Episodes
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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...
EP520: Cash-Pay Generic Drugs Are a Functioning Market in Healthcare—Policymakers Beware and Be Careful
Listen on Your Favorite App In the pachinko machine that is the healthcare industry, with just so many intermediaries, with so much regulatory capture and conflicts of interest that may or may not be visible, so much margin that is shrouded in mystery in an ecosystem as messy as this with so many va...
EP519: The Current State of Primary Care—Inevitable or Fixable? With Lisa Rosenbaum, MD
Listen on Your Favorite App Hello, all you Relentless Tribe members. Today, let's start here. Right now, we are watching a very visible exodus of brilliant, consummate primary care (and other, honestly) physicians leaving traditional practice for concierge medicine or otherwise. For a full transcrip...
EP518: How Do You Explain the Difference Between an ASO Vendor and a TPA? With Claire Brockbank
Listen on Your Favorite App Dr. Alex Sommers: Hi. I'm Alex Sommers. I'm president of Astia Health, an advanced direct primary care organization, an emergency medicine and lifestyle medicine physician, as well as a licensed employer health plan advisor from Wisconsin. I'm curious how you explain the ...
EP517: The Business of Prior Auths: The 401-Level Financial Motive Behind Prior Auths
Listen on Your Favorite App Hello, Relentless Health Value Tribe. Welcome to it. So, yeah … last week, I had a great conversation with Ophelia Johnson ( EP516 ) that is a companion show, I would say, to this one. So, listen to that one first. Listen to this one first. You do you. For a full transcri...
EP516: GLP-1s and Cash Pay From the Pharma Manufacturer Point of View, With Ophelia Johnson
Listen on Your Favorite App Hello, all you Relentless Tribe members. Welcome to it. Today we have a show that will bend your mind in new directions. And yes, I have a head cold at a very weird time of year. I have trouble apparently doing things like normal people. Anyway, we talk a lot on this podc...
EP515: SNF (Skilled Nursing Facility) Fraud—Or Is It Fraud? With Michelle Cera, PhD
Listen on Your Favorite App Hello, all you Relentless Tribe members. Lately, I have been just obsessed with what's hiding in plain sight: the root cause glitches in how American healthcare is built. Not the symptoms now. Not the noise. The actual ground zero. I mean, what we call healthcare in this ...
EP514: Successfully Suing a Health System for Their Anticompetitive Contracts and Also Collecting Damages for Plan Sponsors and Members, With Matt Cantor
Listen on Your Favorite App Hello, all you Relentless Tribe members. This is the third episode in our legal goings-on trifecta, starting with Doug Aldeen in episode 512 covering what amounts to the main reasons plan sponsors wind up suing their brokers or employee benefit consultants. For a full tra...
EP513: Revisiting Cunning Anticompetitive Hospital Contracts, With Brennan Bilberry
Listen on Your Favorite App If you are a large employer, union funds broker, fiduciary, or anyone responsible for a health plan that spends half of its dollars on hospital care (which most do), or if you have anything to do with policy or enforcement of policy, yeah … listen this week and next week....