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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Take Two: EP445: What Does It Take for an Indie Primary Care Practice to Survive Right Now? With Tom X. Lee, MD
46:19
46:19
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46:19In this second take on episode host Stacey Richter speaks with Dr. Tom Lee, founder of One Medical and Galileo. The discussion centers on the survival of independent primary care practices in the current healthcare economy, the associated challenges, and the paradox of primary care. Topics include reducing ER visits, managing downstream specialty s…
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Bonus Clip: Dr. Tom Lee Talks About Why Retail Clinics Are Not Doing So Well, in His Opinion
6:36
6:36
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6:36This short bonus episode is a side bar conversation with Dr. Tom Lee discussing why retail clinics are struggling with Dr. Tom Lee. They explore the shortcomings of retail clinics in providing longitudinal primary care, despite their convenience for minor urgent care and vaccinations. Dr. Lee emphasizes that true primary care requires consistent, l…
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EP481: Seriously, IRL, What Does “No Margin, No Mission” Even Mean? With Benjamin Schwartz, MD, MBA
33:58
33:58
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33:58Balancing Mission and Margin in Healthcare: A Candid Conversation with Dr. Ben Schwartz In this episode, host Stacey Richter engages in a deep dive with Dr. Ben Schwartz to explore the phrase 'No Margin, No Mission' and its practical implications in the healthcare industry. They discuss the complex relationship between profitability and mission-dri…
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Take Two: EP438: Is It Mission and/or Margin? With John Lee, MD
35:59
35:59
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35:59In this Take Two episode of Relentless Health Value, host Stacey Richter reflects on her conversation with Dr. John Lee to explore the challenging intersection between mission and margin in healthcare. They discuss the nuances of cognitive dissonance faced by healthcare professionals, particularly when organizational priorities conflict with patien…
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EP480: Payment Integrity Meets Health System Boasts, Such as Our Rates Are 2x Medicare, With Kimberly Carleson
32:06
32:06
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32:06Enhancing Payment Integrity in Health Systems: An In-depth Discussion with Kimberly Carleson. In Episode 481 of Relentless Health Value, host Stacey Richter speaks with Kimberly Carleson, CEO of US Beacon, about payment integrity within health systems. They delve into strategies some hospitals use to maximize revenue without raising rates and discu…
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Pharma Rebates: A Few Nuances You May Not Have Thought Of, With Ann Lewandowski—Summer Shorts
19:27
19:27
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19:27Exploring the Complexities of Pharma Rebates with Ann Lewandowski In this Summer Short episode of Relentless Health Value, host Stacey Richter converses again with Ann Lewandowski about the intricate dynamics of pharmaceutical rebates, or as Lewandowski prefers, post-sale concessions. The discussion delves into the nuances of these rebates, the imp…
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EP479: Part 2. What Could Go Wrong Covering High-Cost Claimants With Stop-Loss Reinsurance?
27:25
27:25
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27:25In this second discussion with Andreas Mang and Jon Camire of Blackstone, Stacey Richter has an advanced discussion on the intricacies of stop-loss reinsurance for high-cost claimants. This show today, for sure, it’s for plan sponsors and anyone on or about plan sponsors; but also listen if you are serving high-cost claimants some other way. Becaus…
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Take Two: EP433: The Mystery of the Weekly Claims Wire, With Justin Leader
38:49
38:49
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38:49Stacey Richter has a second take on the original episode 433 since it is so relevant right now. Stacey engages in a compelling conversation with Justin Leader, CEO of BenefitsDNA, about the opaque practices of third-party administrators (TPAs) and their impact on healthcare costs. They discuss the hidden fees tucked into weekly claims wires, includ…
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EP478: Stop-Loss Coverage, Part 1: How It Goes Right, and How It Can Go Horribly Wrong, With Andreas Mang and Jon Camire
31:58
31:58
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31:58Host Stacey Richter discusses the intricacies of stop-loss coverage with Andreas Mang and Jon Camire from Blackstone. The episode focuses on defining stop-loss insurance and exploring its critical role in protecting self-insured employers from catastrophic financial losses. The conversation delves into the nuances of individual and aggregate stop-l…
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EP477: Through Line Show: What the Tribe Thinks You Need to Know About Trust or It’s Gonna Be a Problem. Also, Why You Are Smart, With Stacey Richter
18:33
18:33
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18:33In this episode, Stacey Richter explores the impact of trust on healthcare outcomes, drawing from listener contributions and prior episodes of Relentless Health Value. The discussion underscores how trust or the lack thereof affects patients, clinicians, and healthcare systems. Key points include the importance of building trusted relationships, th…
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Bonus Add-on to EP477: How to Earn Trust, With Charles Green
11:33
11:33
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11:33In this bonus add-on to episode 477 of Relentless Health Value, host Stacey Richter revisits a decade-old conversation with trust expert Charles Green, founder of Trusted Advisor Associates. Green discusses the intricacies of building and maintaining trust in healthcare, emphasizing four key trust principles: client focus, collaboration, long-term …
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EP476: Talking Whistleblowing and the Pharma Rebates Whistleblower Case With an Actual Whistleblower, With Ann Lewandowski
35:47
35:47
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35:47In this episode, host Stacey Richter speaks with Ann Lewandowski about whistleblowing in the healthcare industry, focusing on a significant case involving a whistleblower at an employee benefit consultant (EBC) firm. This EBC allegedly pocketed their clients' pharma rebates, violating the Consolidated Appropriations Act of 2021. The discussion high…
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EP475: Is This a Moment or a Movement? With Peter Hayes
34:22
34:22
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34:22In this episode of Relentless Health Value, host Stacey Richter sits down with Peter Hayes to discuss the major forces driving change in the healthcare industry. Hayes outlines three critical factors: changing public opinion, heightened transparency, and new regulations such as the Consolidated Appropriations Act. He emphasizes the unprecedented co…
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EP474: Private Equity in Healthcare—The Big Data Points You Really Need to Know, All Together in One Episode, With Yashaswini Singh, PhD
41:26
41:26
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41:26In Episode 474 of 'Relentless Health Value', host Stacey Richter interviews Dr. Yashaswini Singh, an economist and assistant professor at Brown University, about the growing influence of private equity (PE) in healthcare. The conversation delves into the corporate transformation of medicine, highlighting the potential misalignment between business …
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EP473: Keeping Patients out of the ER: How Trusted Relationships in Primary Care Should Work. A Take 2 With Kenny Cole, MD
34:53
34:53
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34:53This episode of Relentless Health Value features Dr. Kenny Cole from Ochsner Health System. The discussion emphasizes the critical role of trusted relationships and excellent primary care teams in keeping patients out of the emergency room, thus reducing healthcare costs. Stacey Richter revisits this conversation to highlight the importance of care…
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EP472: The Well-Honed, Three-Prong Hospital Playbook to Maximize Revenue From High-Cost Claimants, With Eric Bricker, MD
35:17
35:17
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35:17In Episode 472, Stacey Richter speaks with Dr. Eric Bricker about the impactful strategies hospital systems use to maximize revenue from high-cost patients. They explore the financial complexities and contracting tactics that enable hospitals to profit significantly from a small percentage of high-cost claimants. Key points include the negotiation …
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EP471: High-Cost Claimants in 2025 and Beyond—What Is Really Expensive Not to Know? With Christine Hale, MD, MBA
34:41
34:41
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34:41Recently on Relentless Health Value, we’ve been tinkering around with a few recurring themes—recurring through lines—that are just true about American healthcare these days. In this episode of Relentless Health Value, host Stacey Richter speaks with Dr. Christine Hale about high cost claimants and the implications for healthcare plans in 2025 and b…
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EP470: Continuing the ER and Primary Care Through Line Over to Rural Hospitals and Healthcare, With Nikki King, DHA
35:10
35:10
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35:10In this episode, host Stacey Richter revisits a conversation with Nikki King, CEO of Alliance Health Centers, discussing the critical issues facing rural hospitals and healthcare systems. They delve into the impacts of Medicaid cuts, the financial struggles of rural hospitals reliant on commercial insurance, and potential solutions like freestandin…
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EP469 (Part 2): The Impact on Plan Sponsors of Medicare Site-Neutral Payments and HSA Reforms, With James Gelfand, JD
30:36
30:36
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30:36In part 2 of episode 469, host Stacey Richter discusses the implications of Medicare site neutral payments and Health Savings Account (HSA) reforms with James Gelfand, president and CEO of the ERISA Industry Committee (ERIC). The episode details how plan sponsors should adapt to Medicare's site neutral payment policies aimed at curbing hospital con…
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EP469 (Part 1): The Impact on Plan Sponsors of Medicaid Cuts, With James Gelfand, JD
25:42
25:42
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25:42In part 1 of this two part episode, Stacey Richter speaks with James Gelfand, President and CEO of the ERISA Industry Committee (ERIC), about the potential effects of proposed Medicaid cuts on plan sponsors and their members. They explore ways plan sponsors can prepare for the changes, including Medicaid's four major areas of possible cuts: reducin…
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EP468: Very Common Assumptions That Aren’t Actually True About Member Engagement and the Healthcare Industry, With Matt McQuide
34:39
34:39
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34:39In Episode 468, host Stacey Richter engages in a conversation with Matt McQuide, CEO of Synergy Healthcare. This episode delves into the critical assumptions surrounding member engagement within the healthcare industry. Key points discussed include the role of employers in steering plan members, the importance of member engagement for navigating th…
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EP467: Connecting Sky-High ER Spend to Primary Care Access—Following the Dollar Through Carriers and Hospitals, With Stacey Richter
23:09
23:09
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23:09In this solo episode of 'Relentless Health Value,' host Stacey Richter dives into the intricate relationship between increased emergency room (ER) visits and the lack of access to effective primary care. Discussing insights from recent episodes featuring experts like Matt McQuide, Dr. Christine Hale, and others, Stacey explores how inadequate prima…
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EP466: What Is Rising Faster, Insurance Premiums or Hospital Prices? With Vivian Ho, PhD
36:12
36:12
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36:12Healthcare costs keep rising, but what’s driving those increases? In this episode, Stacey Richter speaks with Dr. Vivian Ho, a health economist at Rice University and Baylor College of Medicine, to break down the real reasons behind skyrocketing commercial insurance premiums. Are insurance premiums rising faster than wages—and why does it matter? W…
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EP465: The Not Super Effective Contracting Industry Norm, Where Jumbo Plans and Others Wind Up Paying $10,000 for $50 Drugs, With Chris Crawford
34:15
34:15
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34:15The Hidden Costs of PBMs: How Aggregate Discount Guarantees Inflate Drug Prices. In episode 465 of Relentlessly Seeking Value, host Stacey Richter interviews Chris Crawford, CEO of RxSaveCard, about the inflated costs within the pharmacy benefits industry. The discussion centers around a lawsuit involving J&J, highlighting how large PBMs can signif…
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EP464: ER Visits Now 6% of Total Plan Spend. Is It Upcoding or What? With Al Lewis
31:40
31:40
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31:40Emergency room costs now make up 6% of total healthcare plan spending—why? In this episode, host Stacey Richter welcomes Al Lewis to break down the data behind rising ER expenses, separating fact from fiction. They discuss whether increased patient acuity or widespread upcoding is driving costs, the impact of the No Surprises Act, and why plan spon…
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