Stacey & Dan Serrano Discuss the payer/provider collaboration
August 10, 202300:01:00

Stacey & Dan Serrano Discuss the payer/provider collaboration

We’re talking about payer/provider collaboration—blocking and tackling, I’m gonna say—from primarily a financial and revenue point of view.

If you don't develop that operational excellence, that inherent organizational muscle that says, Oh, when we have CKD patients, our CKD patients run at a materially lower cost level than a market average, well, then your opportunity to leverage that care model, to take care of those patients, to outperform benchmarks and perform inside risk contracts is not there.

So you can't progress. into those greater levels of risk. You said something super interesting there. What the goal is for an MSSP ACO is to be able to state that ACO can provide care that outperforms a market benchmark. And if you can say that, then you can start moving into greater levels of risk because the delta between how that particular ACO is doing and that market benchmark, like that's the opportunity that you would start negotiating.

Around because those are the dollars that are on the table it sounds like.

Listen to the entire episode here...
https://youtu.be/qfTJyNBOzho
employer benefits professionals, cope health solutions, healthcare leanders, healthcare, medical, idn, ipa, benefits, ckd, relentless health value, patient advocacy, shorts, payers and providers, pharma, aco, CIN, stacey richter, insurance carrier, health industry, Dan Serrano,
|

Episode Support Provided By

Special Thanks to Our 2026 Sustaining Monthly Donors

Kimberly CarlesonDylan YahnBenjamin LightMatt McQuideAnn KempskiSpencer AllenScott TromanhauserMarilyn BartlettSteven ElkinsMatthew Bunte.

Recent Episodes

EP505: The Death of the "What Is Value" Guessing Game for Clinical and Plan Decision-Makers Ready to Move On, With Ahilan Sivaganesan, MD
Relentless Health ValueApril 02, 2026
505
44:0240.31 MB

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
Relentless Health ValueMarch 26, 2026
504
33:3630.76 MB

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
Relentless Health ValueMarch 19, 202619:3717.96 MB

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
Relentless Health ValueMarch 12, 2026
503
46:1642.35 MB

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 ...

EP502: How Some Pretty Wild Medicare Fraud Sabotages ACOs and Also Independent Practices and Could Cost Plan Sponsors Such as Self-insured Employers a Lot of Zeros Downstream, With Brian Machut
Relentless Health ValueMarch 05, 2026
502
38:5835.67 MB

EP502: How Some Pretty Wild Medicare Fraud Sabotages ACOs and Also Independent Practices and Could Cost Plan Sponsors Such as Self-insured Employers a Lot of Zeros Downstream, With Brian Machut

You know, I always kind of wondered what the hackers were doing with all of the medical data that they've managed to get their mitts on over the past, I don't know, however many years. Now, I know at least one thing. If you're a hacker, you can use your stolen medical data to not actually send wildl...

EP501: Speaking of Infusions, Do You Want to Pay $135 or Do You Want to Pay $13,560 for the Exact Same Drug? With Ivana Krajcinovic, PhD
Relentless Health ValueFebruary 26, 2026
501
39:5736.57 MB

EP501: Speaking of Infusions, Do You Want to Pay $135 or Do You Want to Pay $13,560 for the Exact Same Drug? With Ivana Krajcinovic, PhD

Let us chat about today the inches all around us and also about how there is no market in healthcare all at once in this show. Today I am talking with Ivana Krajcinovic. And let me give you some examples of the inches. Two members of a plan get infusions at a hospital. And if these two members had g...

Take Two: EP398: Why Are Commercial Carrier Marketplaces Completely Boring? Maybe Because There Isn't a Marketplace, With Jacob Asher, MD
Relentless Health ValueFebruary 19, 202634:5231.91 MB

Take Two: EP398: Why Are Commercial Carrier Marketplaces Completely Boring? Maybe Because There Isn't a Marketplace, With Jacob Asher, MD

We have been doing a little series called "The Inches Are All Around Us," digging out waste in the $5.6 trillion healthcare sector where half an inch of waste can equal billions of dollars. I'm going to right now introduce another series that is complementary but has a slightly different focus. And ...

Listen and Follow

Sponsored by Aventria Health Group
©2026 BD Bridges LLC. All Rights Reserved.