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, in fact, probably about the halfway point between our two places of business. They are known for their martinis. The show just started, and it's already off the rails.
Anyway, Cora said (casually, mind you), "Whatcha you gonna do for episode 500?" I said, "Oh, I have that all figured out. I'm gonna do episode 499, and then I'm gonna do episode 501, and then I'm gonna figure out episode 500 when I have a little bit more time to think about it. Because right now I'm really, really busy at my day job." As I've said many times, I used to crastinate, then I went pro.
Cora just stared at me, gathering her thoughts maybe. Finally, Cora goes in response to my do episode 499 and then do episode 501 and then do episode 500 sometime later on when I get around to it. Cora goes, "Yeah, well, that is a truly terrible idea." Then she helped me figure out a good plan. So, welcome to episode 500.
For a full transcript of this episode, click here.
If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe.
This podcast is sponsored by Aventria Health Group. While I'm talking about sponsored by, and I know I covered this in the Thanksgiving Show (INBW43), but I really, really wanna thank all of the individuals who have contributed moral and/or financial support.
Back to how episode 500 came to be.
The plan I concocted with Cora started out as a LinkedIn post. Here's the post:
"Ten years ago and 500 episodes ago, I started Relentless Health Value because the healthcare industry felt like a game of pachinko. You drop a program or a policy or a technology in. It bounces around a black box. And sometimes the result is the opposite of what you intended or what you wanted."
I keenly felt my lack of not just essential knowledge but just how to actually deploy that knowledge to move the needle and secure a really patient-centric system.
But then I met the Relentless Health Tribe. You lot. "You are the alchemists of this industry. You take the words [that] you hear here and turn them into [tangible programs and solutions]," things that actually work in this hot mess that we call the healthcare sector.
So, look, the whole reason for Relentless Health Value continuing for all of these years is the impact that you have. Some of this impact I hear about, but a lot of it, frankly, I don't.
So, this is what I asked for on that LinkedIn post. I wrote, "I want to hear from you." And then I asked everyone reading to write their own accountings for how Relentless Health Value and its guests may have influenced their own trajectories toward a better way forward.
Because here's the thing, and how do I wanna say this? Not everyone listens to the show. We are not everyone's cup of tea. We meaning, for sure, me; but yeah, if you're here listening, you, too. So, don't try to claim otherwise. I'm onto you.
We are not only worried about patients/members, but we are also a bunch of deeply knowledgeable wonks who understand—because we need to—how the pipes have been laid and how the dollars flow through them.
Because we get that you cannot actually manage to do the right thing by patients and members a lot of times, unless you have a handle on how this deeply opaque and often wildly counterintuitive world actually works that functions, in many ways, the opposite of what the press release says or the first three pages of the contract, as the case may be.
So, I'm proud of you, and I'm proud that you are listening because if I added up the number of lives that you lot serve—like when you make decisions, how many are impacted by your choices—it's, I don't know, if I had to add it all up, I'd say back of envelope over 80 million people in this country, 100 million. Not sure how to count, because some of you work upstairs at health systems and provider organizations. Some of you are self-insured employers or TPAs (third-party administrators) or consultancies or solution providers, legislative folks, policymakers. Or maybe you just work with one patient at a time trying to figure out how to do that as best you can.
You're here, and I appreciate that from the bottom of my heart, and I would certainly encourage you to look around because there's real power in this village that you are a part of and that can and will matter.
So, again, this show, not for everyone by a long stretch. But who gravitates here are those with a strong desire to find their own North Star, their own beacon, as Alex Sommers, MD, put it. And we're all looking for actionable insights so we can manage to succeed doing something. We are not here to stare at our belly buttons.
And this is often uncomfortable, right? It's sometimes really, really awkward and cognitively dissonant to gather up a clear-eyed sense that maybe our companies, our boss's boss, or colleagues around us are doing things that are, in fact, less aligned with our own values.
And at that point, it is super challenging to figure out a path forward that works at the job and also isn't some kind of personal betrayal of values. The real world is not a sterile, theoretical place. It's full of nasty choices and life that gets really life-y. What's that Mike Tyson quote? "Everybody has a plan until you get punched in the face."
So, yeah, the team over here at Relentless Health Value can and will pat ourselves on the back for hitting this 500-episode milestone. But you are the ones who are turning this oil tanker of a healthcare system around and all of what that entails.
So, that is why I wanted episode 500 to be a celebration of your impact. You are changing healthcare. That whole thing is the gist of the plan that I concocted with Cora Opsahl at the Hotel Chelsea, like, 2.5 hours before I posted that LinkedIn post and kicked this whole thing off.
Fast forward to right now, the post got, like, 100+ beautiful responses and however many reposts with more comments. Plus, I got a whole pile of direct messages, emails, voicemails on the Web site.
And all of these, as I would have suspected, honestly, I was completely not surprised. These recountings of impact were the really, really good sort of impact recountings—the kind that matter, the kind written by people who not only know a lot but also care about each other and the patients and the members, the kind who fully understand the stakes here are higher than all of us.
We are all or will be patients, and so will our families and our friends and everyone we know. This is the purpose and the burden that we all choose to bear despite the complexity, the steep learning curve, despite the number of powerful entities flying around way more interested in profiteering than I, frankly, find acceptable at most any level.
So, right. I've said this before, and I'll probably say it 10 more times. Thanks for being here throughout these past 500 shows. Let's live in the solution. Today is always the first day of what we can build together through the decisions we all make that will coalesce and come together into something really, really meaningful.
To this end, I wanna kick this off by playing this beautiful and really inspiring message that sort of universally summarizes so much of our why around here. It's from Michelle Bernabe.
Michelle Bernabe: Hi, this is Michelle Bernabe; and I write the Substack Moral Health. Episode 373 changed the course of my life.
Stacey: This is the very first episode with Cora Opsahl, and she's talking about how the 32BJ Union Health Fund had a little issue with a very big hospital and what they did about it.
Michelle Bernabe: To really understand it, I have to take you to this kind of ludicrous moment I experienced as a nursing student when I saw this nursing aide in dialogue with this giant red banner that this hospital had up that said "Amazing Things Are Happening Here."
And she just clapped back at the banner, and she was like, "Amazing things are happening here? You are damn right! It's amazing we don't have any clean linens. It's amazing we're out of water pitchers. It's amazing still nobody's around to cover my break."
And she just kinda laughed and strolled on into the distance, and I was like, "Did anyone see that moment?" It kind of haunted me, and unfortunately, it would define my whole career as a New York City nurse—in particular, the distance between the story we tell and the conditions people work and heal inside. And nobody was really talking about that distance.
That is, until years later when I found Relentless Health Value episode 373. And I heard Stacey and Cora talking about that distance and saying the data, the contracts, the incentives are what shaped the healthcare reality we all experience. It changed my life.
Stacey, congratulations on episode 500. I watched amazing things get used as a banner while the basics fell apart, and your show helped me name it as a design problem, not as a personal failure. And it didn't just validate me; it gave me a blueprint and role models and real people to pattern off of for how to build and fight for something better.
So much tribe love.
Stacey: Right back at you, Michelle, and please subscribe to Michelle Bernabe's Substack called Moral Health. As you may be able to easily tell, Michelle is so eloquent and able to encapsulate some really big truths from many micro moments such as this one.
Okay … if we drill one level down here, I'm seeing three major themes jump out for how Relentless Health Value has aided and abetted in some pretty fantastic results and outcomes.
Here's Theme 1: Moving From Theory to Practical Transformation. That's what many of you have said that Relentless Health Value has helped with. We aren't here just to have good conversations. We're here to drive real-world decisions.
I wanna play a recording from Ken Wosczyna.
Ken Wosczyna: Stacey, I really appreciate what you're doing with the Relentless Health Value Podcast. What I appreciate most is how practical it is. I love that you publish the transcript. As someone focused on employers sponsoring healthcare, I can quickly read them, extract what's relevant, and actually use it, not just be inspired by it.
I also love that the vast majority of your guests don't just talk theory. I'd say about 90%, maybe more of them actually walk through what they've implemented, what worked and what didn't. I think that's rare and incredibly valuable.
Stacey: I've heard this expressed so many times, and each time is like the best kind of validation. Those who listen to the show, such as you listening right now, you're the innovators who spot problems and tinker with available resources in an effort to solve these problems.
And just saying, as noted in The Tipping Point by Malcolm Gladwell, bringing fundamental change requires a community where new beliefs can be practiced, expressed, and nurtured.
Ken Wosczyna: A few of the episodes that genuinely shaped how I think and operate, I'd start with episode 240 with Olivia Ross and how it reinforced what employers need to fundamentally rethink how they deliver health benefits and not just tweak around the edges. It validated decisions I was already leaning toward and gave me confidence to push further.
Episode 490, a problem showing hospital myths with Shane Cerone and Sam Flanders, MD. This sharpened how I challenge hospital narratives employers often accept at face value. It changed how I have conversations about hospital pricing and incentives.
Episode 457, featuring Cynthia Fisher, made me far more deliberate about demanding clarity in vendor and carrier contracts.
And I have to say episode 397 with Paul Holmes. This really stood out. I actually spoke with Paul after the episode. It sharpened how I look at PBM (pharmacy benefit manager) contracts, incentives, conflict, and transparency before advice gets trusted.
This podcast consistently leads to real decisions for me, not just good conversations.
Stacey: Thanks, Ken. I could not love this more. I also love your LinkedIn post with the signs that you hold up. Follow Ken on LinkedIn. If you haven't seen these.
Ken Wosczyna: Thanks again to you and your team. I really appreciate the work you're doing.
Stacey: This theme came up a lot, this theory to practical transformation. It was also highlighted by Lori Smith Guliano, who shared that, after listening to episode 468 with Matt McQuide, her team implemented free direct-to-primary care for all members "as a critical foundation that the rest of our strategy will build upon," she said.
LeeAnn Miller highlighted this shift also, noting she was finally able to move away from a big three to a transparent model PBM for a self-insured system after learning about all of the financial conflicts in PBM contracts.
Additionally, Benjamin Light mentioned hearing about running a health system at 143% of Medicare (EP492). He found that inspirational and reinforced the idea that you cannot control costs without controlling the supply side of the equation. You can't have a market without supply and demand.
I really like how Mark Weber in this next comment talks about education, inspiration, and a roadmap. Here's Mark Weber.
Mark Weber: Hi, this is Mark Weber from Aligned Value Advisors. If we've talked healthcare over the years, I've probably quoted or shared a Relentless Health Value Podcast episode with you.
A few years ago, when I shifted my role in the healthcare supply chain from being an employee benefits consultant to joining advanced primary care organization, RHV was my go-to source for information, education, and inspiration.
I guess it's not a coincidence that the top themes that I'm seeing every day are so aligned with those in Stacey's year interview episodes (INBW44). Yes, the pun was intended.
Our mission is to turn these themes into reality from employers and providers alike—to not just talk about value but to build the infrastructure to sustain it.
Relentless Health Value provides the constant inspiration and roadmap that helps me and so many others in the Relentless Tribe to move from the status quo to solutions focused.
Stacey: And here's from Dr. Alex Sommers, who says, "Relentless Health Value [is] both a beacon and a roadmap," which is, frankly, a much more poetic way to say theory to practical transformation. Here's Dr. Sommers.
Dr. Alex Sommers: I'm Dr. Alex Sommers with Astia Health. What a milestone! Congratulations to Stacey Richter and the entire Relentless Health Value team.
What's in a name? Everything. Relentless Health Value has become both a beacon and a roadmap for what it actually takes to transform our industry. The show consistently brings together an impressive group of thinkers and doers led by a true savant who understands this incredibly complex system inside and out, which is no small feat.
Stacey: Thanks for the lovely compliment. Mostly I just have a pretty good memory and an ability to suss out folks who actually know what they're talking about, which is probably, like, 2% of the folks going off on any given topic—just saying the quiet part out loud.
Dr. Alex Sommers: After listening to each episode, I find myself connecting the dots, simplifying the complex, pushing the industry in a better direction, and helping patients and employers do well by doing good.
Every episode is both inspirational and aspirational, but two that really stood out for me are episodes 391 and 462 with Scott Conard, MD. Those conversations introduced me not just to a leader but to a mentor and a friend, someone who truly sees this industry the same way I do—just a bit further down the road.
Stacey and the Relentless Health Value team, your impact is real. Keep going.
Stacey: Thank you, Dr. Alex Sommers, and congrats on your work at Astia Health.
Lastly, for Theme 1, Theory to Practical Transformation, here's John Lee, MD.
Dr. John Lee: Hi, this is John Lee. I'm an ER doctor and an Epic consultant. I started listening to Stacey as I started on my clinical informatics branch of my career.
Back then, my main goal was to create systems that were more usable so my physician colleagues didn't get so frustrated that they punched their fist through the monitor. As a corollary to that, I realized that much of what we do in medicine and how we deliver medicine and operate was "gaming the system" and that a powerful tool to game the system was to leverage EMRs (electronic medical records).
But as I listened to Stacey, I realized that gaming could also be used for good.
Stacey: These are all really interesting points made by Dr. John Lee, who I interviewed, by the way, in episode 438 in a show called something like "Doing the Best You Can When Working in the Belly of the Beast" (ie, when you are someone who is employed by a big insert whatever here, and you're trying to do the best that you can despite some of the choices made by the organization that you work for).
This is why I always try to never equate health system leadership or board-level decisions with those who work a lot of times for these organizations. The individuals working are trying as hard as they can a lot of times in butting up against these leadership teams who may have their own compensation packages tied to "growth."
And you know what growth means? Listen to episode 391 with Dr. Scott Conard that Dr. Alex Sommers just brought up earlier.
It could be just your regular corporate health system or carrier leadership, but it also in this day and age could be that private equity came in and swooped in and ran their playbook.
So, yeah, Dr. John Lee has been able to see how these tech systems operationalize corporate leadership goals in very deeply rooted ways, gaming the system, as Dr. Lee says.
And it will take individuals like Dr. Lee who have the depth of understanding about how all of this works and the mission to serve patients to nudge any given organization in ways to be more aligned with the values of those working there.
Dr. John Lee: I saw that the most fundamental pain point we have in our healthcare system is our, our lack of transparency. And the irony that I've encountered is that our technology stack is both simultaneously one of the biggest culprits contributing to that opacity but also can be one of the primary saviors to promoting that transparency.
And your podcast has inspired me to be part of that solution. Thank you, Stacey.
Stacey: Theme 2: The Power of the Tribe and Collective Momentum. This came up a lot, the idea that no one can fix this broken system alone. We need aligned passion and a common effort to create something better.
"Relentless Health Value has become a convening force for the 'Murderer's Row' of practitioners," Dave Chase said that, "who are just tired of the status quo."
Justin Leader captured this sentiment perfectly, saying, "[The show] unites different factions of change [and] reinforces [the] truth [that] a better way forward will only happen together, not through any one individual."
And then he followed up, Justin Leader, with this recorded message.
Justin Leader: Hi, this is Justin Leader, president of BenefitsDNA. Stacey, for me, it was never a single moment. It has been a collective moment and an ongoing movement. Relentless Health Value brings clarity to complexity and stitches together what was long been divided.
You created a community of what you once called "good eggs," and that term stuck with me.
Stacey: I just wanna say something here about this "good egg" callout, which I couldn't love more because it is and was something really important to me—even if using the term "good egg" puts on full display how much time I spent with my grandmother growing up. If you asked me how old I was as a kid, I'd probably say, "God willing, in May I turn eight … if the Lord sees fit."
But here's the thing, and it matters how I, you, how we perceive ourselves will impact the decisions we make in a very major way: If I think about myself as a good egg and I have a very salient ever-present goal to do the right thing by patients and members, this identity that I hold for myself will strongly bias my behavior. So, call it, I don't know, a shortcut, maybe speaking for myself, to just really firmly identify as a good egg because that's frankly a great way to be one. And maybe the best way to fix healthcare here is if everybody does that. For real now, not just phone it in for the press tour, the congressional testimony.
Justin Leader: What I love most about Relentless Health Value is that it does not divide us. It unites different factions of change and offers hope when the system feels hopeless or stacked against people. It inspires generations to reject the idea that this is as good as it gets.
It also reinforces a simple truth. There is hope for the future. There's a better way forward. It will save lives and change lives, and it will only happen together, not through any one individual. That connectivity has put me in rooms with others who feel the same, pull to challenge the status quo, and build a brighter tomorrow. That's real impact.
Stacey: Right? Yes. And this whole thing is the third part of my personal charter, my manifesto that I go through in episode 400, 100 episodes ago.
It's pretty incontrovertible, I think, at this point that transforming healthcare will require a village; and to me, being a good villager is part of what it means to be a good egg for this reason, because the success of this village to achieve its goal will depend on the intentions of the villagers, the kind of folks they are/you are/I am and how well we are able to work together and not succumb to the old narcissism of small differences that I rant about in Inbetweenisode 39.
So, yeah, the only price of admission to our village is trying to be the best egg we all can be when it counts in all these little decisions where we have to decide whether for real, patients and members come first or what we can do to make that as true as best we can.
All the knowledge we have serves that one goal.
Justin Leader: Congratulations on episode 500. Keep going.
Stacey: Thanks, Justin.
Episode 433 with Justin Leader, "The Mystery of the Weekly Claims Wire." Do go back and listen to it. It's a really great show that reveals a lot about how the dollar actually flows in the healthcare sector.
Still on the topic of Theme 2, The Power of the Tribe and Collective Momentum, Rob Marty shared that even when the system feels overwhelming, listening to this pod provides a tone of "we have to keep trying," and it's helped him move past a place of burnout.
Samantha George echoed the sentiment, stating that Relentless Health Value showed her the value and power of her own voice and gave her the courage to challenge her own perspectives.
Along these same lines, here's Cristin Dickerson, MD.
Dr. Cristin Dickerson: Hi, this is Dr. Cristin Dickerson, founder and CEO of Green Imaging. I get tremendous support from the Relentless Health Value Podcast and its Tribe and the educational and emotional support they provide each week.
Stacey: I hear so often, so very, very often about how someone contacted one of our podcast guests. And then that conversation turned into mentorship, a new business, or just support relationship. And when I hear about stuff like this of which Dr. Dickerson speaks, yeah, this is what makes me most proud.
I believe, especially in healthcare, those of us working fiercely and against all odds sometimes to do the right thing, it really should feel like a community, not just a lonely road. Because as we all know, this is hard. So, thanks to everyone listening for being there for each other. It matters maybe more than you realize at any given time.
Dr. Cristin Dickerson: While I previously focused primarily on cost savings in selling Green Imaging, Elizabeth Mitchell's quote (EP491) on the cost of employees' lost time trying to navigate the broken health system has shifted my focus toward the real access problem that exists in the broken system but can be overcome by innovation and aligned incentives.
Justin Leader's episode (EP433) on TPA spread and the weekly file feed has given me more ammunition for working directly with employers. It would be a rare episode that would not give me some fresh material for marketing and speaking.
Stacey and team, congratulations for compiling such a tremendous body of work and wonderful gift for those of us trying to fight the good fight of changing healthcare.
Stacey: And Dr. Dickerson, if I may just add, thank you so much for sharing your really actionable wisdom, too, such as the whole conversation we had on episode 485 about direct contracting for imaging. Please go back and listen to that if you have not. And then I wanna play this recording from Andrew Gordon.
Andrew Gordon: Hi, listeners. This is Andrew Gordon from the Marshall Allen Project. Relentless Health Value is a podcast that accomplishes a lot of amazing things for healthcare leaders looking to push past the status quo. It's a place for people to discover new innovations, companies, and thought leaders that care deeply for improving care on a systemic level.
It's a place for the positively focused change makers to have a stage where they can broadcast their messaging out to an audience army waiting in the wings to assist in taking action.
Stacey: Thank you, Andrew Gordon, for your kind words, for your shout-outs, and also for picking up the banner of Marshall Allen and his lifelong quest to help American consumers never pay the first bill, as he has said.
Not for any other reason than in healthcare, the first bill, odds are it's probably wrong. And that matters to everyone but particularly to the 41 million Americans or so with medical debt, many of whom would have qualified for charity care, but somehow it wasn't offered.
None of this is an academic exercise at this point, and, I don't know, maybe this is one of the reasons why so many of you who listen are able to connect with each other at the level that you can because it's recognized that squabbling over academic details is a luxury you can't afford when you're face-to-face with some really obvious human issues.
Andrew Gordon: It's a place for all of us to go and keep pace with what's happening in the ever so quickly evolving world of American healthcare.
I've been listening to this show for years. The content from these episodes has trickled into more professional and personal conversations than I can count. I've directly sent episodes to people, and it's one of the few healthcare podcasts I recommend to others on a regular basis.
Episode 491 with Elizabeth Mitchell is powerful, as she discusses how employers are leveraging costs and quality data.
Episode 483 with Jonathan Baran explains the flywheel and the cost deception that comes with employers buying discounts.
Encore episode 391 with Dr. Scott Conard explores mission versus margin and how relational high-value care can be delivered in a fee-for-service world.
Relentless Health Value has changed and will continue to change American healthcare.
Stacey: Right, so there's just real power in this assembly of people who have banded together into this tribe and the collective action that we are able to derive from it.
Here's Theme 3: Unplugging From the Matrix of Healthcare Opacity.
Anthony Hartley actually came up with the term "healthcare matrix." He wrote, "Each episode reveals facts and insights, helping us unplug from [this aforementioned] healthcare 'matrix.' We first have to see it for what it actually is, even when that reality is pretty starkly unattractive."
But around here we are focused on truth telling and exposing the perverse incentives that keep costs high and diminish quality. This is the third theme.
I like something that Ann Lewandowski said. She noted that her aha moment was realizing what has been preached was a lie regarding the idea that patients can actually shop for care in the current system. She said she realized this when she was told that finding a lower price is no reason to go out of network. What?
Here's what Andrew Tsang had to say.
Andrew Tsang: Hey, this is Andrew Tsang, healthcare consultant and writer of the Health Is Other People Substack. I just wanted to share my thoughts about Relentless Health Value, and I don't think you guys have enough time on this slot for me to really give all the praise that I really wanna share about how Relentless Health Value has really opened my perspective.
I had been working in the healthcare industry for about a decade for hospitals and for insurers and some Pharma even. And honestly, I could never really wrap my head around how complicated the U.S. healthcare system was. It always seemed to me to just accept that this is the way it is.
But I remember when this podcast showed up on my feed and I listened to a few episodes, and it really opened my eyes as to how we could get better value out of our health benefits or how to do business with a hospital, or even the rails that healthcare finance runs on.
Stacey: So, better value out of health benefits. I did an AI search, and it came up with 40 episodes on this theme. But let me highlight the shows with Rob Andrews (EP415) about jumbo employers getting better outcomes and saving 15% doing it.
Episode 385 with Dan Mendelson, including five things self-insured employers should be doing right now.
And also, to switch it up, episode 487 with Kevin Lyons about why it's so very, very hard for state and federal health plans to not fall victim to carrier and hospital lobbies such that taxpayers overpay and teachers and firefighters and police officers somehow wind up with a family plan that costs everybody $67,000 a year in 2026. That's, again, episode 487.
For doing business with the hospital, listen to, I wanna say, episode 383 with Nick Stefanizzi.
And for the rails of healthcare, I'd go with episode 497 with Zack Kanter, that episode. It's about clearinghouses and the hot mess happening in that neck of the woods.
Andrew Tsang: The podcast really opened my eyes that there's a possibility to fix this thing that we call U.S. healthcare. Now I don't necessarily agree or understand even the depth of what every guest has to say, but I don't doubt for a second that everyone who shows up on this podcast or, more importantly, anyone who listens to this comes from the same place about getting better value out of our healthcare system.
Stacey: This is a really important point that Andrew is making. Where there's a will, there's a way, and no one knows the right answer here really. Therefore, the best way to find the best way to move forward is for smart people with the will to get something done to retain the capacity of having a civil conversation with those who may disagree with the methods but largely agree on the general goal.
Sadly, as we all know, probably extremely and unfortunately well, the capacity for civil discourse is a flower that does not grow in everyone's garden.
But one thing I love the very most about this Relentless Health Value Tribe is your ability to have really great conversations and not blast each other in completely unproductive ways that help exactly no one, except an algorithm.
So, thank you. And by this, I mean thank you who is listening right now. I'm talking to you.
Andrew Tsang: And I think, Stacey, you've done an amazing job hosting this podcast and articulating a vision and leading this RHV Tribe that I'm really so glad to be a part of. And congrats on episode 500. I hope to listen to 500 more.
Stacey: And I love what Sergei Polevikov had to say here.
Sergei Polevikov: Hi, this is Sergei Polevikov, creator of AI Health Uncut Substack Newsletter and healthcare AI investigator.
Stacey, congrats on the 500th episode of Relentless Health Value. I think you have one of the most influential and long-running shows in healthcare. I just can't get enough of it. I love your show.
Stacey: Well, thanks so much, Sergei. I have learned so much from you, too, with your unflinching assessments of technology and AI in healthcare.
Sergei Polevikov: The first episode I listened to was episode 201 in 2018—eight years ago—with Clint Phillips. I enjoyed it so much that I cited you and Clint in my latest published paper, "Advancing AI in Healthcare: A Comprehensive Review of Best Practices."
You, Stacey, are the Willy Wonka of healthcare. Whoever you decide to put on the show has won the golden ticket. All your guests are great, and you make them even greater by highlighting their successes and providing nice "Healthcare for Dummies" summaries at the beginning of each show, which I truly appreciate.
No one else is doing it. It's like the monologue before every comedy talk show. For many people, it's the most favorite part of the show.
Stacey: Thank you. I guess it is kind of a monologue, and I do walk down the street often enough, kind of rehearsing what I want to say in the intro and definitely looking like I'm full-on talking to myself, which, I guess at that point, I am.
Sergei Polevikov: The industry desperately needs you, Stacey Richter. Please, please keep it up. Let's go to 1000 episodes.
Stacey: I really appreciate this whole comment. Is it a comment if it's an audio recording? But the point here is a really insightful assessment of honestly what we try to do over here. The goal of our show is as simple as it is ridiculous.
How do we actually, for real, fix this hot mess? What are the paths forward and the barriers we'll need to overcome so that we can get ready and really do this thing.
I wanna surface and I wanna flag the things that tech and its humans will need to overcome to succeed. So, we do have quite a few tech listeners, but they're of a piece, of a kind. Our listeners are those in tech who are more concerned about actually serving patients and clinicians and relationships therein, and plan sponsors, ultimate payers, taxpayers.
These are our people. We might not always agree with each other, as Andrew Tsang said earlier, but the North Star is clear. The beacon, as Dr. Alex Sommers, as he put it, is clear for everyone in the room.
For example, if I choose to take the path through the forest and you get yourself a boat and try to get there some other way, we can travel parallel paths and both learn invaluable lessons. That's what this tribe understands. We don't all have to be doing or thinking the same thing to be actually working together toward a common goal.
From a completely different lens, here's Bryce Platt, PharmD, talking about pharmacy.
Bryce Platt: This is Bryce Platt, some guy that posts on LinkedIn about the complexity of U.S. pharmacy. The episode about generic job pricing clarified a lot of pieces for me.
Stacey: This episode with Luke Slindee, PharmD (EP439) is actually one of the most sustainingly popular shows. Originally recorded in 2024, it still gets dozens of downloads week after week after week.
Thanks much for highlighting this episode, Bryce Platt, who everyone should follow on LinkedIn, by the way. His posts keep me, for one, up-to-date on what's happening in the Wild West of pharmacy.
Bryce Platt: There's just so many different drug prices, drug pricing metrics that are involved in the U.S. pharmacy supply chain. And it is incredible that there can be so many different metrics for one piece. Generic drug pricing might be the most complicated pricing system in the world.
Stacey: Yeah, right? By the way, episode 344 with Steve Quimby, MD, about the high price of generic drugs.
And episode 422 with Ben Jolley, PharmD, about indie pharmacies and generic drugs.
Also, on this theme of Unplugging From the Matrix of Healthcare Opacity (the opposite of transparency), Karen Simonton has noticed actually what Dr. John Lee reflected on earlier: how a bunch of episodes exposed how EHRs (electronic health records) and other technologies have probably in way too many cases become revenue cycle management tools.
The EHR has famously, of course, been called a glorified cash register. Just reminding us to look closely at the bean counting machines across the country that are oftentimes hidden in pretty words.
So, here we are at the end of episode 500. Throughout these past 500 shows this past decade—it did take me a while to get my act together—but our real goal has been to drive real-world decisions that finally fix the system.
When those choices are consistent and reality aligned and deeply rooted in actual knowledge of how the actual system works or may react, these decisions add up to a force potentially potent enough to make the healthcare sector in this country finally get closer to doing the right thing for patients—or at least I have to hope so. Otherwise, what are we all even doing here?
But what I will say is you are the ones that are making this whole thing happen. You here in the Relentless Health Value Tribe, you are the alchemists who take these insights and turn them into tangible solutions for the 100 million lives that you serve.
And I'm so honored to be on this mission with you. So honored. So, stay relentless. I honestly can't believe I just said that. It feels very cheeky, but it's also not optional. It's kind of a rate critical. So, thank you, everybody. You mean the world to me. Thanks for being here.
Thanks for doing what you do. On behalf of members, patients, families (mine and yours), thank you so much.
Also mentioned in this episode are Cora Opsahl; Aventria Health Group; Alex Sommers, MD; Michelle Bernabe; 32BJ Union Health Fund; Ken Wosczyna; Olivia Ross; Shane Cerone; Sam Flanders, MD; Cynthia Fisher; Paul Holmes; Lori Smith Guliano; Matt McQuide; LeeAnn Miller; Benjamin Light; Mark Weber; Aligned Value Advisors; Astia Health; Scott Conard, MD; John Lee, MD; Dave Chase; Justin Leader; Rob Marty; Samantha George; Cristin Dickerson, MD; Green Imaging; Elizabeth Mitchell; Andrew Gordon; Marshall Allen Project; Jonathan Baran; Anthony Hartley; Ann Lewandowski; Andrew Tsang; Rob Andrews; Dan Mendelson; Kevin Lyons; Nick Stefanizzi; Zack Kanter; Sergei Polevikov; Clint Phillips; Bryce Platt, PharmD; Luke Slindee, PharmD; Steve Quimby, MD; Benjamin Jolley, PharmD; Karen Simonton; and Mark Cuban.
The following previous episodes are mentioned: EP201 (Clint Phillips); EP240 (Olivia Ross); EP344 (Steven Quimby, MD); EP373 (Cora Opsahl); EP383 (Nick Stefanizzi); EP385 (Dan Mendelson); EP391 (Scott Conard, MD); EP397 (Paul Holmes); EP400 (Stacey); EP415 (Rob Andrews); EP422 (Benjamin Jolley, PharmD); EP433 (Justin Leader); EP438 (John Lee, MD); EP439 (Luke Slindee, PharmD); EP457 (Cynthia Fisher); EP462 (Scott Conard, MD); EP468 (Matt McQuide); EP483 (Jonathan Baran); EP485 (Cristin Dickerson, MD); EP487 (Kevin Lyons); EP490 (Shane Cerone and Sam Flanders, MD); EP491 (Elizabeth Mitchell); EP492 (Sam Flanders, MD, and Shane Cerone); EP497 (Zack Kanter); INBW39 [Narcissism of Small Differences] (Stacey); INBW43 [Thanksgiving Show] (Stacey); INBW44 [Year Review] (Stacey).
For a list of healthcare industry acronyms and terms that may be unfamiliar to you, click here.
For more information, go to aventriahealth.com.
Each week on Relentless Health Value, Stacey uses her voice and thought leadership to provide insights for healthcare industry decision makers trying to do the right thing. Each show features expert guests who break down the twists and tricks in the medical field to help improve outcomes and lower costs across the care continuum. Relentless Health Value is a top 100 podcast on iTunes in the medicine category and reaches tens of thousands of engaged listeners across the healthcare industry.
In addition to hosting Relentless Health Value, Stacey is co-president of QC-Health, a benefit corporation finding cost-effective ways to improve the health of Americans. She is also co-president of Aventria Health Group, a consultancy working with clients who endeavor to form collaborations with payers, providers, Pharma, employer organizations, or patient advocacy groups.
00:00 Introduction and episode 500 announcement.
00:22 The origin of episode 500.
01:49 The LinkedIn post and its impact.
02:43 Celebrating the Relentless Health Tribe.
07:55 Clip from Michelle Bernabe and how EP373 gave her a framework to model off of and understand that the failures in healthcare weren't personal failures.
10:08 Theme 1: Moving From Theory to Practical Transformation.
10:38 Clip from Ken Wosczyna and the episodes that have led to consistently good decisions in his work.
11:27 The Tipping Point by Malcolm Gladwell.
12:55 Examples of tribe members changing and improving their corner of healthcare after being inspired by RHV episodes.
13:54 Clip from Mark Weber.
14:54 Clip from Alex Sommers, MD, and how EP391 and EP462 changed his work.
16:13 Clip from John Lee, MD, and how RHV helped him realize that "gaming the system" can also be used for good.
18:42 Theme 2: The Power of the Tribe and Collective Momentum.
19:28 Clip from Justin Leader.
21:45 Why being a "good villager" is so important to the overall outcome of healthcare.
23:22 Clip from Cristin Dickerson, MD, and how she draws inspiration from various RHV episodes.
25:21 Clip from Andrew Gordon.
27:39 Theme 3: Unplugging From the Matrix of Healthcare Opacity.
28:32 Clip from Andrew Tsang.
29:29 RHV episodes that cover better value out of health benefits.
32:15 Clip from Sergei Polevikov.
34:11 What tech needs to do in order for healthcare to succeed and improve.
35:06 Clip from Bryce Platt, PharmD.
36:01 More RHV episodes on unplugging from pricing opacity.
Recent past interviews:
Click a guest's name for their latest RHV episode!
Dr Jay Kimmel, Mark Noel, Gary Campbell (Take Two: EP341), Zack Kanter, Mark Newman, Stacey Richter (INBW45), Stacey Richter (INBW44), Marilyn Bartlett (Encore! EP450)