employers

EP436: Let’s Talk About TPA and Health Plan Inertia Instead of Jumbo Employer Inertia, With Elizabeth Mitchell
Relentless Health ValueMay 16, 2024
436
41:3338.03 MB

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

Listen On Your Favorite App The episode today is somewhat of a follow-on to the show with Lauren Vela, which was episode 406 about employer inertia. If we’re talking about inertia, though, we’d be remiss not to get a little circumspect about the whole affair and subject some other stakeholders to ou...

EP433: The Mystery of the Weekly Claims Wire: What Are Plan Sponsors Actually Paying For Each Week? With Justin Leader
Relentless Health ValueApril 18, 2024
433
40:0036.61 MB

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

On the show today, I am going to use the term TPA (third-party administrator) and ASO (administrative services only) vendor kind of interchangeably here. But these are the entities that a plan sponsor—for example, a self-insured employer is a plan sponsor—but these plan sponsors will use to administ...

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
Relentless Health ValueApril 11, 202436:5333.77 MB

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

Here’s a great musing that I read on LinkedIn : How will alternative primary care models fare when growth mode gets balanced with profitability and VC-supported burn rate is transformed to Big Retail bottom-line expectations? Mission v. margin. I’m gonna add to this: How will alternative primary car...

EP430: Advice for Digital Health Vendors Selling to Employers, With Barbara Wachsman
Relentless Health ValueMarch 14, 2024
430
38:4535.47 MB

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

We have been spending a bunch of time here on Relentless Health Value talking about PBMs (pharmacy benefit managers) lately and pharmacy benefits, but we are moving into a new topic area. It sort of kicked off three weeks ago with the pod with Rik Renard ( EP427 ) on the importance of care flows if ...

EP429: Following the Dollar Through Pharmacy Acronyms Like WAC, AWP, and NADAC, With Luke Slindee, PharmD
Relentless Health ValueMarch 07, 2024
429
38:2052.64 MB

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

Listen On Your Favorite App In this healthcare podcast we’re talking about pharmacy acronyms or terms like AWP and WAC, and, not really an acronym, but we’ll also talk pharmacy list prices, rebates, discounts. We also have NADAC, but that’s slightly off to the side for reasons we’ll get to in a sec....

EP428: Do-It-Now Advice From the J&J and the DOL v BCBS Lawsuits, With Julie Selesnick
Relentless Health ValueFebruary 29, 2024
428
41:5257.49 MB

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

This show is different, so if you’ve already listened to or read all about the gory details of the J&J and/or the DOL v BCBS lawsuits, this is not gonna be a repeat of that information. Julie Selesnick, my guest today, does cover the very, very top line about these two cases. But after that, we ...

Encore! EP379: How Much Money, Really, Are Employee Benefit Consultants and/or Brokers Making From Plan Sponsors? With AJ Loiacono
Relentless Health ValueFebruary 15, 202435:1348.35 MB

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

For a full transcript of this episode, click here . Here on Relentless Health Value, we have done a bunch of shows lately on how some weird PBM (pharmacy benefit manager) and pharmacy goings-on impact plan members, patients, and also independent pharmacies. During the conversation with Benjamin Jo...

EP422: Some Indie Pharmacy Upshots That Surprised Me—and I Thought I Was Pretty in the Know, With Benjamin Jolley, PharmD
Relentless Health ValueJanuary 04, 2024
422
36:4350.42 MB

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

Listen on Your Favorite App Listen to this show as either a follow-on or a prequel to the shows with Mark Cuban and Ferrin Williams, PharmD, MBA ( EP418 ) and Ge Bai, PhD, CPA ( EP420 ). And if you’re interested in this “what’s going on in the world of PBMs, pharmacies, and employers” topic, also li...

EP418: Mark Cuban With Some Advice for CEOs and CFOs of Self-insured Employers, With Mark Cuban and Ferrin Williams, PharmD, MBA, From Scripta
Relentless Health ValueNovember 16, 2023
418
54:4275.11 MB

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

For a full transcript of this episode, click here . CEOs and CFOs … hey, this show is for you. Let’s start here: What do all of these numbers have in common: $140,000, $3 million, $35 million, and $3 billion? These are all actual examples of how much employers, unions, and some pu...

EP408: Who’s Suing Who? An Overview of Healthcare Legal Goings-on, With Chris Deacon
Relentless Health ValueJune 15, 2023
408
39:4354.53 MB

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

I couldn’t resist the “who’s suing who” because, yeah, you can’t go wrong with Aretha Franklin references. Back on the pod we have Chris Deacon, who is going to give us a rundown of the legal goings-on going on right now that impact self-insured employers, carriers, h...

EP406: The Inertia Show: 5 Excellent Reasons for the “Why” With the Inertia in Benefits Departments, With Lauren Vela
Relentless Health ValueJune 01, 2023
406
32:1144.19 MB

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

Listen On Your Favorite App I’m gonna run through the five reasons Lauren Vela talks about in this healthcare podcast for the “why” with the inertia in benefits departments of self-insured employers. But before I do, let me report that, in sum, they add up to … in many cases, benefits folks sit betw...

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

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

Listen on Your Favorite App If this were a video show, I would stare into the camera with steely eyeballs right now and say that I have a special message for employer CFOs. If you aren’t a CFO, pretend that you are so that you get the full effect here. So, now that we’re all CFOs, let’s pull up the ...

EP149: Overpaying for Healthcare vs Full-Day Kindergarten & Raises for Teachers, with Richard Steinhart, Former School Board Officer
Relentless Health ValueAugust 24, 201732:4244.89 MB

EP149: Overpaying for Healthcare vs Full-Day Kindergarten & Raises for Teachers, with Richard Steinhart, Former School Board Officer

Mr. Steinhart has had a distinguished career as an entrepreneur, investor and executive in the healthcare industry. He has been instrumental in starting or investing in many technology-based companies, several of which have developed products that have become the standard of care in their respective...

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Recent Episodes

EP525: PMPM vs FFS—The Perverse Incentives Plan Sponsors Sometimes Miss, With Cristin Dickerson, MD
Relentless Health ValueAugust 19, 2026
525
16:3315.14 MB

EP525: PMPM vs FFS—The Perverse Incentives Plan Sponsors Sometimes Miss, With Cristin Dickerson, MD

Listen on Your Favorite App So, this one's gonna be a little bit different. Back last year, I sat down with Dr. Cristin Dickerson. She is the founding partner of Green Imaging , which is a physician-led radiology network doing direct contracting for imaging. And we talked about how imaging can run 6...

EP524: Beating Provider Network Pricing Games by Thinking About Buying Healthcare Like a Manufacturer Supply Chain, With John Quinn
Relentless Health ValueAugust 12, 2026
524
17:0215.59 MB

EP524: Beating Provider Network Pricing Games by Thinking About Buying Healthcare Like a Manufacturer Supply Chain, With John Quinn

Listen on Your Favorite App Hello, all you Relentless Tribe members. First off here, I would like to thank Casey Cormier for the really nice recurring donation. Thank you so much, Casey Cormier from  Stratis Group . Lately, traditional provider networks are increasingly being called into questi...

EP523: The Sleeping Giants of Healthcare—Why Self-insured Employers and Clinicians Keep Missing Each Other, With Suhas Gondi, MD, MBA
Relentless Health ValueAugust 05, 2026
523
35:1632.28 MB

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

Listen on Your Favorite App Hello, all you Relentless Tribe members. Before we dive in today, I just wanted to give a quick but massive thank you to Alex Sommers, MD, ABEM, DipABLM, from Astia Health for his generous gift, which we are going to use to help fund a camera for the podcast here to level...

EP522: How Exactly Does GoodRx Make Money? With Ge Bai, PhD, CPA
Relentless Health ValueJuly 29, 2026
522
13:4512.58 MB

EP522: How Exactly Does GoodRx Make Money? With Ge Bai, PhD, CPA

Listen on Your Favorite App Arielle Bose: Hi, Stacey. This is Arielle Bose from EHD Insurance . Big fan of the podcast. We were talking about GoodRx the other day, and it occurred to me that I’m not exactly clear about how they make money. So, Stacey, how does GoodRx make money? For a full transcrip...

EP521: How Revenue Cycle Management (RCM) Became an Over $200 Billion Healthcare Hot Potato, With Andrew Tsang
Relentless Health ValueJuly 22, 2026
521
36:1333.15 MB

EP521: How Revenue Cycle Management (RCM) Became an Over $200 Billion Healthcare Hot Potato, With Andrew Tsang

Listen on Your Favorite App Hey, welcome to Relentless Health Value. Okay … so, on today's show, we are talking about (Andrew Tsang and I) revenue cycle management, which—I say this with real affection—is maybe the least sexy phrase in all of healthcare. It sounds like a back-office spreadsheet prob...

EP520: Cash-Pay Generic Drugs Are a Functioning Market in Healthcare—Policymakers Beware and Be Careful
Relentless Health ValueJuly 15, 2026
520
32:1829.56 MB

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

Listen on Your Favorite App In the pachinko machine that is the healthcare industry, with just so many intermediaries, with so much regulatory capture and conflicts of interest that may or may not be visible, so much margin that is shrouded in mystery in an ecosystem as messy as this with so many va...

EP519: The Current State of Primary Care—Inevitable or Fixable? With Lisa Rosenbaum, MD
Relentless Health ValueJuly 08, 2026
519
40:0036.61 MB

EP519: The Current State of Primary Care—Inevitable or Fixable? With Lisa Rosenbaum, MD

Listen on Your Favorite App Hello, all you Relentless Tribe members. Today, let's start here. Right now, we are watching a very visible exodus of brilliant, consummate primary care (and other, honestly) physicians leaving traditional practice for concierge medicine or otherwise. For a full transcrip...

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