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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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Relentless Health Value™
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Encore! EP249: The War on Financial Toxicity in North Carolina as a Case Study Everybody Should Be Keeping Their Eye On, With Dale Folwell, North Carolina State Treasurer
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32:29
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So, let’s talk about North Carolina. What a weird outlier of the direction of other states getting active on their healthcare spend. I’m talking about Texas, Indiana, Wisconsin ... I’m naming so-called red states because the legislature in North Carolina is a Republican majority. Gotta say, normally I’m down for a little weird. I find it mostly cha…
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EP405: What Else Physicians Trying to Clinically Integrate in the Real World Really Need to Know, With Eric Gallagher
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31:50
Let’s cut to the chase. You’ve gotten to the point where you have a gang of physicians/clinicians/physician practices who have expressed a desire to work together. What do you need to know right now? Eric Gallagher, CEO of the Ochsner Health Network, is my guest in this healthcare podcast; and I largely asked him the same question that I had asked …
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EP404: What Now? Who’s on the Board of Those Big Hospitals? With Suhas Gondi, MD, MBA
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32:58
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32:58
So much of this episode (and this podcast as a whole, really) is about one consistent theme: How do we reset or redesign our healthcare industry, including hospital chains—mostly talking about the big consolidated ones that have a lot of money here—but how do we redesign these leviathans to be more consistent with our values as a country and the va…
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EP403: The Mix & Match With the How Doctors Get Paid, With Rachel Reid, MD, MS
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32:37
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32:37
This is a conversation about physician compensation, which is often oddly misaligned from the way that the whole physician or provider organization is getting paid. Now, first thing to point out: There are lots of different kinds of physicians doing all kinds of different things. As with most everything in healthcare, lumping everybody together and…
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EP402: What Physicians Trying to Clinically Integrate Care in the Real World Need to Know, With Amy Scanlan, MD
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32:56
So, let me just cut to the chase here with very little preamble, and all of this is a setup to the interview that follows, although it is not really what the interview that follows is all about. A mentor of mine used to say, you can’t legislate the heart. Let me also suggest you can’t give someone in finance financial incentives and then expect the…
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EP401: The Most Interesting Questions About the IRA Drug Price Negotiations, With Peter J. Neumann, ScD
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31:37
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Somebody wrote on Twitter the other day that he was gonna give a talk on the use of evidence in drug policy, and Barrett Montgomery replied, “That’ll be a short talk then!” So, let’s talk about the IRA (Inflation Reduction Act) for a moment, specifically the “CMS can negotiate for drugs for Medicare patients” part of the IRA. There’s one topic I do…
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EP400: My Manifesto, Part 2: Where the Rubber Hits the Road
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21:51
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21:51
I hope you listened to episode 399, which was Part 1 of this two-part exploration of my manifesto, meaning my aims and my path or framework to achieve those aims. Regarding the first part of my manifesto, episode 399 from two weeks ago, here’s the tl;dl (too long, didn’t listen) version; but please go back and listen to that show (Part 1) because i…
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Encore! EP285: Who Is Auditing These Healthcare Bills? Also, That Cigna Lawsuit, With Dawn Cornelis, Cofounder and Director of Transparency at ClaimInformatics
30:14
30:14
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Well, this episode became extremely relevant again after that Cigna case bubbled up in the news. Here’s the “too long, didn’t read” version: Attorneys filed a class action lawsuit against Cigna, alleging that the carrier is overcharging for lab services or did overcharge for lab services. The plaintiff is an individual member of a Cigna plan. The c…
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EP399: My Manifesto, Part 1: The Relentless Health Value Tribe, I Salute You.
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This week and in episode 400 of Relentless Health Value, at the encouragement of the Relentless Health Value team, I’m gonna do two shows entitled “My Manifesto,” Part 1 and Part 2. In other words, why did I start Relentless Health Value and what’s the goal around here? I started contemplating this mission to define the mission thinking about how h…
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EP398: Why Is the Commercial Payer Marketplace in California Completely Boring? With Jacob Asher, MD
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Yeah, so while the commercial payer marketplace is completely boring, the reasons it’s boring are not. Let me walk you through this conversation I have in this healthcare podcast with Jacob Asher, MD. First, we establish that the relative number of each carrier’s commercial members in California don’t seem to change year over year … and this has be…
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EP397: The Minefield That Is a PBM Contract and Also Some Advice for EBCs Who Are Taking Money Under the Table, With Paul Holmes
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33:43
If this were a video show, I would stare into the camera with steely eyeballs right now and say that I have a special message for employer CFOs. If you aren’t a CFO, pretend that you are so that you get the full effect here. So, now that we’re all CFOs, let’s pull up the company P&L (Profit and Loss) statement. This is what keeps us all up at night…
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EP396: How to Answer This Question: Will Humira® Biosimilars Reduce Drug Spend? With Anna Hyde
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33:51
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There are two facets of the Humira biosimilar market and launch that Anna Hyde, my guest in this healthcare podcast, talks about. One is market dynamics. The second is provider and patient confidence. These two concepts are tangled up together and cannot be separated. But let me back up a sec and explain, although Anna Hyde covers this really well …
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Encore! EP293: Game Theory Gone Wild: Co-pay Cards, Co-pay Accumulators, and Co-pay Maximizers, With Dea Belazi, PharmD, MPH, President and CEO of AscellaHealth
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Well, this episode is suddenly incredibly relevant again just with all the stuff going on with co-pay maximizers. If you’re gonna understand maximizers, though, you really have to start here. In a nutshell, this whole thing is a battle royale between co-pay cards and patient assistance programs offered by pharma companies versus co-pay accumulators…
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EP395: Consolidated Hospital Systems and Cunning Anticompetitive Contracts, With Brennan Bilberry
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Thanks, shurx, for this review on iTunes entitled “Prepare to Learn.” Shurx wrote: “[RHV] provides key insight from experts that you won’t find anywhere else. It paints the picture of how our healthcare is tangled, and who benefits because of it. Whether it’s drug pricing, PBM shenanigans, hospital billing, or market trends that are challenging the…
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EP394: Spoiler Alert: It Is Counterintuitive Which Hospitals Offer the Most Charity Care, With Vikas Saini, MD, and Judith Garber
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You would think that hospitals with the most money would offer the most charity care—trickle down and all of that. If my health system is big and I have lots of money and profitable commercial patients, I can stuff more dollar bills into the charitable donation balance sheet bucket, right? Except, in general, it’s a fairly solid no on that. Let’s t…
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EP393: How Do You Know if a Practice or a CIN (Clinically Integrated Network) Is Actually Clinically Integrated? With David Muhlestein, PhD, JD
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31:45
Hey, thanks so much to kwebs14 for your super nice review on iTunes the other day. Kwebs wrote: [I have] learned so much, shared so many episodes with colleagues, clients … and gained so much value from regularly listening to [Relentless Health Value]. … Thank you … for providing the platform for so many that believe that we can consistently do bet…
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Encore! EP355: The 5 Business Models for Digital Health Companies, With Nikhil Krishnan
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This week, I am with my Aventria team on-site at one of our clients. We are holding a full-day workshop to help our client figure out who all across the healthcare industry they will need to get aligned with to achieve greater success in the market and how to handle all of these inevitably conflicting interests strategically and also potentially fr…
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EP392: When Patient Journeys Don’t Fit in the EHR System, With Emily Kagan Trenchard From Northwell Health
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So, a few things to remind everybody. First of all, don’t forget EHRs (electronic health records) were purpose built originally for billing. This is no secret. People quite openly have called EHR systems glorified cash registers. If I want to be generous, maybe I would restate this to say that EHRs were designed to document patient interactions. Th…
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EP391: Lessons for Private Equity and Others Trying to Do Right by PCPs and Their Patients, With Scott Conard, MD
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35:20
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35:20
On Relentless Health Value, I don’t often get into our guests’ personal histories. There are a bunch of reasons for this, which, if you buy me beer, we can talk podcast philosophy and I will tell you all about my personal, very arguable opinion here. Nevertheless, in this healthcare podcast, we are going rogue; and I am talking with Scott Conard, M…
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EP390: What Legislators Need to Know About Hospital Prices, With Gloria Sachdev, PharmD, and Chris Skisak, PhD
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34:44
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If you go to the Sage Transparency dashboard Web site, you get a really graphical representation of the prices that any given hospital actually needs to charge so that they break even. You can see precisely which hospitals are operating on thin margins and which ones are not. You might be thinking, “Okay, so ... what’s the big deal about this? Why …
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EP389: The Clapback When Hospitals Cannot Constrain Their Own Prices, With Mike Thompson
34:41
34:41
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34:41
For the past few shows and in a few coming up, we are circling our wagons around a theme: In healthcare in this country, there are two teams. One team is employers, taxpayers, patients … those trying to keep healthcare prices down. Then on the other team, we have those looking for healthcare prices to continue to go up, meaning, as just one example…
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Encore! EP326: The Unfortunate News About HRRP, With Insight Into How to Fix It, With Rishi Wadhera, MD, MPP
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34:18
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34:18
HRRP stands for Hospital Readmissions Reduction Program, by the way. I wanted to encore this episode with Dr. Rishi Wadhera because it’s a great representation of a common root cause reason why quality metrics sometimes don’t end well in real life. This root cause is otherwise known as Goodhart’s Law, and we dig into Goodhart’s law later on in this…
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Encore! EP356: PBMs React to GoodRx, Mark Cuban, and Amazon Pharmacy, With Ge Bai, PhD, CPA
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36:10
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36:10
This show was one of the most popular episodes in the past 12 months. So, here it is again for your listening pleasure. Mostly this whole episode is about the so-called “Big Three” PBMs that provide between the three of them pharmacy benefit services for 95% of insured Americans. PBM stands for pharmacy benefit manager, and the Big Three PBMs being…
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INBW37: Harnessing the Miracle of the Commons to Improve the Patient Journey Nationwide, A Conversation With Dave Dierk, Co-President of Aventria Health Group
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24:34
We have done three inbetweenisodes so far on healthcare stakeholder collaboration. In sum, there are two major issues that patients have with our healthcare industry, and both can only be solved for if healthcare stakeholder collaboration happens: Patients falling into care gaps and winding up with bad downstream consequences Patients not being abl…
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EP388: Merrill Goozner on the Future of Healthcare and Glide Paths to Get There
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In this healthcare podcast, I have Merrill Goozner on the show talking about his prognostications for the future of healthcare in this country and how, realistically, it could be engineered so that the healthcare industry rightsizes itself relative to our GDP. Merrill offers three glide paths to this end. Okay … so, let’s break this down some. Firs…
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