Episodes

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EP468: Very Common Assumptions That Aren’t Actually True About Member Engagement and the Healthcare Industry, With Matt McQuide
March 20, 2025
468
34:3931.72 MB

EP468: Very Common Assumptions That Aren’t Actually True About Member Engagement and the Healthcare Industry, With Matt McQuide

This conversation today with Matt McQuide is such a follow-on to the episode from last week where I encapsulated a major theme from the past five or six episodes. I know I’m on a roll. The thing is, if an employer doesn’t take the initiative and steer members or help them navigate through our curre...

EP467: Connecting Sky-High ER Spend to Primary Care Access—Following the Dollar Through Carriers and Hospitals, With Stacey Richter
March 13, 2025
467
23:0921.19 MB

EP467: Connecting Sky-High ER Spend to Primary Care Access—Following the Dollar Through Carriers and Hospitals, With Stacey Richter

Here’s my new idea for an episode. Welcome to it. I want to talk about a major theme running through the last few episodes of Relentless Health Value. And this theme is, heads up, going to continue through a few upcoming shows as well. For a full transcript of this episode, click here . If you enjo...

EP466: What Is Rising Faster, Insurance Premiums or Hospital Prices? With Vivian Ho, PhD
March 06, 2025
466
36:1233.13 MB

EP466: What Is Rising Faster, Insurance Premiums or Hospital Prices? With Vivian Ho, PhD

This episode has three chapters. Each one answers a key question, and, bottom line, it all adds up to action steps directly and indirectly for many, including plan sponsors probably, community leaders, and also hospital boards of directors. Here’s the three chapters in sum. For a full transcript of...

EP465: The Not Super Effective Contracting Industry Norm, Where Jumbo Plans and Others Wind Up Paying $10,000 for $50 Drugs, With Chris Crawford
February 27, 2025
465
34:1531.34 MB

EP465: The Not Super Effective Contracting Industry Norm, Where Jumbo Plans and Others Wind Up Paying $10,000 for $50 Drugs, With Chris Crawford

First of all, everybody listening here has probably heard of the lawsuit in which J&J—and talking about J&J as a large employer here now, not as a drug company—but J&J is (or maybe was, there’s action afoot) being sued by a plan member because, here’s the short version, allegedly, the J...

EP464: ER Visits Now 6% of Total Plan Spend. Is It Upcoding or What? With Al Lewis
February 20, 2025
494
31:4028.99 MB

EP464: ER Visits Now 6% of Total Plan Spend. Is It Upcoding or What? With Al Lewis

Today, I am speaking with the one, the only Al Lewis, and we’re gonna talk about how 6% of a lot of plan sponsors’ total spend is now going to ER/ED (emergency room/emergency department) visits. That’s a lot of spend. For a full transcript of this episode, click here . If you enjoy this podcast, be...

EP463: Medicare Advantage Policies—Which Will Stay and Which Will Go Now? With Betsy Seals
February 13, 2025
463
35:1132.2 MB

EP463: Medicare Advantage Policies—Which Will Stay and Which Will Go Now? With Betsy Seals

Every Gen X’er listening to this is gonna be singing that Clash  song in your head for the rest of the day. So, let’s turn our attention to Medicare Advantage policy. And on the show today, I grill the one and only Betsy Seals to find out which policies she thinks are going to stay and which a...

Encore! EP384: How Shareholders Impact Carrier Behavior, Exactly and Specifically, With Wendell Potter
February 06, 202535:0132.05 MB

Encore! EP384: How Shareholders Impact Carrier Behavior, Exactly and Specifically, With Wendell Potter

I am drowning in all things Q1 right now. So, this week we’re going with an encore. But this is a great show to go back and reflect upon, as it’s about carriers and how shareholders impact the actions of said carriers. For a full transcript of this episode, click here . If you enjoy this podcast, b...

EP462: Managing Populations of Whole, Actual People Who Are Not the Sum of a Bunch of Different Body Parts, With Scott Conard, MD
January 30, 2025
462
33:3430.73 MB

EP462: Managing Populations of Whole, Actual People Who Are Not the Sum of a Bunch of Different Body Parts, With Scott Conard, MD

Hello, Tribe. I hope everyone is holding up in this Q1 where there is so much going on. I feel like I’m juggling 10 plates while running on a treadmill that keeps stopping and starting at random intervals. How you doing? For a full transcript of this episode, click here . If you enjoy this podcast,...

INBW42: A Philosophical Rabbit Hole of Considerations for Plan Sponsors and Others
January 23, 202527:3925.31 MB

INBW42: A Philosophical Rabbit Hole of Considerations for Plan Sponsors and Others

There have been two episodes lately that have sent me down a rabbit hole that I wanted to bring to your attention. Now, disclaimer: I know you people; you’re busy. You listen on average to, like, 26 minutes of any given episode. So, yeah … look at me being self-aware. I say all this to say welcome ...

Recent Episodes

EP468: Very Common Assumptions That Aren’t Actually True About Member Engagement and the Healthcare Industry, With Matt McQuide
March 20, 2025
468
34:3931.72 MB

EP468: Very Common Assumptions That Aren’t Actually True About Member Engagement and the Healthcare Industry, With Matt McQuide

This conversation today with Matt McQuide is such a follow-on to the episode from last week where I encapsulated a major theme from the past five or six episodes. I know I’m on a roll. The thing is, if an employer doesn’t take the initiative and steer members or help them navigate through our curre...

EP467: Connecting Sky-High ER Spend to Primary Care Access—Following the Dollar Through Carriers and Hospitals, With Stacey Richter
March 13, 2025
467
23:0921.19 MB

EP467: Connecting Sky-High ER Spend to Primary Care Access—Following the Dollar Through Carriers and Hospitals, With Stacey Richter

Here’s my new idea for an episode. Welcome to it. I want to talk about a major theme running through the last few episodes of Relentless Health Value. And this theme is, heads up, going to continue through a few upcoming shows as well. For a full transcript of this episode, click here . If you enjo...

EP466: What Is Rising Faster, Insurance Premiums or Hospital Prices? With Vivian Ho, PhD
March 06, 2025
466
36:1233.13 MB

EP466: What Is Rising Faster, Insurance Premiums or Hospital Prices? With Vivian Ho, PhD

This episode has three chapters. Each one answers a key question, and, bottom line, it all adds up to action steps directly and indirectly for many, including plan sponsors probably, community leaders, and also hospital boards of directors. Here’s the three chapters in sum. For a full transcript of...

EP465: The Not Super Effective Contracting Industry Norm, Where Jumbo Plans and Others Wind Up Paying $10,000 for $50 Drugs, With Chris Crawford
February 27, 2025
465
34:1531.34 MB

EP465: The Not Super Effective Contracting Industry Norm, Where Jumbo Plans and Others Wind Up Paying $10,000 for $50 Drugs, With Chris Crawford

First of all, everybody listening here has probably heard of the lawsuit in which J&J—and talking about J&J as a large employer here now, not as a drug company—but J&J is (or maybe was, there’s action afoot) being sued by a plan member because, here’s the short version, allegedly, the J...

EP464: ER Visits Now 6% of Total Plan Spend. Is It Upcoding or What? With Al Lewis
February 20, 2025
494
31:4028.99 MB

EP464: ER Visits Now 6% of Total Plan Spend. Is It Upcoding or What? With Al Lewis

Today, I am speaking with the one, the only Al Lewis, and we’re gonna talk about how 6% of a lot of plan sponsors’ total spend is now going to ER/ED (emergency room/emergency department) visits. That’s a lot of spend. For a full transcript of this episode, click here . If you enjoy this podcast, be...

EP463: Medicare Advantage Policies—Which Will Stay and Which Will Go Now? With Betsy Seals
February 13, 2025
463
35:1132.2 MB

EP463: Medicare Advantage Policies—Which Will Stay and Which Will Go Now? With Betsy Seals

Every Gen X’er listening to this is gonna be singing that Clash  song in your head for the rest of the day. So, let’s turn our attention to Medicare Advantage policy. And on the show today, I grill the one and only Betsy Seals to find out which policies she thinks are going to stay and which a...

Encore! EP384: How Shareholders Impact Carrier Behavior, Exactly and Specifically, With Wendell Potter
February 06, 202535:0132.05 MB

Encore! EP384: How Shareholders Impact Carrier Behavior, Exactly and Specifically, With Wendell Potter

I am drowning in all things Q1 right now. So, this week we’re going with an encore. But this is a great show to go back and reflect upon, as it’s about carriers and how shareholders impact the actions of said carriers. For a full transcript of this episode, click here . If you enjoy this podcast, b...

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