes and durable medical equipment show how stolen data, suspect claims, and downstream accounting can damage ACOs and independent practices. Infusion pricing becomes a vivid case study in the failure of normal market logic. The show is not breezy, but it is conversational. It explains acronyms, names the traps, and keeps asking what a better decision would look like next Tuesday. Guests bring the technical material. The framing turns that material into a usable map for people who need healthcare to work better, not just sound better.

Made for: The show is for healthcare executives, plan sponsors, benefits leaders, clinicians, entrepreneurs, patient advocates, and policy-minded operators who want the real mechanics behind value-based care. It especially suits listeners who are comfortable with finance, contracting, quality measurement, and delivery-system detail.

What sets it apart: Relentless Health Value stands out by connecting technical healthcare finance to practical buying and delivery decisions. It is less interested in broad reform slogans than in prices, contracts, incentives, quality proof, and the specific places where money and care stop lining up.

In their own words

American Healthcare Entrepreneurs and Execs you might want to know. Talking.Relentless Health Value is a weekly interview podcast hosted by Stacey Richter, a healthcare entrepreneur celebrating fifteen years in the business side of healthcare. This show is for leaders in pharma, devices, payers, providers, patient advocacy and healthcare business. It's for health industry innovators, entrepreneurs or wantrepreneurs or intrapreneurs. Relentless Healthcare Value is the show for you if you want to connect with others trying to manage the triple play: to provide healthcare value while being personally and professionally fulfilled.

As heard by us

Based on 6 episodes we listened to · September 2026

Stacey Richter turns healthcare's opaque prices, contracts, and incentives into practical scrutiny of who pays, who profits, and who can intervene.

Relentless Health Value follows healthcare money through the contracts, incentives, and intermediaries that determine what care costs. In interviews led by Stacey Richter, a startling bill or policy failure becomes the starting point for precise questions about who pays, who…

Read our full review in PlayNext →

Why you'd press play

A TPA's salesperson says yes; its lawyer says no. Stacey Richter wants you to catch the mismatch.

Press play if you want

  • to find out why a chemo infusion can cost $135 here and $13,560 down the street
  • to see what an employer can do with price transparency data besides admire the spreadsheet
Read the full recommendation in PlayNext →
price transparency dataself-insured employer strategyplan sponsor purchasingadvanced primary caredirect-to-employer specialty careprovider network qualityMedicare fraud and suspect billingdrug and infusion pricing

Talks about

Best episodes of Relentless Health Value

Short reviews from the PlayNext desk, based on the episodes we processed.

EP507: 4 Core Concepts to Buy or Deliver the Highest-Value Healthcare—A ReviewApr 16, 2026

A grounded review of how price, quality data, and transparency can reshape healthcare purchasing.

Healthcare value is usually framed as a quality problem, but this review gives the buying decision the same weight. It follows the case for employers and plan sponsors having provider quality data and prices in hand, including rates shown as a percentage of Medicare, before they…

EP503: Smart Collaboration With Direct-to-Employer Specialty Care, With Ryan Wells; Leo Spector, MD, MBA; and Adam StaviskyMar 12, 2026

Episode 503 maps the gap between employers and specialists, then drills into why measuring outcomes is hard but necessary.

Episode 503 of Relentless Health Value frames a familiar coordination problem: self-insured employers and the specialists who care for their members sit at opposite ends of a long, crowded roadway, while carriers, ASOs, TPAs, and large health systems fill the space between them.

EP502: How Some Pretty Wild Medicare Fraud Sabotages ACOs and Also Independent Practices and Could Cost Plan Sponsors Such as Self-insured Employers a Lot of Zeros Downstream, With Brian MachutMar 5, 2026

A Medicare fraud story that traces stolen data into catheter bills, ACO exposure, and CMS accounting.

Relentless Health Value traces a Medicare fraud scheme from stolen medical data into catheter claims, DME bills, and wound-care charges, showing how the fallout can reach ACOs, independent practices, and plan sponsors such as self-insured employers.

EP501: Speaking of Infusions, Do You Want to Pay $135 or Do You Want to Pay $13,560 for the Exact Same Drug? With Ivana Krajcinovic, PhDFeb 26, 2026

A pointed look at how healthcare networks can leave patients facing wildly different prices for the same infusion.

Healthcare pricing comes into focus through a stark pair of infusion bills: $135 at an independent practice and $13,560 at a hospital down the street for the same drug.

Take Two: EP398: Why Are Commercial Carrier Marketplaces Completely Boring? Maybe Because There Isn't a Marketplace, With Jacob Asher, MDFeb 19, 2026

A practical critique of why carrier choice can look like a market without creating real market pressure.

Commercial health-plan competition gets a skeptical, useful audit in this conversation with Jacob Asher, MD. The episode argues that carrier choice can look like a functioning marketplace while failing to create the pressure a real market would apply.

Podcasts like Relentless Health Value

Episodes

  1. 1

    EP478: Stop-Loss Coverage, Part 1: How It Goes Right, and How It Can Go Horribly Wrong, With Andreas Mang and Jon Camire

    ·32m
  2. 2

    EP504: A Back-to-Basics Roadmap Through the Perverse Incentives to Advanced Primary Care, With Ryan Jacobs

    ·34m
  3. 3

    Insights to Outwit the Hot Mess of the Non-Healthcare Market

    ·20m
  4. 4

    EP503: Smart Collaboration With Direct-to-Employer Specialty Care, With Ryan Wells; Leo Spector, MD, MBA; and Adam Stavisky

    ·46m
  5. 5

    EP502: How Some Pretty Wild Medicare Fraud Sabotages ACOs and Also Independent Practices and Could Cost Plan Sponsors Such as Self-insured Employers a Lot of Zeros Downstream, With Brian Machut

    ·39m
  6. 6

    EP501: Speaking of Infusions, Do You Want to Pay $135 or Do You Want to Pay $13,560 for the Exact Same Drug? With Ivana Krajcinovic, PhD

    ·40m
  7. 7

    Take Two: EP398: Why Are Commercial Carrier Marketplaces Completely Boring? Maybe Because There Isn't a Marketplace, With Jacob Asher, MD

    ·35m
  8. 8

    EP500: This Is Episode 500, and It's All About You, Tribe

    ·38m
  9. 9

    EP499: Self-insured Employers and Other Plan Sponsors Are Paying Millions for MSK (Musculoskeletal) Injuries That Would Have Healed Themselves, With Jay Kimmel, MD

    ·28m
  10. 10

    EP498: The Payment Integrity Arms Race—RCM (Revenue Cycle Management) and Plan Sponsors, With Mark Noel

    ·35m
  11. 11

    Take Two: EP341: The "Just Spend Everything You're Given" Trap—Lessons in True Provider Fiscal Discipline, With Gary Campbell

    ·37m
  12. 12

    EP497: What You Don't Know About Healthcare Transactions and Clearinghouses Could Cost You, With Zack Kanter

    ·38m
  13. 13

    EP496: Plan Sponsors Spend About $1.20 to Buy $1 of Healthcare, and Clinical Organizations Receive 80¢ for Every $1.20 Spent, With Mark Newman

    ·37m
  14. 14

    INBW45: Extremely Actionable Themes That We Covered Throughout 2025

    ·23m
  15. 15

    INBW44: The Relentless Health Value Themes That We Covered Throughout 2025—A Recap, Part 1

    ·24m
  16. 16

    Encore! EP450: When Your Health Plan Is $9 Million in the Hole, Who Are You Going to Call? A CPA. And Tell Them to Bring Their Spreadsheets, With Marilyn Bartlett, CPA, CMA, CFM, CGMA

    ·35m
  17. 17

    EP495: Wait … Flip That—A Crazy Revelation I Had About Trying to Fix U.S. Healthcare, With Mick Connors, MD

    ·33m
  18. 18

    EP494: Six Tensions of Pharmaceutical Drug Pricing, With Sarah Emond

    ·40m
  19. 19

    Bonus Add-on for EP494: Who Is ICER and What Is the Arms Race of Pharmaceutical Pricing That the Status Quo Has Created? With Sarah Emond

    ·12m
  20. 20

    INBW43: Five Baskets of Thank Yous to Hand Out, Along With a Plug for Big Demand Curve Energy

    ·17m
  21. 21

    Take Two: EP240: A Direct Contracted and Actually High-Value Network That Elizabeth Mitchell From PBGH Talked About, With Olivia Ross

    ·35m
  22. 22

    EP493: Revelations Mainstream CEOs Are Having About the Healthcare Market Right Now—Also, Some Advice, With John Quinn

    ·37m
  23. 23

    EP492: The Solutions Show: How to Run a High-Quality Hospital at 143% of Medicare, With Sam Flanders, MD, and Shane Cerone

    ·36m
  24. 24

    EP491: Incumbent TPAs and Consultants Getting Called to Jumbo Employer Client HQ to Answer Awkward Questions, With Elizabeth Mitchell

    ·50m
  25. 25

    EP490: The Problem Show: 3 Problematic Hospital Myths, Including "There Is a Healthcare Market," With Shane Cerone and Sam Flanders, MD

    ·36m
  26. 26

    EP489: MARGIN! Margin That Creates a Path to Mission at a Multispecialty Group, With Dan Greenleaf

    ·26m
  27. 27

    EP489: Achieving Mission That Is a Path to Margin at a Multispecialty Practice, With Dan Greenleaf

    ·32m
  28. 28

    EP488: Mark Cuban, Cora Opsahl, Trust, Simplicity, and a Chicken—Today We Talk Healthcare

    ·55m
  29. 29

    EP487 (Part 2): Kevin Lyons Shares What He Learned in Detective Training That He Uses to Follow the Healthcare Dollar

    ·14m
  30. 30

    EP486: The Secrets to Operationalizing Direct Contracting From an OG, With Stan Schwartz, MD

    ·38m
  31. 31

    EP485: Imaging Costs 6% to 11% of Plan Sponsor Spend: How Direct Contracting Can Save Money and Improve Access, With Cristin Dickerson, MD

    ·33m
  32. 32

    Take Two: EP436: Let's Talk About TPA and Health Plan Inertia Instead of Jumbo Employer Inertia, With Elizabeth Mitchell

    ·36m
  33. 33

    EP484: What Are the 3 Most Burning Questions That Plan Sponsors Have Right Now? With Dave Chase

    ·32m
  34. 34

    EP483 (Part 2): Reversing the Healthcare Flywheel to Contain Skyrocketing Healthcare Costs, With Jonathan Baran

    ·30m
  35. 35

    EP483 (Part 1): To Contain Skyrocketing Healthcare Costs or Renewals, You Gotta Understand How the Flywheel Works, With Jonathan Baran

    ·32m
  36. 36

    Bonus Add-on to EP483 (Part 1): Honoring Those in Healthcare Who Are Trying Every Day to Do the Right Thing, With Jonathan Baran

    ·9m
  37. 37

    How Margin Shoves Mission Off of the Bus: A Primary Care Case Study, With Stan Schwartz, MD—Summer Shorts

    ·19m
  38. 38

    EP482: 3 Surprising Ways Carriers Make Lots of Money—What Do Plan Sponsors and Clinical Organizations Really Need to Know? With Preston Alexander

    ·38m
  39. 39

    Take Two: EP445: What Does It Take for an Indie Primary Care Practice to Survive Right Now? With Tom X. Lee, MD

    ·46m
  40. 40

    Bonus Clip: Dr. Tom Lee Talks About Why Retail Clinics Are Not Doing So Well, in His Opinion

    ·7m
  41. 41

    EP481: Seriously, IRL, What Does "No Margin, No Mission" Even Mean? With Benjamin Schwartz, MD, MBA

    ·34m
  42. 42

    Take Two: EP438: Is It Mission and/or Margin? With John Lee, MD

    ·36m
  43. 43

    EP480: Payment Integrity Meets Health System Boasts, Such as Our Rates Are 2x Medicare, With Kimberly Carleson

    ·32m
  44. 44

    Pharma Rebates: A Few Nuances You May Not Have Thought Of, With Ann Lewandowski—Summer Shorts

    ·19m
  45. 45

    EP479: Part 2. What Could Go Wrong Covering High-Cost Claimants With Stop-Loss Reinsurance?

    ·27m
  46. 46

    Take Two: EP433: The Mystery of the Weekly Claims Wire, With Justin Leader

    ·39m
  47. 47

    EP477: Through Line Show: What the Tribe Thinks You Need to Know About Trust or It's Gonna Be a Problem. Also, Why You Are Smart, With Stacey Richter

    ·19m
  48. 48

    Bonus Add-on to EP477: How to Earn Trust, With Charles Green

    ·12m
  49. 49

    EP476: Talking Whistleblowing and the Pharma Rebates Whistleblower Case With an Actual Whistleblower, With Ann Lewandowski

    ·36m
  50. 50

    EP475: Is This a Moment or a Movement? With Peter Hayes

    ·34m
  51. 51

    EP474: Private Equity in Healthcare—The Big Data Points You Really Need to Know, All Together in One Episode, With Yashaswini Singh, PhD

    ·41m
  52. 52

    EP473: Keeping Patients out of the ER: How Trusted Relationships in Primary Care Should Work. A Take 2 With Kenny Cole, MD

    ·35m
  53. 53

    EP472: The Well-Honed, Three-Prong Hospital Playbook to Maximize Revenue From High-Cost Claimants, With Eric Bricker, MD

    ·35m
  54. 54

    EP470: Continuing the ER and Primary Care Through Line Over to Rural Hospitals and Healthcare, With Nikki King, DHA

    ·35m
  55. 55

    EP467: Connecting Sky-High ER Spend to Primary Care Access—Following the Dollar Through Carriers and Hospitals, With Stacey Richter

    ·23m
  56. 56

    EP466: What Is Rising Faster, Insurance Premiums or Hospital Prices? With Vivian Ho, PhD

    ·36m
  57. 57

    EP465: The Not Super Effective Contracting Industry Norm, Where Jumbo Plans and Others Wind Up Paying $10,000 for $50 Drugs, With Chris Crawford

    ·34m
  58. 58

    EP464: ER Visits Now 6% of Total Plan Spend. Is It Upcoding or What? With Al Lewis

    ·32m
  59. 59

    EP463: Medicare Advantage Policies—Which Will Stay and Which Will Go Now? With Betsy Seals

    ·35m
  60. 60

    Encore! EP384: How Shareholders Impact Carrier Behavior, Exactly and Specifically, With Wendell Potter

    ·35m
  61. 61

    EP462: Managing Populations of Whole, Actual People Who Are Not the Sum of a Bunch of Different Body Parts, With Scott Conard, MD

    ·34m
  62. 62

    INBW42: A Philosophical Rabbit Hole of Considerations for Plan Sponsors and Others

    ·28m
  63. 63

    EP461: Pick Only One, Plan Sponsors: Do You Want to Control GLP-1 Volume or Control GLP-1 Unit Cost? With Chris Crawford

    ·23m
  64. 64

    EP460: Rushika Fernandopulle, MD's Theory of Change Starts With Status Quo Healthcare

    ·41m
  65. 65

    EP459: Cost Containment by Co-Pay Maximizer or Co-Pay Accumulator: Points to Ponder, With Bill Sarraille

    ·40m
  66. 66

    INBW41: End-of-Year Wrap-Up and My Personal Charter Encore: Where the Rubber Hits the Road

    ·26m
  67. 67

    Encore! EP419: The Financialization of Health Benefits for Boards of Directors and C-Suites of Self-Insured Employers, With Andreas Mang

    ·39m
  68. 68

    EP458: A Really Unexpected Consideration for Solving Staffing Shortages That Impact Access and Care Quality That Is Based on a Ton of Evidence, With Komal Bajaj, MD

    ·37m
  69. 69

    EP457: It's a Big Thing: Medical Spread Pricing. So, Let's Talk About Contract Transparency, With Cynthia Fisher

    ·34m
  70. 70

    INBW40: Thank Yous and the Intersection of Product Value, Collaboration, and Being a "Giver"

    ·18m
  71. 71

    Encore! EP418: Mark Cuban With a PSA for CEOs and CFOs of Self-insured Employers, With Mark Cuban and Ferrin Williams, PharmD, MBA, From Scripta

    ·56m
  72. 72

    Encore! EP415: Some Jumbo Employers Buying Better Healthcare Outcomes While Saving 15% on Total Cost of Care, With Rob Andrews

    ·40m
  73. 73

    EP456: Advice to Pharma at the Intersection of Product Value, Reputation, and Patient Affordability, With Brian Reid

    ·40m
  74. 74

    EP455: A Leadership Blueprint for Measurably Better Care, With Beau Raymond, MD

    ·39m
  75. 75

    EP454: How the Particle v Epic Lawsuit Impacts Plan Sponsors and Public Health Trying to Get Data, With Brendan Keeler

    ·35m
  76. 76

    EP452: Fiduciary Duty vs the Healthcare Status Quo, With Cora Opsahl

    ·40m
  77. 77

    Spotlight Episode: Oncology Side Effect Management in the Real World, With Dan Nardi From Reimagine Care

    ·19m
  78. 78

    EP451: Hey, Let's Not Talk About Artificial Intelligence, With Spencer Dorn, MD, MPH, MHA

    ·13m
  79. 79

    EP449: For Clinical Leaders, Payers, and Plan Sponsors, Let's Talk About Blind Spots for Getting Patients or Members Appropriate Care, With Marty Makary, MD, MPH

    ·38m
  80. 80

    EP448 (Part 2): 340B: Why Employers Should Probably Care About What's Happening Here, With Shawn Gremminger

    ·26m
  81. 81

    EP448 (Part 1): 340B: Where It Started, Where It Is Now, and Who Is Really Benefiting From This Massive Program, With Shawn Gremminger

    ·38m
  82. 82

    The Euphemism That Has Become Value-Based Care, With Elizabeth Mitchell—Summer Shorts 9

    ·17m
  83. 83

    Encore! EP413: The Intersection of Healthcare Waste, Value-Based Care, and the Potential Rising Power of PCPs, With Will Shrank, MD

    ·35m
  84. 84

    Encore! EP402: What Physicians Trying to Clinically Integrate Care in the Real World Need to Know, With Amy Scanlan, MD

    ·33m
  85. 85

    EP447: Why an "EHR Strategy" Isn't Enough, With Ashleigh Gunter

    ·29m
  86. 86

    EP446: Hey, Let's Not Talk About EHRs, With Spencer Dorn, MD, MPH, MHA

    ·35m
  87. 87

    EP445: Can a Primary-Care-Only Practice Survive in 2024? With Tom X. Lee, MD

    ·48m
  88. 88

    Encore! EP397: The Minefield That Is a PBM Contract and Also Some Advice for EBCs Who Are Taking Money Under the Table, With Paul Holmes

    ·34m
  89. 89

    EP444: Two State Healthcare Laws Often Don't Go as Planned: CON and COPA, With Ann Kempski

    ·35m
  90. 90

    EP443: Let Us Never Pay the First Bill in Honor of Marshall Allen

    ·36m
  91. 91

    EP442: A Short Rumination on Saving Money, Except Not Saving Money. Oncology Side Effect Management as a Case Study, With Andreas Mang

    ·19m
  92. 92

    EP506: How Other Employers, Shareholders, and Clinics Are Using Price Transparency Data—And It's an Arms Race, With Jerry DiMaso

    ·36m
  93. 93

    EP505: The Death of the "What Is Value" Guessing Game for Clinical and Plan Decision-Makers Ready to Move On, With Ahilan Sivaganesan, MD

    ·44m
  94. 94

    EP487 (Part 1): A Former Police Detective Investigates the 3 Big Barriers to the Public Sector Getting Better Affordable Health Benefits, With Kevin Lyons

    A former police detective discusses the three major barriers preventing the public sector from obtaining better affordable health benefits in an interview with Kevin Lyons.

    ·31m
  95. 95

    EP469 (Part 1): The Impact on Plan Sponsors of Medicaid Cuts, With James Gelfand, JD

    This episode explores how Medicaid cuts and Medicare site-neutral payment changes impact plan sponsors, featuring an interview with James Gelfand, president of the ERISA Industry Committee.

    ·26m
  96. 96

    EP469 (Part 2): The Impact on Plan Sponsors of Medicare Site-Neutral Payments and HSA Reforms, With James Gelfand, JD

    This episode discusses the impact of Medicare site-neutral payments and HSA reforms on plan sponsors, featuring insights from James Gelfand on strategies and legislative updates.

    ·31m
  97. 97

    EP468: Very Common Assumptions That Aren't Actually True About Member Engagement and the Healthcare Industry, With Matt McQuide

    This episode discusses common misconceptions about member engagement in healthcare, emphasizing the critical role employers play in steering plan members toward quality, cost-effective care to counter the influence of health systems.

    ·35m
  98. 98

    EP471: High-Cost Claimants in 2025 and Beyond—What Is Really Expensive Not to Know? With Christine Hale, MD, MBA

    This episode discusses the importance of trust and proactive steering of high-cost claimants in American healthcare, featuring insights from Dr.

    ·35m
  99. 99

    EP450: When Your Health Plan Is $9 Million in the Hole, Who Are You Going to Call? A CPA. And Tell Them to Bring Their Spreadsheets, With Marilyn Bartlett, CPA, CGMA, CMA, CFM

    ·35m
  100. 100

    EP505: The Death of the "What Is Value" Guessing Game for Clinical and Plan Decision-Makers Ready to Move On, With Ahilan Sivaganesan, MD

    ·44m
  101. 101

    EP453: Running a TPA (Third-Party Administrator) RFP Process That Is Less of a Wild West Fiduciary Shootout, With Claire Brockbank

    Stacey Richter hosts Claire Brockbank from 32BJ to discuss how self-insured employers can take control of their TPA contracts.

    ·37m·3 clips
  102. 102

    EP506: How Other Employers, Shareholders, and Clinics Are Using Price Transparency Data—And It's an Arms Race, With Jerry DiMaso

    Host Stacey Richter interviews Jerry DeMasso, CEO of Payerset, about how price transparency data is being utilized in healthcare.

    ·36m·3 clips
  103. 103

    Slaying the Three-Headed Monster of Health Plan Networks, With Evan Anderson

    Sep 30, 2026·38m
  104. 104

    A Wildly Underappreciated Point: Overpaying for Infusions Means Overpaying for Stop-Loss Coverage, With Jake Velie and Keith Hartman, RPh

    Sep 23, 2026·38m
  105. 105

    How Stark Law, Stipends, and Noncompetes Drive Hospital Consolidation, With Eric Bricker, MD

    Sep 16, 2026·39m
  106. 106

    Private Equity in Primary Care: What the Data Actually Shows, With Yashaswini Singh, PhD. Episode 528.

    Sep 9, 2026·39m
  107. 107

    Why Should a Plan Sponsor Care About the 340B Charity Program? With Shawn Gremminger

    Sep 2, 2026·23m
  108. 108

    Mark Cuban and Cora Opsahl: The Truth About Pass-Through PBM Contracts and Generic Compliance Ratios

    Aug 26, 2026·20m
  109. 109

    PMPM vs FFS—The Perverse Incentives Plan Sponsors Sometimes Miss, With Cristin Dickerson, MD

    Aug 19, 2026·17m
  110. 110

    Beating Provider Network Pricing Games by Thinking About Buying Healthcare Like a Manufacturer Supply Chain, With John Quinn

    Aug 12, 2026·17m
  111. 111

    The Sleeping Giants of Healthcare—Why Self-insured Employers and Clinicians Keep Missing Each Other, With Suhas Gondi, MD, MBA. EP523

    Aug 5, 2026·35m
  112. 112

    How GoodRx Actually Makes Money: PBMs, Cash Prices, and Pharmacy Contracts, With Ge Bai, PhD, CPA (EP522)

    Jul 29, 2026·14m
  113. 113

    How Revenue Cycle Management (RCM) Became an Over $200 Billion Healthcare Hot Potato, With Andrew Tsang. EP512

    Jul 22, 2026·36m
  114. 114

    Cash-Pay Generic Drugs Are a Functioning Market in Healthcare—Policymakers Beware and Be Careful. EP520

    Jul 15, 2026·32m
  115. 115

    Cognitive Atrophy and Referral Incentives Breaking Primary Care, With Lisa Rosenbaum, MD (EP519)

    Jul 8, 2026·40m
  116. 116

    How Do You Explain the Difference Between an ASO Vendor and a TPA? With Claire Brockbank. Episode 518

    Jul 1, 2026·14m
  117. 117

    Prior Authorizations & Pharma Rebate Contracts — How Financial Motives Keep Generics Off Formularies (EP517)

    Jun 24, 2026·27m
  118. 118

    Cash Pay From the Pharma Manufacturer Point of View, With Ophelia Johnson

    Jun 17, 2026·44m
  119. 119

    Self-Insured Employers: SNF Fraud or Perverse Incentives? Understaffing, Gamed STAR Ratings, and Medicare Dollars at Skilled Nursing Facilities with Michelle Cera

    Jun 10, 2026·43m
  120. 120

    Successfully Suing a Health System for Their Anticompetitive Contracts and Also Collecting Damages for Plan Sponsors and Members, With Matt Cantor. EP514

    Jun 3, 2026·44m
  121. 121

    Revisiting Cunning Anticompetitive Hospital Contracts, With Brennan Bilberry - EP513

    May 27, 2026·36m
  122. 122

    3 Kinds of Broker/EBC Rent-Seeking Payment Models—A Lawyer's Perspective, With Doug Aldeen. EP512

    May 27, 2026·37m
  123. 123

    The Perverse Incentive Trap Hidden Inside Value-Based Care — and What to Do About It. EP512

    May 14, 2026·30m
  124. 124

    Why Employers Pay More Because of Vertically Integrated Medicare Advantage Carriers with Betsy Seals. EP510

    May 7, 2026·36m
  125. 125

    The 7.7% Wake-Up Call: A Roadmap to Align Finance Teams With Non-complacent Benefit Design, With Patrick Nelli. EP509

    Apr 30, 2026·38m
  126. 126

    Why Don't More Self-insured CEOs Take Bold Action in Health Benefits Strategy? With Lee Lewis. (EP508)

    Apr 23, 2026·44m
  127. 127

    EP507: 4 Core Concepts to Buy or Deliver the Highest-Value Healthcare—A Review

    Hidden gem

    Episode 507 is a review with a spine.

    Apr 16, 2026·34m·3 clips
  128. 128

    EP506: How Other Employers, Shareholders, and Clinics Are Using Price Transparency Data—And It's an Arms Race, With Jerry DiMaso

    This episode explores how self-insured employers and clinics are leveraging price transparency data to uncover hidden costs and gain competitive insights in healthcare.

    Apr 9, 2026·36m
  129. 129

    EP505: The Death of the "What Is Value" Guessing Game for Clinical and Plan Decision-Makers Ready to Move On, With Ahilan Sivaganesan, MD

    This episode discusses the 'operative value index' (OVI) as a mathematical framework to eliminate ambiguity in healthcare value assessment, helping clinical leaders and employers make data-driven decisions about high-value care.

    Apr 2, 2026·44m
  130. 130

    EP504: A Back-to-Basics Roadmap Through the Perverse Incentives to Advanced Primary Care, With Ryan Jacobs

    This episode explores advanced primary care (APC) as a proven healthcare strategy that improves patient outcomes and reduces costs, distinguishing it from inadequate models.

    Mar 26, 2026·34m
  131. 131

    Insights to Outwit the Hot Mess of the Non-Healthcare Market

    The host introduces a special episode highlighting listener feedback and insights on practical transformation in the non-healthcare market, focusing on execution over theory.

    Mar 19, 2026·20m
  132. 132

    EP503: Smart Collaboration With Direct-to-Employer Specialty Care, With Ryan Wells; Leo Spector, MD, MBA; and Adam Stavisky

    Hidden gem

    Episode 503 opens with a road map.

    Mar 12, 2026·46m·4 clips
  133. 133

    EP502: How Some Pretty Wild Medicare Fraud Sabotages ACOs and Also Independent Practices and Could Cost Plan Sponsors Such as Self-insured Employers a Lot of Zeros Downstream, With Brian Machut

    Hidden gem

    Brian Mahood follows a Medicare fraud scheme that begins with stolen medical data.

    Mar 5, 2026·39m·2 clips
  134. 134

    EP501: Speaking of Infusions, Do You Want to Pay $135 or Do You Want to Pay $13,560 for the Exact Same Drug? With Ivana Krajcinovic, PhD

    Hidden gem

    The host opens with a question about paying $135 or $13,560 for the same infusion drug.

    Feb 26, 2026·40m·2 clips
  135. 135

    Take Two: EP398: Why Are Commercial Carrier Marketplaces Completely Boring? Maybe Because There Isn't a Marketplace, With Jacob Asher, MD

    Hidden gem

    Relentless Health Value’s Stacey Richter and former health plan chief medical officer Jacob Asher, MD, examine why California’s commercial carrier rankings barely change over 14 years.

    Feb 19, 2026·35m·2 clips
  136. 136

    EP500: This Is Episode 500, and It's All About You, Tribe

    Feb 12, 2026·38m
  137. 137

    EP499: Self-insured Employers and Other Plan Sponsors Are Paying Millions for MSK (Musculoskeletal) Injuries That Would Have Healed Themselves, With Jay Kimmel, MD

    Feb 5, 2026·28m
  138. 138

    EP498: The Payment Integrity Arms Race—RCM (Revenue Cycle Management) and Plan Sponsors, With Mark Noel

    Jan 29, 2026·35m
  139. 139

    Take Two: EP341: The "Just Spend Everything You're Given" Trap—Lessons in True Provider Fiscal Discipline, With Gary Campbell

    Jan 22, 2026·37m
  140. 140

    EP497: What You Don't Know About Healthcare Transactions and Clearinghouses Could Cost You, With Zack Kanter

    Jan 15, 2026·38m
  141. 141

    EP496: Plan Sponsors Spend About $1.20 to Buy $1 of Healthcare, and Clinical Organizations Receive 80¢ for Every $1.20 Spent, With Mark Newman

    Jan 8, 2026·37m
  142. 142

    INBW45: Extremely Actionable Themes That We Covered Throughout 2025

    Dec 31, 2025·23m
  143. 143

    INBW44: The Relentless Health Value Themes That We Covered Throughout 2025—A Recap, Part 1

    Dec 24, 2025·24m
  144. 144

    Encore! EP450: When Your Health Plan Is $9 Million in the Hole, Who Are You Going to Call? A CPA. And Tell Them to Bring Their Spreadsheets, With Marilyn Bartlett, CPA, CMA, CFM, CGMA

    Dec 18, 2025·35m
  145. 145

    EP495: Wait … Flip That—A Crazy Revelation I Had About Trying to Fix U.S. Healthcare, With Mick Connors, MD

    Dec 11, 2025·33m
  146. 146

    EP494: Six Tensions of Pharmaceutical Drug Pricing, With Sarah Emond

    Dec 4, 2025·40m
  147. 147

    Bonus Add-on for EP494: Who Is ICER and What Is the Arms Race of Pharmaceutical Pricing That the Status Quo Has Created? With Sarah Emond

    Dec 4, 2025·12m
  148. 148

    INBW43: Five Baskets of Thank Yous to Hand Out, Along With a Plug for Big Demand Curve Energy

    Nov 26, 2025·17m
  149. 149

    Take Two: EP240: A Direct Contracted and Actually High-Value Network That Elizabeth Mitchell From PBGH Talked About, With Olivia Ross

    Nov 20, 2025·35m
  150. 150

    EP493: Revelations Mainstream CEOs Are Having About the Healthcare Market Right Now—Also, Some Advice, With John Quinn

    Nov 13, 2025·37m
  151. 151

    EP492: The Solutions Show: How to Run a High-Quality Hospital at 143% of Medicare, With Sam Flanders, MD, and Shane Cerone

    Nov 6, 2025·36m
  152. 152

    EP491: Incumbent TPAs and Consultants Getting Called to Jumbo Employer Client HQ to Answer Awkward Questions, With Elizabeth Mitchell

    Oct 30, 2025·50m
  153. 153

    EP490: The Problem Show: 3 Problematic Hospital Myths, Including "There Is a Healthcare Market," With Shane Cerone and Sam Flanders, MD

    Oct 23, 2025·36m
  154. 154

    EP489: MARGIN! Margin That Creates a Path to Mission at a Multispecialty Group, With Dan Greenleaf

    Oct 16, 2025·26m
  155. 155

    EP489: Achieving Mission That Is a Path to Margin at a Multispecialty Practice, With Dan Greenleaf

    Oct 9, 2025·32m
  156. 156

    EP488: Mark Cuban, Cora Opsahl, Trust, Simplicity, and a Chicken—Today We Talk Healthcare

    Oct 2, 2025·55m
  157. 157

    EP487 (Part 2): Kevin Lyons Shares What He Learned in Detective Training That He Uses to Follow the Healthcare Dollar

    Sep 25, 2025·14m
  158. 158

    EP487 (Part 1): A Former Police Detective Investigates the 3 Big Barriers to the Public Sector Getting Better Affordable Health Benefits, With Kevin Lyons

    Sep 18, 2025·31m
  159. 159

    EP486: The Secrets to Operationalizing Direct Contracting From an OG, With Stan Schwartz, MD

    Sep 11, 2025·38m
  160. 160

    EP485: Imaging Costs 6% to 11% of Plan Sponsor Spend: How Direct Contracting Can Save Money and Improve Access, With Cristin Dickerson, MD

    Sep 4, 2025·33m
  161. 161

    Take Two: EP436: Let's Talk About TPA and Health Plan Inertia Instead of Jumbo Employer Inertia, With Elizabeth Mitchell

    Aug 28, 2025·36m
  162. 162

    EP484: What Are the 3 Most Burning Questions That Plan Sponsors Have Right Now? With Dave Chase

    Aug 21, 2025·32m
  163. 163

    EP483 (Part 2): Reversing the Healthcare Flywheel to Contain Skyrocketing Healthcare Costs, With Jonathan Baran

    Aug 14, 2025·30m
  164. 164

    EP483 (Part 1): To Contain Skyrocketing Healthcare Costs or Renewals, You Gotta Understand How the Flywheel Works, With Jonathan Baran

    Aug 7, 2025·32m
  165. 165

    Bonus Add-on to EP483 (Part 1): Honoring Those in Healthcare Who Are Trying Every Day to Do the Right Thing, With Jonathan Baran

    Aug 7, 2025·9m
  166. 166

    How Margin Shoves Mission Off of the Bus: A Primary Care Case Study, With Stan Schwartz, MD—Summer Shorts

    Jul 31, 2025·19m
  167. 167

    EP482: 3 Surprising Ways Carriers Make Lots of Money—What Do Plan Sponsors and Clinical Organizations Really Need to Know? With Preston Alexander

    Jul 24, 2025·38m
  168. 168

    Take Two: EP445: What Does It Take for an Indie Primary Care Practice to Survive Right Now? With Tom X. Lee, MD

    Jul 17, 2025·46m
  169. 169

    Bonus Clip: Dr. Tom Lee Talks About Why Retail Clinics Are Not Doing So Well, in His Opinion

    Jul 17, 2025·7m
  170. 170

    EP481: Seriously, IRL, What Does "No Margin, No Mission" Even Mean? With Benjamin Schwartz, MD, MBA

    Jul 10, 2025·34m
  171. 171

    Take Two: EP438: Is It Mission and/or Margin? With John Lee, MD

    Jul 3, 2025·36m
  172. 172

    EP480: Payment Integrity Meets Health System Boasts, Such as Our Rates Are 2x Medicare, With Kimberly Carleson

    Jun 26, 2025·32m
  173. 173

    Pharma Rebates: A Few Nuances You May Not Have Thought Of, With Ann Lewandowski—Summer Shorts

    Jun 19, 2025·19m
  174. 174

    EP479: Part 2. What Could Go Wrong Covering High-Cost Claimants With Stop-Loss Reinsurance?

    Jun 12, 2025·27m
  175. 175

    Take Two: EP433: The Mystery of the Weekly Claims Wire, With Justin Leader

    Jun 5, 2025·39m
  176. 176

    EP478: Stop-Loss Coverage, Part 1: How It Goes Right, and How It Can Go Horribly Wrong, With Andreas Mang and Jon Camire

    May 29, 2025·32m
  177. 177

    EP441: Tables Get Turned. This Is Me Interviewed by Abby Burns From Radio Advisory About What Is Value

    Jun 20, 2024·40m
  178. 178

    EP440: What Is the Optimal Size for a Medical Practice? With David Muhlestein, PhD, JD

    Jun 13, 2024·38m
  179. 179

    EP439: Fixing the Generic Drug Pricing Problem, Where Patients Pay More When They Use Their Insurance, With Luke Slindee, PharmD

    Jun 6, 2024·29m
  180. 180

    EP438: Recognizing Cognitive Dissonance and Thinking About How to Overcome It When in the Belly of the Beast, With John Lee, MD

    May 30, 2024·39m
  181. 181

    EP437: The Most Powerful Committee No One Ever Heard of and Their Role in Primary Care and Mental Health Struggles, With Brian Klepper, PhD

    May 23, 2024·16m
  182. 182

    EP436: Let's Talk About TPA and Health Plan Inertia Instead of Jumbo Employer Inertia, With Elizabeth Mitchell

    May 16, 2024·42m
  183. 183

    Encore! EP363: How to Cut Healthcare Admin Burden in Half, With David Scheinker, PhD

    May 9, 2024·34m
  184. 184

    EP435: Optimized Pharmacy Benefits Are Required if You Want to Do or Buy Value-Based Care, With Dan Mendelson

    May 2, 2024·35m
  185. 185

    EP434: 5 Surprises About Bundled Payments, With Benjamin Schwartz, MD, MBA

    Apr 25, 2024·40m
  186. 186

    EP433: The Mystery of the Weekly Claims Wire: What Are Plan Sponsors Actually Paying For Each Week? With Justin Leader

    Apr 18, 2024·40m
  187. 187

    Encore! EP391: A Case Study for Anyone Trying to Level Up Primary Care That I'm Gonna Call "How Margin Shoves Mission Off the Bus," With Scott Conard, MD

    Apr 11, 2024·37m
  188. 188

    Encore! EP297: A Driver of Patient Engagement and Clinician Team Success That Is Almost Always Overlooked, With Jerry Durham

    Apr 4, 2024·35m
  189. 189

    EP432: The Knifepoint Intersection of Margin and Mission and the Peril of Cutting Clinical "Waste," With Kate Wolin, ScD

    Mar 28, 2024·38m
  190. 190

    EP431: How Accountability for Outcomes Works in the Real World With Kenny Cole, MD

    Mar 21, 2024·39m
  191. 191

    EP430: Advice for Digital Health Vendors Selling to Employers, With Barbara Wachsman

    Mar 14, 2024·39m
  192. 192

    EP429: Following the Dollar Through Pharmacy Acronyms Like WAC, AWP, and NADAC, With Luke Slindee, PharmD

    Mar 7, 2024·38m
  193. 193

    EP428: Do-It-Now Advice From the J&J and the DOL v BCBS Lawsuits, With Julie Selesnick

    Feb 29, 2024·42m
  194. 194

    EP427: How Do Digital Health Vendors Deliver Patient Outcomes and Experiences? With Rik Renard

    Feb 22, 2024·36m
  195. 195

    Encore! EP379: How Much Money, Really, Are Employee Benefit Consultants and/or Brokers Making From Plan Sponsors? With AJ Loiacono

    Feb 15, 2024·35m
  196. 196

    EP426: Cost Containment Versus Value-based Drug Purchasing, With Nina Lathia, RPh, MSc, PhD

    Feb 8, 2024·33m
  197. 197

    EP425: Three Ways for "Regular" Clinical Practices to Take Cash When It's Cheaper for a Patient Than Using Their Insurance, With Marshall Allen

    Feb 1, 2024·39m
  198. 198

    INBW39: The Narcissism of Small Differences Is a Really Must-Know Concept When Attempting to Fix the Healthcare Industry

    Jan 25, 2024·19m
  199. 199

    EP424: Five Things for Hospital System Execs to Get Real About in 2024, With Peter Hayes

    Jan 18, 2024·45m
  200. 200

    EP423: Maximizers and the "the Drugs Aren't Covered" Schemes Employers Use to Save Money (or Not) on Pharmacy Benefits, With Joey Dizenhouse

    Jan 11, 2024·44m
  201. 201

    EP422: Some Indie Pharmacy Upshots That Surprised Me—and I Thought I Was Pretty in the Know, With Benjamin Jolley, PharmD

    Jan 4, 2024·37m
  202. 202

    Encore! EP392: When Patient Journeys Don't Fit in the EHR, With Emily Kagan Trenchard

    Dec 28, 2023·31m
  203. 203

    Encore! EP372: Step One for Employers and Unions—Get Your Data, With Cora Opsahl

    Dec 21, 2023·32m
  204. 204

    EP421: Wildly Improving Outcomes When the Patient Is, for Reals, in the Center—For Maternity and Beyond, With Jodilyn Owen

    Dec 14, 2023·36m
  205. 205

    EP420: Paying Cash for Generic Drugs—Some Finer Points That Had Totally Gone Over My Head, With Ge Bai, PhD, CPA

    Dec 7, 2023·37m
  206. 206

    EP419: The Financialization of Health Benefits for Boards of Directors and C-Suites of Self-Insured Employers, With Andreas Mang

    Nov 30, 2023·38m
  207. 207

    Encore! EP381: For Reals, Becoming Customer-centric, Transforming, or Innovating at a Very Large Organization, With Karen Root

    Nov 23, 2023·32m
  208. 208

    EP418: Mark Cuban With Some Advice for CEOs and CFOs of Self-insured Employers, With Mark Cuban and Ferrin Williams, PharmD, MBA, From Scripta

    Nov 16, 2023·55m
  209. 209

    Encore! EP385: Morgan Health and the 5 Things Self-insured Employers Should Do Right Now, With Dan Mendelson

    Nov 9, 2023·34m
  210. 210

    EP417: 5 Kinds of Payer and Provider Collaborations and 5 Must-Haves for Said Collaborations to Work, With Josh Berlin, JD

    Nov 2, 2023·34m
  211. 211

    EP416: Why Should Med Schools Teach the Business of Medicine? With Adam Brown, MD, MBA

    Oct 26, 2023·41m
  212. 212

    EP415: Some Jumbo Employers Buying Better Healthcare Outcomes While Saving 15% on Total Cost of Care, With Rob Andrews

    Oct 19, 2023·43m
  213. 213

    EP414: An IRL How-To for Delivering Better Care and Getting Paid for It—A Value-Based Case Study, With Justina Lehman

    Oct 12, 2023·40m
  214. 214

    EP413: The Intersection of Healthcare Waste, Value-Based Care, and the Potential Rising Power of PCPs, With Will Shrank, MD

    Oct 5, 2023·35m
  215. 215

    EP411: Getting Paid (or Paying) for New Innovations Used in Hospitals as Part of a Procedure or a DRG—Also Bloodstream Infections and Dialysis, With Secretary David Shulkin, MD, and Erin Mistry

    Sep 29, 2023·10m
  216. 216

    Encore! EP361: The Gap in Closing Care Gaps, With Carly Eckert, MD, PhD(c), MPH

    Sep 28, 2023·31m
  217. 217

    EP412: Leadership of the Art and Science of Medicine, With Robert Pearl, MD

    Sep 21, 2023·33m
  218. 218

    Are Physicians (and the Rest of Us, Nothing for Nothing) Knights, Knaves, and/or Pawns? With Larry Bauer, MSW, MEd—Summer Shorts 8

    Sep 14, 2023·21m
  219. 219

    Why Do Actuarial Risk Horizons Really Matter for Anybody Trying to Improve Patient Outcomes? With Keith Passwater and JR Clark—Summer Shorts 7

    Aug 31, 2023·20m
  220. 220

    Should You Not Give Employees the Benefit Design They Think They Want? With Lauren Vela—Summer Shorts 6

    Aug 24, 2023·9m
  221. 221

    Payers Trying to Differentiate Themselves by Working With Provider Organizations … or Not, With Jacob Asher, MD—Summer Shorts 5

    Aug 17, 2023·14m
  222. 222

    Supergroups, Super ACOs, and Ochsner's Value-Based Care Journey, With Eric Gallagher—Summer Shorts 4

    Aug 10, 2023·18m
  223. 223

    EP410: The Imperative and a 201-Level Financial How-To for Payers and Provider Organizations to Collaborate to Help CKD Patients and Others With Chronic Conditions, With Dan Serrano

    Aug 3, 2023·34m
  224. 224

    EP409: 3 Really Cool Innovative Primary Care Bright Spots and a Few Notes for Policymakers and Payers, With Larry Bauer, MSW, MEd

    Jul 27, 2023·38m
  225. 225

    Does Advanced Primary Care Reduce Access for Patients? With Vivek Garg, MD, MBA—Summer Shorts 3

    Jul 20, 2023·6m
  226. 226

    What Happens When Someone Tries to Un-transform a Transformed PCP Practice? With Scott Conard, MD—Summer Shorts 2

    Jul 13, 2023·6m
  227. 227

    How Come There Aren't More Hospital Antitrust Cases? With Brennan Bilberry—Summer Shorts 1

    Jul 6, 2023·8m
  228. 228

    INBW38: What I'm Up to Right Now, Big RHV Plans for the Summer—Also Doug Pohl, Justina Lehman, and Dr. Amy Scanlan

    Jun 29, 2023·10m
  229. 229

    Encore! EP365: The Real Deal With PBM Contracts and Drug Rebates, With Scott Haas

    Jun 22, 2023·33m
  230. 230

    EP408: Who's Suing Who? An Overview of Healthcare Legal Goings-on, With Chris Deacon

    Jun 15, 2023·40m
  231. 231

    EP407: Considering Comprehensive Primary Care at Humana, With Vivek Garg, MD, MBA

    Jun 8, 2023·35m
  232. 232

    EP406: The Inertia Show: 5 Excellent Reasons for the "Why" With the Inertia in Benefits Departments, With Lauren Vela

    Jun 1, 2023·32m
  233. 233

    Encore! EP249: The War on Financial Toxicity in North Carolina as a Case Study Everybody Should Be Keeping Their Eye On, With Dale Folwell, North Carolina State Treasurer

    May 25, 2023·32m
  234. 234

    EP405: What Else Physicians Trying to Clinically Integrate in the Real World Really Need to Know, With Eric Gallagher

    May 18, 2023·32m
  235. 235

    EP404: What Now? Who's on the Board of Those Big Hospitals? With Suhas Gondi, MD, MBA

    May 11, 2023·33m
  236. 236

    EP403: The Mix & Match With the How Doctors Get Paid, With Rachel Reid, MD, MS

    May 4, 2023·33m
  237. 237

    EP402: What Physicians Trying to Clinically Integrate Care in the Real World Need to Know, With Amy Scanlan, MD

    Apr 27, 2023·33m
  238. 238

    EP401: The Most Interesting Questions About the IRA Drug Price Negotiations, With Peter J. Neumann, ScD

    Apr 20, 2023·32m
  239. 239

    EP400: My Manifesto, Part 2: Where the Rubber Hits the Road

    Apr 13, 2023·22m
  240. 240

    Encore! EP285: Who Is Auditing These Healthcare Bills? Also, That Cigna Lawsuit, With Dawn Cornelis, Cofounder and Director of Transparency at ClaimInformatics

    Apr 6, 2023·30m
  241. 241

    EP399: My Manifesto, Part 1: The Relentless Health Value Tribe, I Salute You.

    Mar 30, 2023·12m
  242. 242

    EP398: Why Is the Commercial Payer Marketplace in California Completely Boring? With Jacob Asher, MD

    Mar 23, 2023·34m
  243. 243

    EP397: The Minefield That Is a PBM Contract and Also Some Advice for EBCs Who Are Taking Money Under the Table, With Paul Holmes

    Mar 16, 2023·34m
  244. 244

    EP396: How to Answer This Question: Will Humira® Biosimilars Reduce Drug Spend? With Anna Hyde

    Mar 9, 2023·34m
  245. 245

    Encore! EP293: Game Theory Gone Wild: Co-pay Cards, Co-pay Accumulators, and Co-pay Maximizers, With Dea Belazi, PharmD, MPH, President and CEO of AscellaHealth

    Mar 2, 2023·34m
  246. 246

    EP395: Consolidated Hospital Systems and Cunning Anticompetitive Contracts, With Brennan Bilberry

    Feb 23, 2023·36m
  247. 247

    EP394: Spoiler Alert: It Is Counterintuitive Which Hospitals Offer the Most Charity Care, With Vikas Saini, MD, and Judith Garber

    Feb 16, 2023·34m
  248. 248

    EP393: How Do You Know if a Practice or a CIN (Clinically Integrated Network) Is Actually Clinically Integrated? With David Muhlestein, PhD, JD

    Feb 9, 2023·32m
  249. 249

    Encore! EP355: The 5 Business Models for Digital Health Companies, With Nikhil Krishnan

    Feb 2, 2023·36m
  250. 250

    EP392: When Patient Journeys Don't Fit in the EHR System, With Emily Kagan Trenchard From Northwell Health

    Jan 26, 2023·32m
  251. 251

    EP391: Lessons for Private Equity and Others Trying to Do Right by PCPs and Their Patients, With Scott Conard, MD

    Jan 19, 2023·35m
  252. 252

    EP390: What Legislators Need to Know About Hospital Prices, With Gloria Sachdev, PharmD, and Chris Skisak, PhD

    Jan 12, 2023·35m
  253. 253

    EP389: The Clapback When Hospitals Cannot Constrain Their Own Prices, With Mike Thompson

    Jan 5, 2023·35m
  254. 254

    Encore! EP326: The Unfortunate News About HRRP, With Insight Into How to Fix It, With Rishi Wadhera, MD, MPP

    Dec 29, 2022·34m
  255. 255

    Encore! EP356: PBMs React to GoodRx, Mark Cuban, and Amazon Pharmacy, With Ge Bai, PhD, CPA

    Dec 22, 2022·36m
  256. 256

    INBW37: Harnessing the Miracle of the Commons to Improve the Patient Journey Nationwide, A Conversation With Dave Dierk, Co-President of Aventria Health Group

    Dec 15, 2022·25m
  257. 257

    EP388: Merrill Goozner on the Future of Healthcare and Glide Paths to Get There

    Dec 8, 2022·35m
  258. 258

    EP387: Medicare Advantage Trends and How Medicare Advantage Plans Will or Will Not Succeed, With Betsy Seals, CEO and Cofounder of Rebellis Group

    Dec 1, 2022·35m
  259. 259

    INBW36: Will Healthcare Stakeholders Who Don't Collaborate Wind Up With a Business Problem?

    Nov 24, 2022·19m
  260. 260

    Encore! EP351: Everybody in the Healthcare Industry Getting Up in Everyone Else's Business, With Eric Bricker, MD

    Nov 16, 2022·35m
  261. 261

    EP386: What You Need to Know About ER Bills Post the No Surprises Act, With Al Lewis

    Nov 10, 2022·32m
  262. 262

    EP385: Morgan Health and the 5 Things Self-insured Employers Should Do Right Now, With Dan Mendelson

    Nov 3, 2022·35m
  263. 263

    EP384: How Shareholders Impact Payer Behavior, Exactly and Specifically, With Wendell Potter

    Oct 27, 2022·36m
  264. 264

    EP383: Direct Contracting as a Health System Business Strategy, With Nick Stefanizzi

    Oct 20, 2022·33m
  265. 265

    Encore! EP335: Why Private Equity Is Willing to Pay $55,000 per Patient to Primary Care Start-ups, With Brian Klepper, PhD

    Oct 13, 2022·33m
  266. 266

    EP382: Pharma Conflicts of Interest and the Anti-Kickback Statute, With Aaron Mitchell, MD, MPH

    Oct 6, 2022·33m
  267. 267

    EP381: For Reals, Becoming Customer-centric, Transforming, or Innovating at a Very Large Organization, With Karen Root

    Sep 29, 2022·33m
  268. 268

    EP380: 7 Big Reasons Medicare Drug Price Negotiation Actually Happened This Time Around—What Changed? With Mark Miller, PhD

    Sep 22, 2022·33m
  269. 269

    EP379: How Much Money, Really, Are Employee Benefit Consultants and/or Brokers Making From Plan Sponsors? With AJ Loiacono

    Sep 15, 2022·35m
  270. 270

    EP378: The Status of Telehealth Reimbursement and Other Telehealth Policy Updates, With Josh LaRosa, MPP

    Sep 8, 2022·33m
  271. 271

    INBW35: Collaboration Between Healthcare Providers, Payers, and Others Is Required to Improve Chronic Care Patient Outcomes

    Sep 1, 2022·14m
  272. 272

    Encore! EP295: The Not Entirely New but Definitely Improved Way to Measure Primary Care, With Rebecca Etz, PhD

    Aug 25, 2022·31m
  273. 273

    Encore! EP337: A Patient-First Specialty Pharmacy, Not a Money-First Specialty Pharmacy, With Olivia Webb

    Aug 18, 2022·33m
  274. 274

    EP377: Specialty Pharmacy, PBM, Hospital, Employer, and Pharma Strategic Maneuvering, With Mike Baldzicki, CRCM

    Aug 11, 2022·32m
  275. 275

    EP376: Interoperability—Who's Who and Doing What? With Lisa Bari, MBA, MPH

    Aug 4, 2022·34m
  276. 276

    EP375: Medicare Advantage Plans in the Hot Seat, With Betsy Seals, CEO and Cofounder of Rebellis Group

    Jul 28, 2022·32m
  277. 277

    EP374: How to Grade a Health Plan and a Few Validated Success Stories, With Dave Chase, Cofounder of Health Rosetta

    Jul 21, 2022·36m
  278. 278

    EP373: How to Kick a Big Hospital Out of Your Network, With Cora Opsahl

    Jul 14, 2022·29m
  279. 279

    EP372: Step One for Employers and Unions—Get Your Data, With Cora Opsahl

    Jul 7, 2022·34m
  280. 280

    Encore! EP308: How Financial Toxicity Wreaks Havoc on Value-Based Payment Success, With Mark Fendrick, MD

    Jun 30, 2022·35m
  281. 281

    EP371: Buy and Bill vs Pharmacy Bagging—Which Is Better for a Plan Sponsor and Patients? With Erik Davis and Autumn Yongchu

    Jun 23, 2022·33m
  282. 282

    EP370: How Do Some Health Systems Manage to Charge 6x the Cost of a Specialty Pharmacy Med to Infuse It? With Erik Davis and Autumn Yongchu

    Jun 16, 2022·32m
  283. 283

    EP369: What's Up With Specialty Pharmacy Bagging? With Keith Hartman, RPh

    Jun 9, 2022·33m
  284. 284

    Encore! EP282: Do You Know How Much Cancer Centers Get Paid to Put Patients on Drugs? With Aaron Mitchell, MD, MPH

    Jun 2, 2022·33m
  285. 285

    INBW34: The Absence of Collaboration Between Healthcare Stakeholders: What It Means

    May 26, 2022·19m
  286. 286

    EP368: How to Successfully Roll Out New Benefit Designs to Employees and New Care Delivery Models at a Provider Organization, With Ashleigh Gunter

    May 19, 2022·31m
  287. 287

    EP367: Why Would a Hospital Direct Contract With an Employer Looking to Pay Less? With Doug Hetherington

    May 12, 2022·34m
  288. 288

    EP366: An In-Depth Dissection of Our Dysfunctional Healthcare Benefits Market, With Kevin Schulman, MD

    May 5, 2022·33m
  289. 289

    EP365: The Real Deal With PBM Contracts and Drug Rebates, With Scott Haas

    Apr 28, 2022·33m
  290. 290

    EP364: A Way to Think About Transforming the Healthcare Industry, With David Muhlestein, PhD, JD

    Apr 21, 2022·36m
  291. 291

    EP363: How to Cut the Healthcare Administrative Burden in Half, With David Scheinker, PhD

    Apr 14, 2022·32m
  292. 292

    EP362: A CFO Talks About a Hybrid Business Model, With Ali Ucar

    Apr 7, 2022·33m
  293. 293

    EP361: The Gap in Closing Care Gaps, With Carly Eckert, MD

    Mar 31, 2022·32m
  294. 294

    EP360: How to Deliver Value-Based Care That Meets Value-Based Payment Objectives, With Jeb Dunkelberger

    Mar 24, 2022·29m
  295. 295

    EP359: Value-Based Payments—You Get What You Pay For, With Dan O'Neill

    Mar 17, 2022·35m
  296. 296

    EP358: How Health Insurance Plan Design Can Lead to Patients Sacrificing Needed Care, Their Mental Health, and (Sometimes) Buying Groceries, With Wayne Jenkins, MD

    Mar 10, 2022·34m
  297. 297

    EP357: Standing Up Telehealth That Actually Advances Providers' Core Business, With Liliana Petrova

    Mar 3, 2022·35m
  298. 298

    EP356: PBMs React to GoodRx, Mark Cuban, and Amazon Pharmacy, With Ge Bai, PhD, CPA

    Feb 24, 2022·36m
  299. 299

    EP355: The 5 Business Models of Digital Health Companies, With Nikhil Krishnan

    Feb 17, 2022·35m
  300. 300

    EP354: 7 Vital Success Factors to Stand Up a CIN (Clinically Integrated Network), With Shawn Rhodes

    Feb 10, 2022·33m
  301. 301

    EP353: What You Need to Know About Specialty Pharmacy Formularies and Rebating, With Pramod John, PhD

    Feb 3, 2022·31m
  302. 302

    EP352: Some Big Actionable Surprises About the Efficacy and Effectiveness of Specialty Pharmaceuticals, With Pramod John, PhD

    Jan 27, 2022·28m
  303. 303

    EP351: Everybody in the Healthcare Industry Getting Up in Everyone Else's Business, With Eric Bricker, MD, From AHealthcareZ

    Jan 20, 2022·36m
  304. 304

    EP350: Employers Direct Contracting With Hospitals, in Real Life, With Katy Talento

    Jan 13, 2022·36m
  305. 305

    INBW33: Thank You, and a Few Thoughts

    Jan 6, 2022·14m
  306. 306

    INBW32: The Ultimate Impact of Telehealth: A Thought Experiment

    Dec 30, 2021·19m
  307. 307

    Encore! EP294: Building a Center of Excellence: A Playbook for Physician Entrepreneurs, With Steve Schutzer, MD

    Dec 23, 2021·34m
  308. 308

    EP349: How Integrated Is a Clinically Integrated Network, Actually? With Lisa Trumble

    Dec 16, 2021·31m
  309. 309

    EP348: Your Burning Questions About Payviders Answered! With Jeb Dunkelberger

    Dec 9, 2021·32m
  310. 310

    EP347: Rolling Out Healthcare Initiatives That Actually Get Uptake With the Populations You Aim to Serve, With Ian Tong, MD, About the Black Community Innovation Coalition

    Dec 2, 2021·34m
  311. 311

    Encore! EP288: The "Big Three" PBMs Spinning Up GPOs—What? With Mike Schneider

    Nov 25, 2021·30m
  312. 312

    EP346: How Did Health Systems Get Addicted to the Inflated Prices They Charge Employers and Some Patients? 2021 Update, With Peter Hayes, President and CEO of the Healthcare Purchaser Alliance of Maine

    Nov 18, 2021·36m
  313. 313

    EP345: Can Pharma Imagine How Our Health System Will Look in the Future? With Paul Simms

    Nov 11, 2021·32m
  314. 314

    EP344: The High Cost of Generic Drugs, With Steven Quimby, MD

    Nov 4, 2021·33m
  315. 315

    EP343: What Provider Leadership Teams Need to Know to Operationalize Value-Based Care, With David Carmouche, MD

    Oct 28, 2021·30m
  316. 316

    EP342: How the Consolidated Appropriations Act (CAA) and ERISA Fiduciary Requirements Are an Anchor for Self-insured Employers to Navigate the Complexity of Healthcare, With Christin Deacon

    Oct 21, 2021·37m
  317. 317

    EP341: How to Cut Administrative Waste AND Attract and Retain Doctors and Nurses, With Gary Campbell

    Oct 14, 2021·33m
  318. 318

    EP340: How Digital Front Doors Can Enable Value-Based Care, With Kristin Begley

    Oct 7, 2021·32m
  319. 319

    AEE17: Employers and Reference-Based Pricing—David Contorno's Latest Thinking

    Oct 5, 2021·9m
  320. 320

    EP339: Helping Employers Navigate the Perilous Medical-Industrial Complex, With David Contorno

    Sep 30, 2021·31m
  321. 321

    EP338: Ideas to Meet Rural Healthcare's Tough Challenges, With Nikki King, DHA

    Sep 23, 2021·34m
  322. 322

    EP337: A Patient-First Specialty Pharmacy, Not a Money-First Specialty Pharmacy, With Olivia Webb

    Sep 16, 2021·33m
  323. 323

    EP336: The Barbarians at the Gate—Who Are They and How Do They Cause Trouble for the Healthcare Industry Status Quo? With Brandon Weber

    Sep 9, 2021·33m
  324. 324

    INBW30: A Hot Take on Healthcare Stakeholders Not Collaborating

    Sep 2, 2021·8m
  325. 325

    AEE16: The Destruction of Primary Care—A Short History, With Brian Klepper, PhD

    Aug 31, 2021·10m
  326. 326

    EP335: Why Is Private Equity Willing to Pay $55,000 per Patient to Primary Care Start-ups? With Brian Klepper, PhD

    Aug 26, 2021·33m
  327. 327

    EP334: Do Consumers Ditch High-Cost Providers After Shopping With Price Transparency Tools? With Sunita Desai, PhD

    Aug 19, 2021·33m
  328. 328

    EP333: Actually Using Care Plans in the Real World, With (in Order of Appearance) Jeff Hogan, Darrell Moon, Dr. Grace Terrell, Dr. Rich Klasco, Nicole Bradberry, and Kelly Conroy

    Aug 12, 2021·19m
  329. 329

    EP332: A New OS for Provider Organizations—The Patient-Centered Value System (PCVS), With Tony DiGioia, MD

    Aug 5, 2021·32m
  330. 330

    EP331: Employers Buyer Beware! Six Tricks Wellness and Point-solution Vendors Use to Overstate Their Results, With Al Lewis, Cofounder and CEO of Quizzify

    Jul 29, 2021·32m
  331. 331

    EP330: What Is Going On Over at Health Systems? With John Marchica, CEO at Darwin Research Group

    Jul 22, 2021·32m
  332. 332

    EP329: Virtual-First Health Care Solutions—Their Promise and a Few Outstanding Questions, With Joe Connolly From Visana Health

    Jul 15, 2021·30m
  333. 333

    EP328: An Interview Specifically for Health Care Executives, With Marshall Allen, Author of the Best Seller Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win

    Jul 8, 2021·43m
  334. 334

    ENCORE EP 263 - The Start-up Who Won Medicare's AI Contest, Beating Out IBM, Deloitte, and Mayo—A Conversation With Andrew Eye

    Jul 1, 2021·32m
  335. 335

    EP327: Pharma Hooking Up With Start-ups, With Naomi Fried, PhD, About PharmStars™

    Jun 24, 2021·32m
  336. 336

    EP326: The Unfortunate News About HRRP, With Insights on How to Fix It, With Rishi Wadhera, MD, MPP

    Jun 17, 2021·37m
  337. 337

    EP325: The Show in Which Dr. Mai Pham Disagrees With Three of My Value-Based Care Premises

    Jun 10, 2021·37m
  338. 338

    EP324: ACOs (Accountable Care Organizations): Do They, in Fact, Improve the Quality of Care and Reduce Costs? With Nicole Bradberry and Kelly Conroy

    Jun 3, 2021·34m
  339. 339

    Encore! EP244: A Playbook for Jumbo Employers—or Providers, Consultants, Carriers, or Pharma Who Get Paid by Jumbo Employers, With Lee Lewis, Chief Strategy Officer at the Health Transformation Alliance

    May 27, 2021·31m
  340. 340

    EP323: A Short Take on Digital Tools Purporting to Maximize Throughput, With Arshad Rahim, MD, MBA, FACP, of Mount Sinai Health System

    May 20, 2021·18m
  341. 341

    EP322: Cherry Picking, Lemon Dropping, and Other Learnings for Value-Based Care Models, With Monica Lypson, MD, MHPE

    May 13, 2021·31m
  342. 342

    EP321: How to Point Out Low-Value Care Without Starting a Fistfight, With Rich Klasco, MD

    May 6, 2021·30m
  343. 343

    AEE15: A Sidebar Conversation About the Importance and Challenges for Health Systems to Collaborate With Pharma Manufacturers, With David Carmouche, MD, From Ochsner, a Large Health System

    May 4, 2021·6m
  344. 344

    EP320: Is Telehealth vs In-Person Care Like Some Kind of Winner-Takes-All Cage Fight? With Christian Milaster From Ingenium

    Apr 29, 2021·30m
  345. 345

    EP319: How Do We Improve Outcomes in Skilled Nursing and Also Assisted Living Facilities? With Grace Terrell, MD

    Apr 22, 2021·31m
  346. 346

    EP318: A Primer for Pharma Looking to Collaborate With Health Systems, From the Point of View of Troy Larsgard, a Pharmaceutical Category Manager at Johns Hopkins

    Apr 15, 2021·28m
  347. 347

    EP317: Wait, the Latest Action on Drug Pricing Reform Can Be Found in the Infrastructure Bill? With Josh LaRosa, MPP, Policy Director, Wynne Health Group

    Apr 8, 2021·27m
  348. 348

    EP316: Unexpectedly Talking About Employers, With David Carmouche, MD, From Ochsner, a Large Health System

    Apr 1, 2021·22m
  349. 349

    EP315: The Very Unsexy Essential for Technology to Drive Outcomes That Nobody Talks About, With Bob Matthews

    Mar 25, 2021·32m
  350. 350

    AEE14: A Short Lesson for Self-insured Employers: Dr. Doug Eby Gives Some Advice That Everybody Should Hear Who Is Interested in Improving Outcomes and Lowering Costs, With Douglas Eby, MD, MPH, CPE

    Mar 23, 2021·8m
  351. 351

    EP314: Why Do SNF (Skilled Nursing Facility) Patients Need Two Pharmacies and a PBM? Following the Kinda Long Long-term Care Pharmaceutical Supply Chain, With Sheldon Weiss, MD

    Mar 18, 2021·29m
  352. 352

    EP313: Partnering Up With Fiercely Local and Fiercely Independent Pharmacies, With Dan Strause and Drew Leatherberry

    Mar 11, 2021·30m
  353. 353

    EP312: Radically Improving Population Health: Listen and Learn From One of Our Country's Best-Kept Secrets, With Douglas Eby, MD, MPH, CPE

    Mar 4, 2021·34m
  354. 354

    AEE13: Have You Ever Wondered How GoodRx Makes Money? With Ge Bai, PhD, CPA

    Mar 2, 2021·8m
  355. 355

    EP311: How Aging in Place Becomes a Business Problem for FFS Providers, With Sumit Nagpal

    Mar 2, 2021·29m
  356. 356

    EP310: The 2020 Shkreli Awards for the Worst Examples of Profiteering and Dysfunction in Health Care, With Vikas Saini, MD, and Shannon Brownlee

    Feb 18, 2021·30m
  357. 357

    EP309: FFS Providers Getting Locked Out of Referral Flows, Right Now, As We Speak, With Jeff Hogan

    Feb 11, 2021·32m
  358. 358

    EP308: At Least Two Surprising Insights About Value-Based Care, With Mark Fendrick, MD

    Feb 4, 2021·35m
  359. 359

    EP307: The Surprise Billing Legislation: Its Impact on Providers, Hospitals, Self-insured Employers, and (Most of All) Patients, With Loren Adler

    Jan 28, 2021·34m
  360. 360

    EP306: A Deep Dive Into Amazon's Pharmacy and the Amazon Pharmacy Model Some Employers Are Running With, With Ge Bai, PhD, CPA

    Jan 21, 2021·30m
  361. 361

    EP305: The 1% Most Expensive Claimants Racking Up Massive FFS Bills and Still Not Getting the Help They Need From Our Health Care System, With Darrell Moon, CEO of Orriant

    Jan 14, 2021·33m
  362. 362

    AEE12: Steve Blumberg and I Discuss the 2020 Humana Value-based Care Report

    Jan 12, 2021·8m
  363. 363

    EP304: How a Provider Population Health Leader Who Went to Work for a Payer Thinks About Health Care Transformation, With Steve Blumberg, VP of Practice Transformation for GuideWell Health

    Jan 7, 2021·28m
  364. 364

    Encore! EP216: How Medicare Part D Plans Became Addicted to Drug Rebates, With Chris Sloan From Avalere Health

    Dec 31, 2020·32m
  365. 365

    Encore! EP231: Pharmaceutical Contracting, PBMs, Pharmacies, Employers, and the Latest HHS Rebate Proposal, With AJ Loiacono, CEO of Capital Rx

    Dec 24, 2020·38m
  366. 366

    INBW29: The Secret to Transforming Our Health Care System Revealed—A Summary of the Wisdom of Relentless Health Value Guests in 2020

    Dec 17, 2020·25m
  367. 367

    EP303: The Conflict Between QALYs for Drug Value and Specific Well-Funded Patient Advocacy Groups, With Anna Kaltenboeck From the Drug Pricing Lab at Memorial Sloan Kettering

    Dec 10, 2020·29m
  368. 368

    EP302: The Gigantic Problem I Have With Talk About Telehealth, With Blake McKinney, MD, From CirrusMD

    Dec 3, 2020·31m
  369. 369

    Encore! EP206: Turns Out, High‑Deductible Plans Do Not Drive High‑Quality, Cost‑Effective Care, With Ashok Subramanian, CEO and Founder of Centivo

    Nov 26, 2020·33m
  370. 370

    EP301: What Is Up With the Hospital and Payer Transparency Rules From CMS Now and Also After January 20? With Jeff Leibach, MBA

    Nov 19, 2020·33m
  371. 371

    EP300: Getting the Right Drugs Developed and Thinking Different About How to Pay for Them, With Bruce Rector, MD

    Nov 12, 2020·32m
  372. 372

    EP299: FFS (Fee for Service) Is a Whole Business Model—It's Not Just a Way to Get Paid, With Alan Kaplan, MD, MBA, Assistant Professor of Urology at Georgetown University and a Practicing Urologist

    Nov 5, 2020·32m
  373. 373

    EP298: The Intersection of Value-Based Payments and Behavioral Health—Also, the Rise of Telepsychiatry, With Don Fowls, MD

    Oct 29, 2020·33m
  374. 374

    EP297: How the Front Desk Can Make or Break Patient Trust and, Potentially, Outcomes, With Jerry Durham From The Client Experience Company

    Oct 22, 2020·34m
  375. 375

    EP296: Oncology FAQs About Telehealth, Standardizing Care, and Drug Prices, With Vincent Rajkumar, MD, of Mayo Clinic, Rochester

    Oct 15, 2020·33m
  376. 376

    EP295: Surprising Insights About Measuring Primary Care Performance, With Rebecca Etz, PhD

    Oct 8, 2020·33m
  377. 377

    EP294: Building a Center of Excellence: A Playbook for Physician Entrepreneurs, With Steve Schutzer, MD

    Oct 1, 2020·33m
  378. 378

    EP293: Game Theory Gone Wild: Co-pay Cards, Co-pay Accumulators, and Co-pay Maximizers, With Dea Belazi, PharmD, MPH, President and CEO of AscellaHealth

    Sep 24, 2020·32m
  379. 379

    EP292: Teladoc Buys Livongo: What Are the Implications for Providers, Employers, and the Market? Part 2, With Matt Anderson, MD, MBA, and Brian Klepper, PhD

    Sep 17, 2020·32m
  380. 380

    EP292: Teladoc Buys Livongo: What Are the Implications for Providers, Employers, and the Market? Part 1, With Bob Matthews and Dan O'Neill, MA, MS

    Sep 15, 2020·32m
  381. 381

    EP291: What Are Medicare Advantage Plans Up to Right About Now? With Betsy Seals, Cofounder of the Rebellis Group

    Sep 10, 2020·33m
  382. 382

    Encore! EP225: Why, Right Now, It Is No Longer Optional to Suck at Patient Centricity, With Joe Selby, MD, MPH, Former Executive Director of PCORI

    Sep 3, 2020·31m
  383. 383

    EP290: COVID-19—Shining a Light on the Crafty Gambits Used by Some (Not All) Hospital Billing Departments, With Doug Aldeen

    Aug 27, 2020·33m
  384. 384

    EP289: The Right Amount of Oncology Screening and Care—In a Pandemic and Not in a Pandemic, With Bishal Gyawali, MD, PhD

    Aug 20, 2020·36m
  385. 385

    EP288: The "Big Three" PBMs Spinning Up GPOs—What? With Mike Schneider, Principal at Avalere Health

    Aug 13, 2020·30m
  386. 386

    EP287: The Time for Entrepreneurial Physician Leaders Is Right Now, With Dan O'Neill, MA, MS

    Aug 6, 2020·32m
  387. 387

    EP286: Advice for Health Systems in the Face of Consumerism and Value-based Contracts, With John Rodis, MD, MBA

    Jul 30, 2020·34m
  388. 388

    EP285: The Fascinating Story of Billions of Dollars Going Missing When the Back Office Pays Health Care Bills, With Dawn Cornelis, Cofounder and Director of Transparency at ClaimInformatics

    Jul 23, 2020·34m
  389. 389

    EP284: When Prescribers Know How Much a Drug Will Cost Patients at the Point of Prescribing, With Carm Huntress, CEO and Cofounder of RxRevu

    Jul 16, 2020·35m
  390. 390

    EP283: Your Telehealth Success May Be a Launchpad for Health System Innovation and Human-centered Health Care, With Sylvia Romm, MD, MPH, Chief Innovation Officer at Atlantic Health System

    Jul 9, 2020·33m
  391. 391

    INBW27: Two Metrics to Measure the Value of Care Delivered

    Jul 2, 2020·18m
  392. 392

    EP282: Do You Know How Much Cancer Centers Get Paid to Put Patients on Drugs? With Aaron Mitchell, MD, MPH

    Jun 25, 2020·35m
  393. 393

    EP281: COVID-19—Badly Managed Health System Supply Chains Steal From Patients and the Providers Who Let This Happen, With Rob Austin From Guidehouse

    Jun 18, 2020·35m
  394. 394

    EP280: COVID-19—Will Currently-in-Use Technology Advancements Wind Up Disrupting Traditional Models of Health Care Delivery and Reimbursement? With Yauheni Solad, MD, and Rahul Dubey

    Jun 11, 2020·38m
  395. 395

    EP279: COVID-19—How Did Health Systems Get Addicted to the Inflated Prices They Charge Employers and Some Patients? With Peter Hayes, President and CEO of the Healthcare Purchaser Alliance of Maine

    Jun 4, 2020·38m
  396. 396

    EP278: COVID-19—Will COVID-19 Result in a New Normal for Value-based Pharmaceutical Pricing? With Maura Calsyn From the Center for American Progress

    May 28, 2020·31m
  397. 397

    EP277: COVID-19—Is Now the Time When Value-based Payments Overcome a Fierce and Sticky Fee-for-Service Overlord? With Eric Weaver, Executive Director of the Accountable Care Learning Collaborative

    May 21, 2020·32m
  398. 398

    EP276: COVID-19—Advice for Self-insured Employers and That Prediction of a 4% to 40% Premium Increase in the Fully Insured Market, With Brian Scott From Point6 Healthcare

    May 14, 2020·26m
  399. 399

    EP275: COVID-19—Will Self-insured Employer Costs Ultimately Go Up? The Why and How to Protect Your Company From Predatory Health Care Pricing, With Brian Scott, From Point6 Healthcare

    May 12, 2020·31m
  400. 400

    EP274: COVID-19—What Telehealth Means After the Pandemic, With Jonathan Thierman, MD, PhD, From LifeBridge Health System

    May 7, 2020·21m
  401. 401

    EP273: COVID-19—At What Level Will Telehealth Survive After the End of the Pandemic? With Jonathan Thierman, MD, PhD, From LifeBridge Health System

    Apr 30, 2020·29m
  402. 402

    EP272: COVID-19—Why This Pandemic Is a Game Changer for PCPs and the Employers and Plans Who Pay Them, With Guy Culpepper, MD

    Apr 28, 2020·35m
  403. 403

    EP271: COVID-19—A Surprise Billing Defense Strategy for Patients AND Employers in the Middle of a Pandemic, With Al Lewis, Rachel Miner, David Contorno, and Doug Aldeen

    Apr 23, 2020·41m
  404. 404

    EP270: COVID-19—How to Save Primary Care Practices With the Marshall Plan for Prospective Payment Models, With Dave Chase, Cofounder and CEO of Health Rosetta

    Apr 16, 2020·26m
  405. 405

    EP269: COVID-19—Prepping for the Next Wave: What Payers and Providers Should Be Doing Right Now to Get Ready, With Eric Bricker, MD, From AHealthcareZ

    Apr 9, 2020·34m
  406. 406

    AEE11: COVID-19 Billing, With Doug Aldeen and Al Lewis

    Apr 7, 2020·18m
  407. 407

    EP268: COVID-19—After June: Action Steps for Hospitals, Payers, Employers, and Pharma, With Marty Makary, MD, MPH

    Apr 2, 2020·27m
  408. 408

    EP267: COVID-19—From Now Until June: Action Steps for Hospitals, Payers, Employers, Pharma, With Marty Makary, MD, MPH

    Mar 30, 2020·32m
  409. 409

    EP266: When the Scrubs and the Suits Partner Together, Everybody Is Happier … Except Maybe Those Looking to Exploit Patients, With Matt Anderson, MD, MBA

    Mar 26, 2020·31m
  410. 410

    EP265: The What, the How, and the Questionable Why of Digital Therapeutic Formularies, With Randy Vogenberg, PhD

    Mar 19, 2020·29m
  411. 411

    EP264: How Prior Auths Collide With Trust, With Ron Wince, CEO of Myndshft

    Mar 12, 2020·34m
  412. 412

    EP263: How Population Health Leaders Use Artificial Intelligence Right Now, With Andrew Eye From ClosedLoop

    Mar 5, 2020·37m
  413. 413

    EP262: The Ease of Doing Business, With Brian Van Winkle and Rishab Shah From Johns Hopkins Medicine and Working With NODE.Health

    Feb 27, 2020·32m
  414. 414

    EP261: Six Essential Steps to Get Population Health Right, With Fred Goldstein, President and Founder of Accountable Health, LLC

    Feb 20, 2020·31m
  415. 415

    AEE10: An Update on the Snowball of Drug Pricing Initiatives in Washington Right Now, With Josh LaRosa, MPP, Policy Director, Wynne Health Group

    Feb 18, 2020·15m
  416. 416

    EP260: The Latest Shkreli Awards for the Worst Examples of Profiteering and Dysfunction in the Health Care Industry, With Shannon Brownlee and Vikas Saini, MD, of the Lown Institute

    Feb 13, 2020·32m
  417. 417

    EP259: What Are Payers Looking to Solve For Right Now? With Rahul Dubey of Percynal Health Innovations

    Feb 6, 2020·33m
  418. 418

    EP258: Areas of Promise, With Seven Health Care Thought Leaders

    Jan 30, 2020·32m
  419. 419

    EP257: Rating the Raters of Hospital Quality, With Karl Bilimoria, MD, From Northwestern Medicine

    Jan 23, 2020·33m
  420. 420

    EP256: A Major Health Care Cost Driver Revealed: Misdiagnoses in Radiology, With Ron Vianu, Founder and CEO of Covera Health

    Jan 16, 2020·33m
  421. 421

    EP255: UCHealth: A Short List of Hospital Innovations Rolled Out in 2019, With Richard Zane, MD, From UCHealth

    Jan 9, 2020·28m
  422. 422

    EP254: How to Achieve Outcomes That Matter to Patients, With Nadine Jackson McCleary, MD, MPH, BSN

    Jan 2, 2020·26m
  423. 423

    INBW26: A Three-Prong Plan to Find Areas of Promise and/or Promising Companies in Health Care

    Dec 19, 2019·19m
  424. 424

    EP253: How to Use Health IT to Help Patients and Providers Collaborate, With George Mathew, Chief Medical Officer at DXC Technology

    Dec 12, 2019·30m
  425. 425

    EP252: The Not-So-Obvious Thing That Musculoskeletal Care and a 4-Minute Mile Have in Common, With Chad Gray, CEO of Integrated Musculoskeletal Care

    Dec 5, 2019·33m
  426. 426

    INBW25: Behind the Marketing: Preparing Account Management for Successful Selling Into Health Systems, With Dave Dierk, Co-President of Aventria Health Group

    Nov 28, 2019·37m
  427. 427

    Encore! EP176: Why We Think We're Getting Good Health Care, When We Aren't, With Dr. Robert Pearl, Author and Former CEO of the Permanente Medical Group. Co-hosted by Stacey Richter and Alex Akers

    Nov 21, 2019·36m
  428. 428

    EP251: Preventing Readmissions and Improving Patient Outcomes With Telehealth and Other Digital Tools, With Dr. Kimberly Noel From Stony Brook Medicine

    Nov 14, 2019·31m
  429. 429

    EP250: How to Make Patient-Collected Data Actionable for Shared Decision Making, With Vicky Tiase From NewYork-Presbyterian Hospital

    Nov 7, 2019·33m
  430. 430

    EP249: The War on Financial Toxicity in North Carolina, With Dale Folwell, North Carolina State Treasurer

    Oct 31, 2019·34m
  431. 431

    EP248: United We Could Definitely Stand Against Rising Health Care Costs, With Mark Blum From America's Agenda

    Oct 24, 2019·34m
  432. 432

    EP247: From Quality Measures to Medicare Advantage (Maybe for All) and Price Gouging, With John Gorman, CEO and Chairman of Nightingale Partners

    Oct 17, 2019·34m
  433. 433

    EP246: Even a Dream House Needs Plumbing, and Even Visionary Innovation Needs a Capable EHR Infrastructure, With Pam Arora, SVP and CIO at Children's Health in Dallas

    Oct 10, 2019·32m
  434. 434

    EP245: Arithmetically Impossible, With Al Lewis, Cofounder and CEO of Quizzify

    Oct 3, 2019·33m
  435. 435

    EP244: A Playbook for Jumbo Employers—or Providers, Consultants, Carriers, or Pharma Who Get Paid by Jumbo Employers, With Lee Lewis, Chief Strategy Officer at the Health Transformation Alliance

    Sep 26, 2019·37m
  436. 436

    EP243: Who Will Be Impacted by the Snowball of Drug Pricing Initiatives Pouring Out of Washington Right Now? With Josh LaRosa, MPP, Policy Associate, Wynne Health Group

    Sep 19, 2019·32m
  437. 437

    EP242: The Price We Pay: What Broke American Health Care—and How to Fix It, With Marty Makary, MD

    Sep 12, 2019·45m
  438. 438

    EP241: Putting the Squeeze on Community Pharmacies, With Vinay Patel, Founder, Self Insured Pharmacy Networks

    Sep 5, 2019·36m
  439. 439

    INBW24: Are Patients Consumers?

    Aug 29, 2019·18m
  440. 440

    EP240: The Inside Scoop on How Medical Travel Improves Health Outcomes and Lowers Costs for Employers, With Olivia Ross, Associate Director of the Employers Centers of Excellence Network

    Aug 22, 2019·32m
  441. 441

    EP239: How to Escape From Legal Purgatory When Collaborating, With Bill Tanenbaum of Polsinelli

    Aug 15, 2019·31m
  442. 442

    EP238: Who Will Be the Knights in Shining Armor Who Fix the American Health Care System? With Brian Klepper, PhD, From the Validation Institute

    Aug 8, 2019·36m
  443. 443

    EP237: Improving Health Care Value by Pausing and Asking Questions, With Derek Winn, Cofounder at Distilled Concepts and Consultant at the Business Benefits Group

    Aug 1, 2019·32m
  444. 444

    EP236: Customer Experience Advice: When Building to Simplicity, It Has to Be Perfect, With Liliana Petrova, CEO/Founder at The Petrova Experience

    Jul 25, 2019·34m
  445. 445

    EP235: The Right Providers Will Maximize Health Care Value. So Who Are the Right Providers? With Suzanne Clough, MD, CMO at ArmadaHealth

    Jul 18, 2019·33m
  446. 446

    EP234: Customer Experience Drives Trust, and the Two Together Drive Outcomes, With Claire Sporton of Confirmit

    Jul 11, 2019·19m
  447. 447

    INBW23: What I Said at the Rare Disease Roundtable Last Week

    Jul 4, 2019·16m
  448. 448

    EP233: Integrative Oncology Is a Clinically Proven Approach—Here's to Hoping That News Gets Out to Payers and Patients, With Glenn Sabin of FON Consulting

    Jun 27, 2019·25m
  449. 449

    EP232: Why the Right KPIs Are Vital to Improve Patient/Customer Experience, With Jon Skinner From The Verde Group

    Jun 20, 2019·26m
  450. 450

    EP231: Pharmaceutical Contracting, PBMs, Pharmacies, Employers, and the HHS Rebate Proposal: What You Need to Know Now, With AJ Loiacono, CEO of Capital Rx

    Jun 13, 2019·50m
  451. 451

    EP230: The Best Way to Improve Patient Outcomes and Satisfaction and Reduce Burnout, With John Lynn, Founder of Healthcare Scene, Expo.Health, and HITMC

    Jun 6, 2019·31m
  452. 452

    EP229: One Core Skill All Successful Start-up Teams Possess, With Alex Fair, Managing Partner at MedStartr Ventures and CEO of MedStartr

    May 30, 2019·28m
  453. 453

    INBW22: A Very Practical Opioid Alternatives Program for Employers

    May 23, 2019·10m
  454. 454

    EP228: How to Figure Out What Patients Really Want, With Julie Rish, PhD, From the Cleveland Clinic

    May 16, 2019·31m
  455. 455

    EP227: What Should Pharma Be Doing Right Now About the HHS Proposal to Effectively Curtail PBM Rebates?, With Kuo Tong, Managing Director at Navigant

    May 9, 2019·31m
  456. 456

    EP226: Is the Surprise Billing Gold Rush Screeching to a Halt?, With Devon Herrick, PhD, Health Economist and Policy Analyst

    May 2, 2019·33m
  457. 457

    EP225: Can We Afford to Make Health Care Patient-centric?, With Joe Selby, MD, MPH, Executive Director of PCORI

    Apr 25, 2019·31m
  458. 458

    EP224: Underestimate Employers at Your Peril, With Suzanne Delbanco, PhD, Executive Director of Catalyst for Payment Reform

    Apr 18, 2019·35m
  459. 459

    EP223: Digital Therapeutics: Which Ones Make the Cut?, With Megan Coder, Executive Director of the Digital Therapeutics Alliance

    Apr 11, 2019·32m
  460. 460

    EP222: How to Get Real Results From Your Innovation Department, With Naomi Fried, CEO of Health Innovation Strategies

    Apr 4, 2019·30m
  461. 461

    EP221: How to Get Dr. Google to Actually Help Clinicians and Their Patients, With Chris Cullmann of Guidemark Health

    Mar 28, 2019·32m
  462. 462

    EP220: Episodes of Care Payments: A Lower-Risk Way to Take On Risk, With François de Brantes of Remedy Partners

    Mar 21, 2019·28m
  463. 463

    EP219: How to Deliver Population Health in the Real World (and Get Paid for It), With Arshad Rahim, MD, MBA, FACP, of Mount Sinai Health System

    Mar 14, 2019·29m
  464. 464

    EP218: Integrating Social Determinants of Health Into the Clinical Workflow, With Ram Raju, MD, of Northwell Health

    Mar 7, 2019·33m
  465. 465

    EP217: A CFO's Take on Health Insurance, With Steve Watson, CFO and Founder of Summit Path Group

    Feb 28, 2019·35m
  466. 466

    EP216: Getting Rid of Drug Rebates, With Chris Sloan From Avalere Health

    Feb 21, 2019·34m
  467. 467

    AEE9: The Pharmaceutical Triple Aim, With Tom Kottler From HealthPrize Technologies

    Feb 19, 2019·6m
  468. 468

    EP215: The Hullabaloo Around Chargemasters, With Practical Advice for Hospitals to Fix Yours, With Caroline Znaniec From Luna Health

    Feb 14, 2019·32m
  469. 469

    AEE8: VBP Forward Conference—Value-Based Payment Forward Conference, With Don Lee

    Feb 12, 2019·9m
  470. 470

    EP214: Actually Operationalizing Innovation, With Katie D. McMillan of Duke University Health System and Roylyn Fernandez of DeLappe Consulting

    Feb 7, 2019·28m
  471. 471

    EP213: Using Digital Medicine to Solve for Social Determinants of Health, With Louis Morrow of IRIS and Tiffany Wandy of LifeBridge Health

    Jan 31, 2019·18m
  472. 472

    EP212: The Current State of Standardizing Cancer Care With Pathways, With Kathy Lokay From Via Oncology

    Jan 24, 2019·28m
  473. 473

    AEE7: 9 Experts From Across the Industry Weigh In on Digital Medicine Solutions From the NODE.Health Digital Medicine Conference

    Jan 22, 2019·19m
  474. 474

    EP211: Going Beyond the Cheerleading: The NODE.Health Digital Medicine Conference, With Jay Erickson, Brian Van Winkle, and Shahid Shah

    Jan 17, 2019·33m
  475. 475

    EP210: How Social Workers Improve Patient Outcomes: The Big Reveal, With Jonathan Singer, PhD, LCSW, Host of The Social Work Podcast and Associate Professor at Loyola University Chicago School of Social Work

    Jan 10, 2019·36m
  476. 476

    EP209: Primary Care is an Investment. The Rest of Healthcare is a Payment, with Dr. Jed Constantz

    Jan 3, 2019·33m
  477. 477

    INBW21: Different Views on How to Drive Value in Health Care—Disruption vs Incrementalism

    Dec 20, 2018·28m
  478. 478

    EP208: It Takes Physician Leadership and Vision to Operationalize Value-Based Care, With Eric Weaver, SVP, Strategy and Transformation at Innovista

    Dec 13, 2018·29m
  479. 479

    EP207: Disrupt or Be Disrupted, With A.G. Breitenstein, Partner at Optum Ventures

    Dec 6, 2018·29m
  480. 480

    EP206: Turns Out, High-Deductible Plans Don't Drive High-Quality, Cost-Effective Health Care, With Ashok Subramanian, CEO and Founder of Centivo

    Nov 29, 2018·37m
  481. 481

    Encore! EP56: How Convenience Becomes Adherence, With TJ Parker From PillPack

    Nov 22, 2018·38m
  482. 482

    INBW20: Can Pharma and IDNs Collaborate? A Conversation With Stacey Richter and Dave Dierk, Co-Presidents at Aventria Health Group

    Nov 15, 2018·33m
  483. 483

    EP205: The Cost and Quality Impact of Mistreating Millennial CEOs of Health Care, With Maya Dusenbery, Journalist and Author of Doing Harm

    Nov 8, 2018·33m
  484. 484

    EP204: Population Health, One Step at a Time, With Virginia Gurley, MD, MPH, Senior Vice President and Chief Medical Officer at AxisPoint Health

    Nov 1, 2018·31m
  485. 485

    EP203: Some Radical Common Sense About Listening to Patients, With Greg Makoul, Founder and CEO of PatientWisdom

    Oct 25, 2018·33m
  486. 486

    EP202: The P&L of Value-Based Care, With Frazer Buntin, President of Value-Based Services at Evolent Health

    Oct 18, 2018·34m
  487. 487

    EP201: What's the Right Diagnosis and the Right Treatment, With Clint Phillips, Founder of 2nd.MD and Medici

    Oct 11, 2018·31m
  488. 488

    EP200: Shenanigans to Deny Coverage for Evidence-Based Treatments, With Stacey Worthy, Partner at DCBA Law & Policy

    Oct 4, 2018·36m
  489. 489

    AEE6: 1400 Health System Health Care Services Deals, With James Nicholls of Fitzroy Health

    Oct 2, 2018·9m
  490. 490

    EP199: The Unrealized Value Hidden Inside Some Health Systems, With James Nicholls of Fitzroy Health

    Sep 27, 2018·29m
  491. 491

    EP198: The Trend Toward Direct-to-Employer ACOs, With Eric Parmenter, National Leader of Value-Based Care at Collective Health

    Sep 20, 2018·34m
  492. 492

    EP197: The Debut of Virtual Reality and Augmented Reality in Health Care, With Brian Peet, President of MediSolutions

    Sep 13, 2018·30m
  493. 493

    EP196: Advocating for Diabetes Advocacy, With Kelly Close, Founder of the diaTribe Foundation and dQ&A

    Sep 6, 2018·34m
  494. 494

    INBW19: The Power of the Patient's Choice, With Crane Stavig, Garden Designer, Patient, and Consumer

    Aug 30, 2018·31m
  495. 495

    EP195: PEnTech Triple Play: Above the Brand, Patient Centricity, and the Schism Between Pharma and Start-ups

    Aug 23, 2018·24m
  496. 496

    EP194: Why Capturing Patient Reported Outcomes Makes a Whole Lot of Sense, With Dyan Bryson of Inspired Health Strategies

    Aug 16, 2018·31m
  497. 497

    EP193: The Data of 1 Million Americans, with Edith P. Mitchell, MD, FACP, FCCP

    Aug 9, 2018·28m
  498. 498

    AEE5: Today vs the Day All of the HMOs Crashed and Burned, With Alex Jung, Partner and Managing Director in Parthenon-EY

    Aug 7, 2018·8m
  499. 499

    EP192: Desperately Seeking Patient Centricity within the Current Health Care Ecosystem, With Don Lee of The #HCBiz Show! and President of Glide Health IT and Stacey Richter, Co-President of Aventria Health Group and Host of Relentless Health Value

    Aug 2, 2018·57m
  500. 500

    AEE4: Co-pays, Contracts, and the 'Knives' That Are Out for PBMs, With John Gorman

    Jul 31, 2018·7m