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Recent Episodes

EP481: Seriously, IRL, What Does “No Margin, No Mission” Even Mean? With Benjamin Schwartz, MD, MBA
July 10, 2025
481
33:5831.09 MB

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

Last week, I announced I was on a tear to really get to the bottom of no margin, no mission. How do we, in real life, operationalize these very sort of inspirational but kind of vague words? This conversation is largely me grilling Dr. Ben Schwartz on what no margin, no mission means to him, and ho...

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....

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