For a full transcript of this episode, click here. On the show today, I am going to use the term TPA (third-party administrator) and ASO (administrative services only) vendor kind of interchangeably here. But these are the entities that a plan

Encore! EP391: A Case Study for Anyone Trying to Level Up Primary Care That I’m Gonna Call “How Margin Shoves Mission Off the Bus,” With Scott Conard, MD

13 days ago 36m 53s

For a full transcript of this episode, click here. Here’s a great musing that I read on LinkedIn: How will alternative primary care models fare when growth mode gets balanced with profitability and VC-supported burn rate is transformed to Big R

Encore! EP297: A Driver of Patient Engagement and Clinician Team Success That Is Almost Always Overlooked, With Jerry Durham

20 days ago 34m 32s

For a full transcript of this episode, click here. This show has implications for provider organizations of all stripes, especially those looking to succeed in value-based care or those who need patient trust and relationships for any other rea

EP432: The Knifepoint Intersection of Margin and Mission and the Peril of Cutting Clinical “Waste,” With Kate Wolin, ScD

27 days ago 38m 18s

For a full transcript of this episode, click here. First of all, I just want to start out this pod and really thank everyone listening and for showing up for a show like this one. You do it and you are here because you care about patients/membe

EP431: How Accountability for Outcomes Works in the Real World With Kenny Cole, MD

Mar 21st, 2024 39m 24s

For a full transcript of this episode, click here. There’s this meme that’s going around on the interwebs with the caption, “Sometimes the shortest distance in between two places isn’t a straight line.” What? Yeah, because actually there’s thre

EP430: Advice for Digital Health Vendors Selling to Employers, With Barbara Wachsman

Mar 14th, 2024 38m 45s

For a full transcript of this episode, click here. We have been spending a bunch of time here on Relentless Health Value talking about PBMs (pharmacy benefit managers) lately and pharmacy benefits, but we are moving into a new topic area. It so

EP429: Following the Dollar Through Pharmacy Acronyms Like WAC, AWP, and NADAC, With Luke Slindee, PharmD

Mar 7th, 2024 38m 20s

For a full transcript of this episode, click here. In this healthcare podcast we’re talking about pharmacy acronyms or terms like AWP and WAC, and, not really an acronym, but we’ll also talk pharmacy list prices, rebates, discounts. We also hav

EP428: Do-It-Now Advice From the J&J and the DOL v BCBS Lawsuits, With Julie Selesnick

Feb 29th, 2024 41m 52s

For a full transcript of this episode, click here. This show is different, so if you’ve already listened to or read all about the gory details of the J&J and/or the DOL v BCBS lawsuits, this is not gonna be a repeat of that information. Julie S

EP427: How Do Digital Health Vendors Deliver Patient Outcomes and Experiences? With Rik Renard

Feb 22nd, 2024 36m 23s

For a full transcript of this episode, click here. Hey, Relentless Health Value Tribe, thanks so much for being here this week. I gotta say, I really appreciate all of you who write and tell me that you kick off your Thursdays by listening to t

Encore! EP379: How Much Money, Really, Are Employee Benefit Consultants and/or Brokers Making From Plan Sponsors? With AJ Loiacono

Feb 15th, 2024 35m 13s

For a full transcript of this episode, click here. Here on Relentless Health Value, we have done a bunch of shows lately on how some weird PBM (pharmacy benefit manager) and pharmacy goings-on impact plan members, patients, and also independent

EP426: Cost Containment Versus Value-based Drug Purchasing, With Nina Lathia, RPh, MSc, PhD

Feb 8th, 2024 33m 26s

For a full transcript of this episode, click here. Here’s something Randy Vogenberg, PhD, wrote the other day; and I made some light edits: Research has documented the unintended impacts of poor pharmacy benefit strategy. Examples include incre

EP425: Three Ways for “Regular” Clinical Practices to Take Cash When It’s Cheaper for a Patient Than Using Their Insurance, With Marshall Allen

Feb 1st, 2024 39m 20s

For a full transcript of this episode, click here. This show today is for physicians or other clinicians or providers who are still taking insurance—those who are going about their day being pretty normal ... but at the same time, they’re notic

INBW39: The Narcissism of Small Differences Is a Really Must-Know Concept When Attempting to Fix the Healthcare Industry

Jan 25th, 2024 19m 9s

For a full transcript of this episode, click here. This inbetweenisode is me geeking out, so if that’s not your thing, you’ve been warned. There’s a term I’d like to encourage anyone interested to look up. It’s the narcissism of small differenc

EP424: Five Things for Hospital System Execs to Get Real About in 2024, With Peter Hayes

Jan 18th, 2024 45m 7s

For a full transcript of this episode, click here. Here’s a quote from Ann M. Richardson, MBA. She wrote it on LinkedIn, and I love it: Quiet the noise that doesn’t add value. Surround yourself with intelligent and respectful people who can del

EP423: Maximizers and the “the Drugs Aren’t Covered” Schemes Employers Use to Save Money (or Not) on Pharmacy Benefits, With Joey Dizenhouse

Jan 11th, 2024 44m 17s

For a full transcript of this episode, click here. For a deep dive into the way back backstory here, listen to the show with Dea Belazi, PharmD, MPH. That’s episode 293, and it’s entitled “Game Theory Gone Wild,” because gone wild is what has h

EP422: Some Indie Pharmacy Upshots That Surprised Me—and I Thought I Was Pretty in the Know, With Benjamin Jolley, PharmD

Jan 4th, 2024 36m 43s

For a full transcript of this episode, click here. Listen to this show as either a follow-on or a prequel to the shows with Mark Cuban and Ferrin Williams, PharmD, MBA (EP418) and Ge Bai, PhD, CPA (EP420). And if you’re interested in this “what

Encore! EP392: When Patient Journeys Don’t Fit in the EHR, With Emily Kagan Trenchard

Dec 28th, 2023 30m 48s

For a full transcript of this episode, click here. I thought I would encore this show after coming back from the 2023 NODE Conference held in the Microsoft building in New York City, which I always enjoy. NODE stands for Network of Digital Evid

Encore! EP372: Step One for Employers and Unions—Get Your Data, With Cora Opsahl

Dec 21st, 2023 31m 43s

For a full transcript of this episode, click here. Why did I decide to encore this episode where Cora Opsahl from 32BJ spends 29 minutes talking about the importance of getting your data if you are an employer or a union health fund? Let me quo

EP421: Wildly Improving Outcomes When the Patient Is, for Reals, in the Center—For Maternity and Beyond, With Jodilyn Owen

Dec 14th, 2023 35m 35s

For a full transcript of this episode, click here. I want to kick off this show with a clip from episode 415 with Rob Andrews, wherein he so very eloquently sets the stage here: We think that one of the core problems here is that too many inter

EP420: Paying Cash for Generic Drugs—Some Finer Points That Had Totally Gone Over My Head, With Ge Bai, PhD, CPA

Dec 7th, 2023 36m 57s

For a full transcript of this episode, click here. This show is a very natural follow-on to episode 418 with Mark Cuban and Ferrin Williams, PharmD, MBA. This show is the how, as in, “How did everything that we talked about in the earlier show

EP419: The Financialization of Health Benefits for Boards of Directors and C-Suites of Self-Insured Employers, With Andreas Mang

Nov 30th, 2023 38m 20s

For a full transcript of this episode, click here. Are you on the board of directors of a company? Or are you a shareholder of a publicly traded company? Or are you a CEO or a CFO who reports to a board of directors or these shareholders? Well,

Encore! EP381: For Reals, Becoming Customer-centric, Transforming, or Innovating at a Very Large Organization, With Karen Root

Nov 23rd, 2023 32m 13s

Why did I decide to encore this show about being customer-centric and transforming or innovating at a very large organization? Well, two main reasons. First reason can be neatly summed up by this recent Tweet from Rik Renard, which I have edite

EP418: Mark Cuban With Some Advice for CEOs and CFOs of Self-insured Employers, With Mark Cuban and Ferrin Williams, PharmD, MBA, From Scripta

Nov 16th, 2023 54m 42s

CEOs and CFOs … hey, this show is for you. Let’s start here: What do all of these numbers have in common: $140,000, $3 million, $35 million, and $3 billion? These are all actual examples of how much employers, unions, and some public entities s

Encore! EP385: Morgan Health and the 5 Things Self-insured Employers Should Do Right Now, With Dan Mendelson

Nov 9th, 2023 34m 6s

There are two big reasons why I decided to encore this show with Dan Mendelson from Morgan Health at this exact moment in time. 1. It’s a great show (one of our most popular shows in the last year, actually) with lots of keen insights for self-

EP417: 5 Kinds of Payer and Provider Collaborations and 5 Must-Haves for Said Collaborations to Work, With Josh Berlin, JD

Nov 2nd, 2023 33m 43s

Yeah, it’s a fact that the vast majority of past and present provider and payer relationships are not exactly collaborative. They may better be described as fairly adversarial, actually—especially when viewed through the lens of provider organi