Episodes
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EP537: Physicians as the Sleeping Giant—Why Many Doctors Don't Push Back and Some Advice, With Benjamin Schwartz, MD, MBA
Listen on Your Favorite App Benjamin Schwartz, MD, MBA: You got to start kinda nudging the giant. And I think from the physician standpoint, that is … the simplest thing is just educate yourself, understand what's going on, take an interest in it, and that's how you start. And then you go from there...
EP536: Operationalizing the Architecture of Primary Care Patient Experience, With Rebecca Andrews, MD
Listen On Your Favorite App Stacey: If you are a plan sponsor thinking about, for example, primary care as a way to optimize healthcare spend, do know that any given plan sponsor will really only get maximum possible benefit from an investment in primary care, advanced primary care, when and only wh...
EP535: When Patient Experience Means Parking and Pianos, Plan Sponsors Pay for Hotels, Not Outcomes—What to Measure Instead, With Robyn Leone
LIsten on Your Favorite App On episode 532 a few weeks ago, Chris Klomp from HHS was talking about ER (emergency room) usage as a signal, not just a statistic. If too many folks show up in the ER, consider this a signal that there's something missing. It means a patient who doesn't have access to pr...
EP534: The One Question to Test if a TPA Is Actually Independent, With Kimberly Carleson
Listen On Your Favorite App Here's a question I have heard more than once: What is a practical, speedy way to assess whether a TPA (third-party administrator) is truly independent and willing to protect the plan's interests, this plan sponsor's interests, versus being captive to, for example, networ...
EP533: Level Funding Is Self-funding: 5 Avoidable Contract Risks, With Frank Pennachio
Hello, all you Relentless Tribe members. Thanks for hanging with me today to talk about a bunch of things. One of them being what exactly are level-funded plans, and what are the upsides, and then what are the risks? Because here's the thing. I was talking to an employer the other day, an employer w...
EP532: Why Avoidable ER Visits Aren't the Real Cost Problem: Revisiting Our 2016 Interview With HHS Nominee Chris Klomp
Listen on Your Favorite App Today we are dipping into the archives for an essential replay from 2016, one decade ago, featuring Chris Klomp back when he served as CEO of a company called Collective Medical. With the nomination of Chris Klomp to serve as deputy secretary of the Department of Health a...
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...