Relentless Health Value

Hello, all you Relentless Tribe members. Thanks for hanging with me today to talk about a bunch of things. One of them being what exactly are level-funded plans, and what are the upsides, and then what are the risks? Because here's the thing. I was talking to an employer the other day, an employer w...

Listen on Your Favorite App Today we are dipping into the archives for an essential replay from 2016, one decade ago, featuring Chris Klomp back when he served as CEO of a company called Collective Medical. With the nomination of Chris Klomp to serve as deputy secretary of the Department of Health a...

Listen on Your Favorite App Today, Evan Anderson and I are talking about carrier networks, how they started, how it's going. Because irrespective of whatever the plan was at the very beginning, any given network, especially talking about the big status quo networks, has evolved into what I'll call a...

Listen on Your Favorite App Hello, all you Relentless Tribe members. Thanks for hanging with me this week. When a self-insured plan sponsor sees an infusion claim hit their high-cost case report, and a lot of these infusions are really expensive, so many of them hit the high-cost claim report. For a...

Listen on Your Favorite App Hello, all you Relentless Tribe members. Hey, thanks for being here with me every week, some of you every single Thursday. Give yourself a little round of applause, maybe silently and in your own head, depending on where you are. But yeah, you matter. You being here matte...

Listen on Your Favorite App Hello, all you Relentless Tribe members. Here's the backstory for this episode. Remember episode 519 with Lisa Rosenbaum, MD, where we played a high-stakes kind of game show called "Is the Current State of Primary Care an Absolute Inevitability, or Is It a Needless, Subop...

Listen on Your Favorite App Hello, all you Relentless Tribe members. If you have listened to this show for any length of time, you know one of our favorite truths around here, which is where there's mystery, there's margin. But today, we aren't just here to point out the mystery. We're here to look ...

Listen on Your Favorite App So, this one's gonna be a little bit different. Back last year, I sat down with Dr. Cristin Dickerson. She is the founding partner of Green Imaging , which is a physician-led radiology network doing direct contracting for imaging. And we talked about how imaging can run 6...

Listen on Your Favorite App Hello, all you Relentless Tribe members. First off here, I would like to thank Casey Cormier for the really nice recurring donation. Thank you so much, Casey Cormier from  Stratis Group . Lately, traditional provider networks are increasingly being called into questi...

Listen on Your Favorite App Hello, all you Relentless Tribe members. Before we dive in today, I just wanted to give a quick but massive thank you to Alex Sommers, MD, ABEM, DipABLM, from Astia Health for his generous gift, which we are going to use to help fund a camera for the podcast here to level...

Listen on Your Favorite App Arielle Bose: Hi, Stacey. This is Arielle Bose from EHD Insurance . Big fan of the podcast. We were talking about GoodRx the other day, and it occurred to me that I’m not exactly clear about how they make money. So, Stacey, how does GoodRx make money? For a full transcrip...

Listen on Your Favorite App Hey, welcome to Relentless Health Value. Okay … so, on today's show, we are talking about (Andrew Tsang and I) revenue cycle management, which—I say this with real affection—is maybe the least sexy phrase in all of healthcare. It sounds like a back-office spreadsheet prob...

Listen on Your Favorite App In the pachinko machine that is the healthcare industry, with just so many intermediaries, with so much regulatory capture and conflicts of interest that may or may not be visible, so much margin that is shrouded in mystery in an ecosystem as messy as this with so many va...

Listen on Your Favorite App 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 concierge medicine or otherwise. For a full transcrip...

Listen on Your Favorite App Dr. Alex Sommers: Hi. I'm Alex Sommers. I'm president of Astia Health, an advanced direct primary care organization, an emergency medicine and lifestyle medicine physician, as well as a licensed employer health plan advisor from Wisconsin. I'm curious how you explain the ...

Listen on Your Favorite App Hello, Relentless Health Value Tribe. Welcome to it. So, yeah … last week, I had a great conversation with Ophelia Johnson ( EP516 ) that is a companion show, I would say, to this one. So, listen to that one first. Listen to this one first. You do you. For a full transcri...

Listen on Your Favorite App Hello, all you Relentless Tribe members. Welcome to it. Today we have a show that will bend your mind in new directions. And yes, I have a head cold at a very weird time of year. I have trouble apparently doing things like normal people. Anyway, we talk a lot on this podc...

Listen on Your Favorite App Hello, all you Relentless Tribe members. Lately, I have been just obsessed with what's hiding in plain sight: the root cause glitches in how American healthcare is built. Not the symptoms now. Not the noise. The actual ground zero. I mean, what we call healthcare in this ...

Listen on Your Favorite App Hello, all you Relentless Tribe members. This is the third episode in our legal goings-on trifecta, starting with Doug Aldeen in episode 512 covering what amounts to the main reasons plan sponsors wind up suing their brokers or employee benefit consultants. For a full tra...

Listen on Your Favorite App If you are a large employer, union funds broker, fiduciary, or anyone responsible for a health plan that spends half of its dollars on hospital care (which most do), or if you have anything to do with policy or enforcement of policy, yeah … listen this week and next week....