pbm impact

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

For a full transcript of this episode, click here . 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 PBM...

EP241: Putting the Squeeze on Community Pharmacies, With Vinay Patel, Founder, Self Insured Pharmacy Networks
Relentless Health ValueSeptember 05, 2019
241
35:3148.78 MB

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

There are 65,000 community pharmacies in the United States today, and the total cost to locate, staff, and operate these pharmacies is about 9% of our total national drug spending. That’s less than 1% of our national health expenditure—and falling. This is despite the fact that about 85% of our nati...

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Recent Episodes

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
Relentless Health ValueMarch 05, 2026
502
38:5835.67 MB

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

You know, I always kind of wondered what the hackers were doing with all of the medical data that they've managed to get their mitts on over the past, I don't know, however many years. Now, I know at least one thing. If you're a hacker, you can use your stolen medical data to not actually send wildl...

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
Relentless Health ValueFebruary 26, 2026
501
39:5736.57 MB

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

Let us chat about today the inches all around us and also about how there is no market in healthcare all at once in this show. Today I am talking with Ivana Krajcinovic. And let me give you some examples of the inches. Two members of a plan get infusions at a hospital. And if these two members had g...

Take Two: EP398: Why Are Commercial Carrier Marketplaces Completely Boring? Maybe Because There Isn't a Marketplace, With Jacob Asher, MD
Relentless Health ValueFebruary 19, 202634:5231.91 MB

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

We have been doing a little series called "The Inches Are All Around Us," digging out waste in the $5.6 trillion healthcare sector where half an inch of waste can equal billions of dollars. I'm going to right now introduce another series that is complementary but has a slightly different focus. And ...

EP500: This Is Episode 500, and It's All About You, Tribe
Relentless Health ValueFebruary 12, 2026
500
38:2135.11 MB

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

Listen On Your Favorite App This episode would not be happening, to be frank, if Cora Opsahl hadn't asked me what my plans were for episode 500. A few weeks ago, we were in the lobby bar at the legendary Hotel Chelsea—Sid Vicious, Patti Smith, you know the place. In our defense, the Hotel Chelsea is...

EP499: Self-insured Employers and Other Plan Sponsors Are Paying Millions for MSK (Musculoskeletal) Injuries That Would Have Healed Themselves, With Jay Kimmel, MD
Relentless Health ValueFebruary 05, 2026
499
28:0425.7 MB

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

Hello, all you and the Relentless Health Tribe trying to figure out how to do right by patients and the folks footing the bill. Welcome to it. This is episode 499, one episode before episode 500. So, come back next week for that one. Listen on Your Favorite App All right, so today, let's talk about ...

EP498: The Payment Integrity Arms Race—RCM (Revenue Cycle Management) and Plan Sponsors, With Mark Noel
Relentless Health ValueJanuary 29, 2026
498
34:3531.65 MB

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

Listen On Your Favorite App This episode is part of the "Inches Are All Around Us" series because … yeah, you'll see why fast enough. So, last week or two weeks ago, if you listened to that episode about clearinghouses with Zack Kanter ( EP497 ), you may or may not recall. And if you didn't listen t...

Take Two: EP341: The "Just Spend Everything You're Given" Trap—Lessons in True Provider Fiscal Discipline, With Gary Campbell
Relentless Health ValueJanuary 22, 202636:5633.8 MB

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

Listen On Your Favorite App This episode is part of the "Inches Are All Around Us" series looking for all the little pockets—inches, if you will—that comprise the greater than $1 trillion in healthcare waste in this country annually. For a full transcript of this episode, click here . If you enjoy t...

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