Episodes
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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...
EP530: A Wildly Underappreciated Point: Overpaying for Infusions Means Overpaying for Stop-Loss Coverage, With Jake Velie and Keith Hartman, RPh
Listen on Your Favorite App Hello, all you Relentless Tribe members. Thanks for hanging with me this week. When a self-insured plan sponsor sees an infusion claim hit their high-cost case report, and a lot of these infusions are really expensive, so many of them hit the high-cost claim report. For a...
EP529: How Stark Law, Stipends, and Noncompetes Drive Hospital Consolidation, With Eric Bricker, MD
Listen on Your Favorite App Hello, all you Relentless Tribe members. Hey, thanks for being here with me every week, some of you every single Thursday. Give yourself a little round of applause, maybe silently and in your own head, depending on where you are. But yeah, you matter. You being here matte...
EP528: The Current State of Primary Care—Inevitable or Fixable? Will It Be Private Equity to the Rescue? With Yashaswini Singh, PhD
Listen on Your Favorite App Hello, all you Relentless Tribe members. Here's the backstory for this episode. Remember episode 519 with Lisa Rosenbaum, MD, where we played a high-stakes kind of game show called "Is the Current State of Primary Care an Absolute Inevitability, or Is It a Needless, Subop...
EP526: Generic Compliance Ratios, Pass-Through Contracts, and Other Pharmacy Plumbing, With Mark Cuban and Cora Opsahl
Listen on Your Favorite App Hello, all you Relentless Tribe members. If you have listened to this show for any length of time, you know one of our favorite truths around here, which is where there's mystery, there's margin. But today, we aren't just here to point out the mystery. We're here to look ...
EP525: PMPM vs FFS—The Perverse Incentives Plan Sponsors Sometimes Miss, With Cristin Dickerson, MD
Listen on Your Favorite App So, this one's gonna be a little bit different. Back last year, I sat down with Dr. Cristin Dickerson. She is the founding partner of Green Imaging , which is a physician-led radiology network doing direct contracting for imaging. And we talked about how imaging can run 6...
EP524: Beating Provider Network Pricing Games by Thinking About Buying Healthcare Like a Manufacturer Supply Chain, With John Quinn
Listen on Your Favorite App Hello, all you Relentless Tribe members. First off here, I would like to thank Casey Cormier for the really nice recurring donation. Thank you so much, Casey Cormier from Stratis Group . Lately, traditional provider networks are increasingly being called into questi...
EP523: The Sleeping Giants of Healthcare—Why Self-insured Employers and Clinicians Keep Missing Each Other, With Suhas Gondi, MD, MBA
Listen on Your Favorite App Hello, all you Relentless Tribe members. Before we dive in today, I just wanted to give a quick but massive thank you to Alex Sommers, MD, ABEM, DipABLM, from Astia Health for his generous gift, which we are going to use to help fund a camera for the podcast here to level...
EP522: How Exactly Does GoodRx Make Money? With Ge Bai, PhD, CPA
Listen on Your Favorite App Arielle Bose: Hi, Stacey. This is Arielle Bose from EHD Insurance . Big fan of the podcast. We were talking about GoodRx the other day, and it occurred to me that I’m not exactly clear about how they make money. So, Stacey, how does GoodRx make money? For a full transcrip...
EP521: How Revenue Cycle Management (RCM) Became an Over $200 Billion Healthcare Hot Potato, With Andrew Tsang
Listen on Your Favorite App Hey, welcome to Relentless Health Value. Okay … so, on today's show, we are talking about (Andrew Tsang and I) revenue cycle management, which—I say this with real affection—is maybe the least sexy phrase in all of healthcare. It sounds like a back-office spreadsheet prob...