Episodes
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EP511: The Tension When Clinical Teams Take On Risk for Policymakers and Others Looking to Rustle Up Future Perverse Incentives, With Dr. Siva and Monica Lypson, MD, MHPE
Listen on Your Favorite App Last week, we talked Medicare Advantage with Betsy Seals ( EP510 ), and we talked about finding members who a plan can serve well. This makes sense because Medicare Advantage is a capitated program. In other words, Medicare Advantage plans get paid by CMS a per member per...
EP510: The Impact on You of Medicare Advantage Goings-on (2026 Edition), With Betsy Seals
Listen on Your Favorite App I came up with at least one way to tell the difference between making a fair profit and profiteering. If someone makes more money when the patients or members they serve are worse off, yeah, call that profiteering. For a full transcript of this episode, click here . If yo...
EP509: The 7.7% Wake-Up Call: A Roadmap to Align Finance Teams With Non-complacent Benefit Design, With Patrick Nelli
Listen on Your Favorite App Sarah Monroe: Hi. This is Sarah Monroe in Chicago, and I'm a benefits procurement leader. And I'm curious why you think so few executives take proactive bold action in health benefits strategy given the magnitude of opportunity. Stacey: Isn't that a great question? For a ...
EP508: Why Don't More Self-insured CEOs Take Bold Action in Health Benefits Strategy? With Lee Lewis
Listen on Your Favorite App This episode is the very first episode that we have done that is an AMA—an Ask Me Anything—and here is our very first question. Sarah Monroe: Hi. This is Sarah Monroe in Chicago, and I'm a benefits procurement leader. And I'm curious why you think so few executives take p...
EP507: 4 Core Concepts to Buy or Deliver the Highest-Value Healthcare—A Review
Listen on Your Favorite App Look, we wonks, meaning you and me, you're listening to this, so I am on to you. But we wonks in the Relentless Tribe, we move like lightning on Relentless Health Value. We tend to cover lots of ground pretty fast. So, sometimes I like to, with great intention, sum up wha...
EP506: How Other Employers, Shareholders, and Clinics Are Using Price Transparency Data—And It's an Arms Race, With Jerry DiMaso
Listen on Your Favorite App, So, we have a few miniseries afoot here on Relentless Health Value right now, and one of them is "The Inches That Are All Around Us"—finding the hidden fees, the hidden friction for plans and members and clinics themselves a lot of times in those inches. For a full trans...
EP505: The Death of the "What Is Value" Guessing Game for Clinical and Plan Decision-Makers Ready to Move On, With Ahilan Sivaganesan, MD
Listen On Your Favorite App Hello, Relentless Tribe. Thank you so much for showing up today. All right … to start, let me lay out the goal of the episode today. This episode is for you if you are a self-funded employer looking to ensure your members are steered and tiered to real high-value care and...
EP504: A Back-to-Basics Roadmap Through the Perverse Incentives to Advanced Primary Care, With Ryan Jacobs
Listen On Your Favorite App It's been a while since we started from the beginning, so let's just take stock of the basics in this show, refresh ourselves if you're a longtime listener, or welcome if you're new around here. Today we are digging on and about what I would call the poster child for prov...
INBW46: Relentless Tribe Goings-On With Insights to Outwit the Hot Mess of the Non-Healthcare Market
Listen On Your Favorite App This inbetweenisode I wanna try something new for two reasons. One of them is that I need to check this episode off my to-do list because I am crushed for time. I'm going to be headed to Arizona tomorrow for the Collective Health Conference , which will have occurred thre...
EP503: Let's Go From Lazy PPO Networks to Smart Collaboration With Direct-to-Employer Specialty Care, With Ryan Wells; Leo Spector, MD, MBA; and Adam Stavisky
Listen On Your Favorite App Today we are digging into something I've said probably way too often: Collaboration is the next breakthrough innovation. And I'm doubling down on this because in the current healthcare landscape, two parties that actually should be talking—like burning up the phone wires ...