loophole

EP439: Fixing the Generic Drug Pricing Problem, Where Patients Pay More When They Use Their Insurance, With Luke Slindee, PharmD
June 06, 2024
439
28:5639.74 MB

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

Listen On Your Favorite App In the Ge Bai show ( EP420 ), one solve was offered for helping patients pay the lowest possible price for generic drugs. In this healthcare podcast, Luke Slindee, PharmD, offers another solve. That’s where this conversation is going, but now let’s start from the beginni...

Encore! EP356: PBMs React to GoodRx, Mark Cuban, and Amazon Pharmacy, With Ge Bai, PhD, CPA
December 22, 202236:1049.67 MB

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

This show was one of the most popular episodes in the past 12 months. So, here it is again for your listening pleasure. Mostly this whole episode is about the so-called “Big Three” PBMs that provide between the three of them pharmacy benefit services for 95% of insured Americans. PBM ...

Recent Episodes

Take Two: EP438: Is It Mission and/or Margin? With John Lee, MD
July 03, 202535:5932.93 MB

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

Listen On Your Favorite App I am so focused right now on the intersection (or lack thereof) of mission and margin, so I’m taking a second listen to this episode right now with John Lee, MD, because it is so ridiculously relevant given that I am, as stated, on a bit of a tear. For a full transcript ...

EP480: Payment Integrity Meets Health System Boasts, Such as Our Rates Are 2x Medicare, With Kimberly Carleson
June 26, 2025
480
32:0629.38 MB

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

Listen On Your Favorite App You know that episode from this spring with Eric Bricker, MD ( EP472 ) about stop-loss provisions as a way for some hospitals so inclined to make more money without (technically, at least) raising rates—like, they can substantially increase the overall revenue from plan ...

Pharma Rebates: A Few Nuances You May Not Have Thought Of, With Ann Lewandowski—Summer Shorts
June 19, 202519:2717.81 MB

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

Listen On Your Favorite App So much can be said about pharma rebates or, as I’m starting to call them after speaking with my guest today, Ann Lewandowski, monies received back from manufacturers or even post-sale concessions. And we get a little bit into this today why rebates is just so much lingu...

EP479: What Could Go Wrong Covering High-Cost Claimants With Stop-Loss Reinsurance? With Andreas Mang and Jon Camire
June 12, 2025
479
27:2525.09 MB

EP479: What Could Go Wrong Covering High-Cost Claimants With Stop-Loss Reinsurance? With Andreas Mang and Jon Camire

Listen On Your Favorite App This show today, for sure, it’s for plan sponsors and anyone on or about plan sponsors; but also listen if you are serving high-cost claimants some other way. Because what you’ll learn here today is some insights relative to how plan sponsors go about making sure that th...

Take Two: EP433: The Mystery of the Weekly Claims Wire, With Justin Leader
June 05, 202538:4935.53 MB

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

Listen On Your favorite App I decided to take a second listen to this episode due to the large number of posts on LinkedIn and conversations by the likes of Peter Hayes , Jamie Greenleaf , Steve Ditto , Julie Selesnick , Chris Deacon , Darren Fogarty just about the dollars disappearing when TPAs (t...

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
478
31:5829.26 MB

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

Listen On Your Favorite App Hey, question for you. Can it ever actually be better for a claim to get lasered? If your knee-jerk reaction is, “Nope. No, not so much. Lasered claims are always bad,” and/or if you have no idea what I’m talking about, do continue to listen. This question gets answered....

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
May 22, 2025
477
18:3325.47 MB

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

Listen On Your Favorite App A couple months ago, I did my very first episode ( EP467 ) that locked down a very clear through line, a theme tying together a bunch of RHV (Relentless Health Value) episodes from earlier this year. That earlier through line was a lack of good primary care means higher ...

Listen and Follow

Sponsored by Aventria Health Group
©2025 BD Bridges LLC. All Rights Reserved.