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American Healthcare Entrepreneurs and Execs you might want to know. Talking. Relentless Health Value is a weekly interview podcast hosted by Stacey Richter, a healthcare entrepreneur celebrating fifteen years in the business side of healthcare. This show is for leaders in pharma, devices, payers, providers, patient advocacy and healthcare business. It's for health industry innovators, entrepreneurs or wantrepreneurs or intrapreneurs. Relentless Healthcare Value is the show for you if you wan ...
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EP317: Wait, the Latest Action on Drug Pricing Reform Can Be Found in the Infrastructure Bill? With Josh LaRosa, MPP, Policy Director, Wynne Health Group
26:38
26:38
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26:38
Let’s get a fast bead on what’s going on with drug pricing reform, shall we? Every time I wade into these waters, my head about explodes. So, I very much appreciate the opportunity to quiz Josh LaRosa from the always-well-informed Wynne Health Group. Here’s the goings-on in a nutshell: There’s goings-on. This infrastructure bill that’s in all the n…
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EP316: Unexpectedly Talking About Employers, With David Carmouche, MD, From Ochsner, a Large Health System
22:16
22:16
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22:16
I don’t know what I thought we were going to talk about during my interview with David Carmouche, MD; but I’m glad it turned out exactly as it did. Lately, we’ve had a number of guests on Relentless Health Value talking from the point of view of the employer: what a self-insured employer wants and needs from the large, and small, providers in their…
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EP315: The Very Unsexy Essential for Technology to Drive Outcomes That Nobody Talks About, With Bob Matthews
31:36
31:36
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31:36
Medicine is complex. It’s getting more complex. We double what we know in medicine every 73 days. There’s 800,000 journal articles published every year. It is impossible for any human to keep up. It’s just impossible. There’s a lot of talk about amazing technology to help humans manage the 26,000 variables in heart failure treatment or what have yo…
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AEE14: A Short Lesson for Self-insured Employers: Dr. Doug Eby Gives Some Advice That Everybody Should Hear Who Is Interested in Improving Outcomes and Lowering Costs, With Douglas Eby, MD, MPH, CPE
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8:18
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8:18
Have you never heard of the Nuka System of Care? If that’s the case, it is an award-winning and really remarkable health system in Alaska. In this 5-minute “An Expert Explains,” Dr. Douglas Eby, medical director over at Nuka, gets directly to the point. A key component to making sure that the people/customers in your plan get the best care is to ma…
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EP314: Why Do SNF (Skilled Nursing Facility) Patients Need Two Pharmacies and a PBM? Following the Kinda Long Long-term Care Pharmaceutical Supply Chain, With Sheldon Weiss, MD
28:34
28:34
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28:34
This episode is for anyone as curious as I have been about pharmaceutical supply chain goings-on in long-term care facilities like skilled nursing facilities, otherwise known as SNFs. There are a lot of players in the mix: You have your PBMs. You have your wholesale pharmacies. You have your LTC (meaning long-term care) pharmacies. You have the fac…
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EP313: Partnering Up With Fiercely Local and Fiercely Independent Pharmacies, With Dan Strause and Drew Leatherberry
29:40
29:40
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29:40
Let’s talk about one aspect of health care that’s not talked about possibly often enough: big national health care players siphoning money out of local communities—potentially a lot of money depending on where you are and considering that health care is inching toward about 20% of the GDP. But besides the money leaving the community, another downsi…
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EP312: Radically Improving Population Health: Listen and Learn From One of Our Country’s Best-Kept Secrets, With Douglas Eby, MD, MPH, CPE
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33:56
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33:56
This episode is a master class in raising health outcomes at lower costs from an award-winning health care system in … Alaska?! Who knew? In fact, I learned about the work of the Southcentral Foundation and the Nuka System of Care only because I happen to listen to Swedish health care podcasts and heard about them on one of those shows. Color me su…
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EP311: How Aging in Place Becomes a Business Problem for FFS Providers, With Sumit Nagpal
29:20
29:20
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29:20
This episode might be about local providers getting disintermediated not by virtual front doors like I discussed with Jeff Hogan in EP309 but by entities providing virtual continuous care at home. Predictivae and proactive, the idea is to help reduce acute events requiring on-premises care. But if someone does wind up needing ramped-up care, they c…
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AEE13: Have You Ever Wondered How GoodRx Makes Money? With Ge Bai, PhD, CPA
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8:10
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8:10
In this health care podcast, Ge Bai explains GoodRx’s business model and how PBMs and pharmacies fit in to that business model. Here’s the short version: GoodRx takes advantage of the dysfunction in the pharmacy supply chain. And while they help patients save money, their master plan only works because pharmacies would be charging cash pay patients…
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EP310: The 2020 Shkreli Awards for the Worst Examples of Profiteering and Dysfunction in Health Care, With Vikas Saini, MD, and Shannon Brownlee
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30:03
The Shkreli Awards have been published each year, for the past five years and counting, by the Lown Institute. The Shkreli Awards are a much-anticipated top 10 list of the worst examples of profiteering and dysfunction in health care. This year’s list, celebrating the most excellently egregious profiteering in 2020, are unique in the sense that eve…
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EP309: FFS Providers Getting Locked Out of Referral Flows, Right Now, As We Speak, With Jeff Hogan
31:51
31:51
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31:51
This episode is a tale of what happens when some employers decide to open up a few virtual front doors and when these virtual front doors lead only to referrals to providers who are willing to be accountable and offer financial predictability. That’s what these employers want, after all. They want accountability and financial predictability. Many e…
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EP308: At Least Two Surprising Insights About Value-Based Care, With Mark Fendrick, MD
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34:42
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34:42
And here I thought I knew a lot about value-based care. In this health care podcast, I am speaking with Mark Fendrick, MD, who is the director over at the University of Michigan Center for Value-Based Insurance Design. This conversation is for those of you who already know pretty much about value-based care concepts. If you do not, I’d go back and …
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EP307: The Surprise Billing Legislation: Its Impact on Providers, Hospitals, Self-insured Employers, and (Most of All) Patients, With Loren Adler
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33:49
In this health care podcast, I speak with Loren Adler, who is the associate director of USC-Brookings Schaeffer Initiative for Health Policy and has a particular focus on surprise billing. I wanted to talk to Loren about the surprise billing legislation that is going into effect on 1/1/22. I will let Loren explain, but, in short, this legislation r…
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EP306: A Deep Dive Into Amazon’s Pharmacy and the Amazon Pharmacy Model Some Employers Are Running With, With Ge Bai, PhD, CPA
30:20
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30:20
Here’s a trigger warning: This show gets pretty deep into some of the nether regions of PBM (pharmacy benefit manager) contractual terms with pharmacies. If you are not, I’m gonna say, pretty familiar with PBM goings-on, I’d suggest you listen to EP241 with Vinay Patel first or skip the first third of this show. In this health care podcast, I am sp…
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EP305: The 1% Most Expensive Claimants Racking Up Massive FFS Bills and Still Not Getting the Help They Need From Our Health Care System, With Darrell Moon, CEO of Orriant
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32:49
My guest in this health care podcast is Darrell Moon, who is the CEO over at Orriant. I was super intrigued by some of the work that Darrell and his team are doing regarding high-cost claimants. Said a different and probably better way, certain people in need of care were identified because they were costing so much. Year after year after year, the…
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AEE12: Steve Blumberg and I Discuss the 2020 Humana Value-based Care Report
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7:40
Humana recently came out with their Value-based Care Report. The subhead is Physician Progress and Patient Outcomes. It’s a very fancy report with a lot of pages and graphics, and this impressive format definitely caught the attention of some of our industry. I read one blog post really keying in on one sort of depressing aspect of the report, name…
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EP304: How a Provider Population Health Leader Who Went to Work for a Payer Thinks About Health Care Transformation, With Steve Blumberg, VP of Practice Transformation for GuideWell Health
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27:32
In this health care podcast, I speak with Steve Blumberg, VP of practice transformation for GuideWell Health, a subsidiary of GuideWell. How’s this for an interesting career trajectory? Steve spent the last decade working on population health and value-based care delivery ... on the provider side. Recently, he transferred over to the payer side, wo…
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Encore! EP216: How Medicare Part D Plans Became Addicted to Drug Rebates, With Chris Sloan From Avalere Health
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31:44
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31:44
Alex Azar, who is the current Health and Human Services (HHS) secretary (until January 21 anyway), came out with a reboot of the proposal that effectively halts the practice of pharma manufacturers paying rebates to Part D plans. This reboot is supposed to go into effect on 1/1/2022. But this podcast is less about this may-or-may-not-actually-happe…
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Encore! EP231: Pharmaceutical Contracting, PBMs, Pharmacies, Employers, and the Latest HHS Rebate Proposal, With AJ Loiacono, CEO of Capital Rx
37:30
37:30
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37:30
In November 2020, there was an Executive Order entitled “Lowering Prices for Patients by Eliminating Kickbacks to Middlemen.” And we had HHS (US Department of Health and Human Services) Secretary Alex Azar and the HHS Office of Inspector General finalizing a regulation to eliminate the current system of drug rebates in Med D (Medicare Part D). And …
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INBW29: The Secret to Transforming Our Health Care System Revealed—A Summary of the Wisdom of Relentless Health Value Guests in 2020
25:23
25:23
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25:23
I had a vision for this inbetweenisode. I wanted to highlight the wisdom of our amazing guests this year. I really wanted to find some theme that might be a key to our health care transformation. To achieve maximum suspense, here’s the very short story of how I got from “Is there a common thread of wisdom throughout all the RHV episodes this year?”…
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EP303: The Conflict Between QALYs for Drug Value and Specific Well-Funded Patient Advocacy Groups, With Anna Kaltenboeck From the Drug Pricing Lab at Memorial Sloan Kettering
29:21
29:21
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29:21
You know back in the olden days when a foot of measurement was actually the measure of your own foot? So, I might measure something and it’s, like, 19 feet. And then you measure the same exact thing and it’s 38 feet because you have tiny feet. This is the analogy that kept running through my mind as I was talking with Anna Kaltenboeck in this healt…
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EP302: The Gigantic Problem I Have With Talk About Telehealth, With Blake McKinney, MD, From CirrusMD
31:05
31:05
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31:05
Sometimes when I overhear a conversation/argument about telehealth, it occurs to me that there’s a lot of fighting words about some things and very, very little about other things which I’d regard as equally, or maybe even more, important. Some of the sparring tends to jump immediately to tactics and UX (user experience), absent of strategy and CX …
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Encore! EP206: Turns Out, High‑Deductible Plans Do Not Drive High‑Quality, Cost‑Effective Care, With Ashok Subramanian, CEO and Founder of Centivo
32:32
32:32
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32:32
There’s lots going on these days with transparency. Three cost transparency rules, as a matter of fact, just came out of CMS, for example. These rules demand that hospitals and payers make available cost information so patients can shop and employers can also shop. That last part there, about employers and/or payers being able to shop … that might …
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EP301: What Is Up With the Hospital and Payer Transparency Rules From CMS Now and Also After January 20? With Jeff Leibach, MBA
33:18
33:18
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33:18
Three transparency rules have come out of CMS in the past months. My guest in this health care podcast, Jeff Leibach, calls these three rules three steps on a ladder. They build on each other. The first rule was announced last year, and it was for hospitals to post their chargemasters. You could consider this a baseline step. It’s not really all th…
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EP300: Getting the Right Drugs Developed and Thinking Different About How to Pay for Them, With Bruce Rector, MD
31:47
31:47
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31:47
Wow! It’s episode 300. That’s a milestone. Because of you, we’ve grown to be one of the largest podcasts for health care executives—so, thank you to every one of you who has recommended the show to your friends and colleagues, which is really the highest compliment. Thanks also to all the listeners of this show who have written reviews, LinkedIn po…
