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

EP537: Physicians as the Sleeping Giant—Why Many Doctors Don't Push Back and Some Advice, With Benjamin Schwartz, MD, MBA
Relentless Health ValueNovember 11, 2026
537
35:1932.33 MB

EP537: Physicians as the Sleeping Giant—Why Many Doctors Don't Push Back and Some Advice, With Benjamin Schwartz, MD, MBA

Listen on Your Favorite App Benjamin Schwartz, MD, MBA: You got to start kinda nudging the giant. And I think from the physician standpoint, that is … the simplest thing is just educate yourself, understand what's going on, take an interest in it, and that's how you start. And then you go from there...

EP536: Operationalizing the Architecture of Primary Care Patient Experience, With Rebecca Andrews, MD
Relentless Health ValueNovember 04, 2026
536
37:5134.64 MB

EP536: Operationalizing the Architecture of Primary Care Patient Experience, With Rebecca Andrews, MD

Listen On Your Favorite App Stacey: If you are a plan sponsor thinking about, for example, primary care as a way to optimize healthcare spend, do know that any given plan sponsor will really only get maximum possible benefit from an investment in primary care, advanced primary care, when and only wh...

EP535: When Patient Experience Means Parking and Pianos, Plan Sponsors Pay for Hotels, Not Outcomes—What to Measure Instead, With Robyn Leone
Relentless Health ValueOctober 28, 2026
535
37:1834.15 MB

EP535: When Patient Experience Means Parking and Pianos, Plan Sponsors Pay for Hotels, Not Outcomes—What to Measure Instead, With Robyn Leone

LIsten on Your Favorite App On episode 532 a few weeks ago, Chris Klomp from HHS was talking about ER (emergency room) usage as a signal, not just a statistic. If too many folks show up in the ER, consider this a signal that there's something missing. It means a patient who doesn't have access to pr...

EP534: The One Question to Test if a TPA Is Actually Independent, With Kimberly Carleson
Relentless Health ValueOctober 21, 202608:538.13 MB

EP534: The One Question to Test if a TPA Is Actually Independent, With Kimberly Carleson

Listen On Your Favorite App Here's a question I have heard more than once: What is a practical, speedy way to assess whether a TPA (third-party administrator) is truly independent and willing to protect the plan's interests, this plan sponsor's interests, versus being captive to, for example, networ...

EP533: Level Funding Is Self-funding: 5 Avoidable Contract Risks, With Frank Pennachio
Relentless Health ValueOctober 14, 2026
533
37:1334.07 MB

EP533: Level Funding Is Self-funding: 5 Avoidable Contract Risks, With Frank Pennachio

Hello, all you Relentless Tribe members. Thanks for hanging with me today to talk about a bunch of things. One of them being what exactly are level-funded plans, and what are the upsides, and then what are the risks? Because here's the thing. I was talking to an employer the other day, an employer w...

EP532: Why Avoidable ER Visits Aren't the Real Cost Problem: Revisiting Our 2016 Interview With HHS Nominee Chris Klomp
Relentless Health ValueOctober 07, 2026
532
37:2034.17 MB

EP532: Why Avoidable ER Visits Aren't the Real Cost Problem: Revisiting Our 2016 Interview With HHS Nominee Chris Klomp

Listen on Your Favorite App Today we are dipping into the archives for an essential replay from 2016, one decade ago, featuring Chris Klomp back when he served as CEO of a company called Collective Medical. With the nomination of Chris Klomp to serve as deputy secretary of the Department of Health a...

EP531: Slaying the Three-Headed Monster of Health Plan Networks, With Evan Anderson
Relentless Health ValueSeptember 30, 2026
531
38:0634.88 MB

EP531: Slaying the Three-Headed Monster of Health Plan Networks, With Evan Anderson

Listen on Your Favorite App Today, Evan Anderson and I are talking about carrier networks, how they started, how it's going. Because irrespective of whatever the plan was at the very beginning, any given network, especially talking about the big status quo networks, has evolved into what I'll call a...

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