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Relentless Health Value Relentless Health Value Stacey Richter Indianapolis News Today | 2 Min News | The Daily News Now! Indianapolis News Today | 2 Min News | The Daily News Now! The Daily News Now! WRFH/Radio Free Hillsdale 101.7 FM WRFH/Radio Free Hillsdale 101.7 FM Student Content The Nicole Sandler Show The Nicole Sandler Show Nicole Sandler Crime Stories with Nancy Grace Crime Stories with Nancy Grace iHeartPodcasts and CrimeOnline Cleveland Cavaliers News Today | 2 Min News | The Daily News Now! Cleveland Cavaliers News Today | 2 Min News | The Daily News Now! The Daily News Now! Wayne Allyn Root’s WAR Zone Audio Hours Wayne Allyn Root’s WAR Zone Audio Hours Talk Media Network Rebel News Podcast Rebel News Podcast Rebel News Part Of The Problem Part Of The Problem GaS Digital Network Bill O’Reilly’s No Spin News and Analysis Bill O’Reilly’s No Spin News and Analysis Bill O'Reilly Taxpayer Talk Taxpayer Talk New Zealand Taxpayers' Union Inc. Ekot senaste nytt Ekot senaste nytt Sveriges Radio LuAnna: The Podcast LuAnna: The Podcast Global The Yishai Fleisher Israel Podcast The Yishai Fleisher Israel Podcast Yishai Fleisher Entrez dans l'Histoire Entrez dans l'Histoire RTL The Great America Show The Great America Show Fawcett Strategies Top Story with Tom Llamas Top Story with Tom Llamas NBC News Road Trip After Hours w/ WWE Hall of Famer Teddy Long and Host Mac Davis Road Trip After Hours w/ WWE Hall of Famer Teddy Long and Host Mac Davis Mac Davis and WWE Hall of FamerTeddy Long Free State with Joe Brolly and Dion Fanning Free State with Joe Brolly and Dion Fanning Gold Hat Productions No Doubt About It No Doubt About It Mark and Krysty Ronchetti Shipping Forecast Shipping Forecast BBC Radio 4 "the BARgument 2.0" "the BARgument 2.0" Chris Spafford SOUTHEAST IOWA TODAY With John Bain SOUTHEAST IOWA TODAY With John Bain John R Bain The Barn Podcast Network The Barn Podcast Network Hot Route Media ABC7 Eyewitness News ABC7 Eyewitness News ABC7 Los Angeles Doom Scrollin' with Sam Tripoli and Midnight Mike Doom Scrollin' with Sam Tripoli and Midnight Mike Sam Tripoli | Midnight Mike FutureCast/未来播报 FutureCast/未来播报 atelierqin Fala Glauber Podcast Fala Glauber Podcast Fala Glauber Reform California with Carl DeMaio Reform California with Carl DeMaio Carl DeMaio SIGNAL STREAM SIGNAL STREAM Signal Stream InvestTalk InvestTalk Hosts Justin Klein & Luke Guerrero, CFA | Wealth Managers and Investment Advisors Drinkin‘ Bros Podcast Drinkin‘ Bros Podcast Tetherball Academy Media Cincinatti Reds News Today | 2 Min News | The Daily News Now! Cincinatti Reds News Today | 2 Min News | The Daily News Now! The Daily News Now! News Headlines in Morse Code at 10 WPM News Headlines in Morse Code at 10 WPM Mark Percival News Headlines in Morse Code at 15 WPM News Headlines in Morse Code at 15 WPM Mark Percival News Headlines in Morse Code at 30 WPM News Headlines in Morse Code at 30 WPM Mark Percival San Francisco Giants News Today | 2 Min News | The Daily News Now! San Francisco Giants News Today | 2 Min News | The Daily News Now! The Daily News Now!
Relentless Health Value

News

Relentless Health Value

Stacey Richter

EP519: The Current State of Primary Care—Inevitable or Fixable? With Lisa Rosenbaum, MD

July 08, 2026 4:00pm 40 min

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 c...

How Do You Explain the Difference Between an ASO Vendor and a TPA? With Claire Brockbank. Episode 518

July 01, 2026 4:00pm 14 min

The ASO vs. TPA Decision That Quietly Costs Self-Funded Employers More What's the real difference between an ASO and a TPA — and why does it matter that self-insured employers working with an ASO pay, by one referenced e...

Prior Authorizations & Pharma Rebate Contracts — How Financial Motives Keep Generics Off Formularies (EP517)

June 24, 2026 4:00pm 27 min

The PBM Rebate Math That Turns Prior Auths Into a Pharma Negotiating Tool What if a prior authorization has less to do with your medical need than with how big a rebate check a PBM is collecting on a competing drug? In t...

Cash Pay From the Pharma Manufacturer Point of View, With Ophelia Johnson

June 17, 2026 4:00pm 44 min

Only about half of new GLP-1 prescriptions got approved for coverage in 2023 — a gap Ophelia Johnson says is why pharma manufacturers started building cash-pay and direct-to-employer channels instead of waiting on PBMs. ...

Self-Insured Employers: SNF Fraud or Perverse Incentives? Understaffing, Gamed STAR Ratings, and Medicare Dollars at Skilled Nursing Facilities with Michelle Cera

June 10, 2026 4:00pm 43 min

Is it fraud — or is it just a perverse incentive? That question sits at the center of Hunterbrook Media's latest investigation into skilled nursing facilities (SNFs), and the answer, as Stacey Richter puts it, matters to...

Successfully Suing a Health System for Their Anticompetitive Contracts and Also Collecting Damages for Plan Sponsors and Members, With Matt Cantor. EP514

June 03, 2026 4:00pm 43 min

How the Sutter Health Antitrust Case Opened the Door for Employers and Members to Recover Hospital Overcharge Damages What happens when a self-insured employer or health plan member finally says enough is enough and take...

Revisiting Cunning Anticompetitive Hospital Contracts, With Brennan Bilberry - EP513

May 27, 2026 4:30pm 36 min

The Hospital Contract Playbook: Four Clauses That Turn Market Power Into Higher Prices. Episode 513. Across the country, hospital systems have used their growing market power to write four specific contract terms into th...

3 Kinds of Broker/EBC Rent-Seeking Payment Models—A Lawyer's Perspective, With Doug Aldeen. EP512

May 27, 2026 12:01pm 36 min

A Lawyer's Field Guide to Rent-Seeking Broker and EBC Payment Models. Epsiode 512. Brokers and employee benefit consultants often get compensated in ways health plans never fully see — and even when the dollars are techn...

The Perverse Incentive Trap Hidden Inside Value-Based Care — and What to Do About It. EP512

May 14, 2026 9:50am 29 min

When Risk-Based Payment Becomes Its Own Upcoding Arms Race. Episode 511 Medicare Advantage plans get paid more for sicker patients, which is why upcoding became a problem — and now health systems are upcoding visit compl...

Why Employers Pay More Because of Vertically Integrated Medicare Advantage Carriers with Betsy Seals. EP510

May 07, 2026 4:30am 35 min

The Line Between Fair Profit and Profiteering in Medicare Advantage. Episode 510 There's a simple test for telling a fair profit from profiteering in Medicare Advantage: does the carrier make more money when the patients...

The 7.7% Wake-Up Call: A Roadmap to Align Finance Teams With Non-complacent Benefit Design, With Patrick Nelli. EP509

April 30, 2026 4:30am 37 min

The Seven-Step Roadmap That Gets CFOs to Stop Being Passive Price Takers on Health Benefits. Episode 509. As a companion to last week's CEO-focused episode, Stacey Richter talks with Patrick Nelli — CEO of Aligned Market...

Why Don't More Self-insured CEOs Take Bold Action in Health Benefits Strategy? With Lee Lewis. (EP508)

April 23, 2026 4:30am 44 min

The Three False Dogmas Keeping CEOs From Fixing Their Health Plan. Episode 508. In the show's first-ever Ask Me Anything episode, Stacey Richter puts a listener's question to Lee Lewis, chief strategy officer and GM medi...

4 Core Concepts to Buy or Deliver the Highest Value Healthcare — A Review With 14 Expert Voices (EP507)

April 16, 2026 4:30am 33 min

Buy Healthcare, Not Insurance: A Through-Line Review of the Four Concepts Behind High-Value Care. Episode 507. Stacey Richter pulls together clips from 14 past guests to lay out the four core concepts for buying or deliv...

Price Transparency Data: How Employers, Shareholders, and Clinics Use It, With Jerry DiMaso (EP506)

April 09, 2026 4:30am 35 min

The Price Transparency Arms Race: What Self-Insured Employers and Clinics Can Both Do With the Data. Episode 506. Health price transparency data isn't just a compliance exercise anymore — it's becoming a competitive weap...

The Death of the "What Is Value" Guessing Game for Clinical and Plan Decision-Makers Ready to Move On, With Ahilan Sivaganesan, MD (EP505)

April 02, 2026 4:30am 43 min

Time-Driven Costing and the Operative Value Index for Surgical Care, With Ahilan Sivaganesan, MD. Why "Value Equals Outcomes Over Cost" Doesn't Work Until You Can Actually Measure Both. Episode 505. What if the only way ...

A Back-to-Basics Roadmap Through the Perverse Incentives to Advanced Primary Care, With Ryan Jacobs (EP504)

March 26, 2026 5:30am 33 min

Why Evidence-Backed Primary Care Still Can't Scale, and a 3-Step Roadmap to Get Around It. Episode 504. Why isn't advanced primary care (APC) everywhere, if the evidence for it is this strong? Stacey Richter talks with R...

Insights to Outwit the Hot Mess of the Non-Healthcare Market (INBW46)

March 19, 2026 5:30am 19 min

Listener Insights on Better Decisions, Price Transparency, and PBM Spread Pricing Tricks. Why "Insight Is Common, Execution Is Rare" Is the Whole Game in Fixing Healthcare. Episode INBW46. In this inbetweenisode, Stacey ...

From Lazy PPO Networks to Smart Collaboration — A Roadmap for Direct-to-Employer Specialty Care

March 12, 2026 5:30am 46 min

Direct-to-Employer Specialty Care and Centers of Excellence 3.0, With Ryan Wells, Leo Spector, MD, and Adam Stavisky Why Self-Insured Employers and Specialists Need to Start Talking Directly Instead of Through a Lazy Mid...

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. (EP502)

March 05, 2026 5:30am 38 min

Why $3.5 Billion in Fake Catheters and an Even Bigger Skin Substitute Grift End Up Costing Self-Insured Employers Too. Episode 502. Hackers are using stolen medical data to bill CMS for catheters and other durable medica...

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

February 26, 2026 5:30am 39 min

Two members of a plan received infusions at a hospital. If they had gone down the street, the plan would have spent $1 million less — for the same drug. That is the infusion nonmarket in 2026. In this episode, Stacey Ric...

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