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 want to connect with others trying to manage the triple play: to provide healthcare value while being personally and professionally fulfilled.
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We have been spending a bunch of time here on Relentless Health Value talking about PBMs (pharmacy benefit managers) lately and pharmacy benefits, but we are moving into a new topic area. It sort of kicked off three weeks ago with the pod with Rik Renard (EP427) on the importance of care flows if you are a digital health vendor trying to get co...
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In this healthcare podcast we’re talking about pharmacy acronyms or terms like AWP and WAC, and, not really an acronym, but we’ll also talk pharmacy list prices, rebates, discounts. We also have NADAC, but that’s slightly off to the side for reasons we’ll get to in a sec.
Most of these acronyms refer to a number with a dollar...
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This show is different, so if you’ve already listened to or read all about the gory details of the J&J and/or the DOL v BCBS lawsuits, this is not gonna be a repeat of that information. Julie Selesnick, my guest today, does cover the very, very top line about these two cases. But after that, we move on fast—because what I wanted to get to today...
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Hey, Relentless Health Value Tribe, thanks so much for being here this week. I gotta say, I really appreciate all of you who write and tell me that you kick off your Thursdays by listening to this show every week.
You just pop open your app and you listen to the show. Because yeah, we’re a pretty sure thing over here. If the ...
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Here on Relentless Health Value, we have done a bunch of shows lately on how some weird PBM (pharmacy benefit manager) and pharmacy goings-on impact plan members, patients, and also independent pharmacies. During the conversation with Benjamin Jolley, PharmD (EP422), for example, Benjamin mentioned that he thinks some of these contract terms th...
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Here’s something Randy Vogenberg, PhD, wrote the other day; and I made some light edits: Research has documented the unintended impacts of poor pharmacy benefit strategy. Examples include increasing costs of care, bankruptcies, and member satisfaction declines.
And, yeah … agreed. Also, probably health problems if we’re talki...
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This show today is for physicians or other clinicians or providers who are still taking insurance—those who are going about their day being pretty normal ... but at the same time, they’re noticing one and/or two things potentially going on.
Here’s thing one: They may be seeing patients struggling to afford care, especially pa...
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This inbetweenisode is me geeking out, so if that’s not your thing, you’ve been warned.
There’s a term I’d like to encourage anyone interested to look up. It’s the narcissism of small differences. It explains a lot. The narcissism of small differences is the idea that those who, maybe in theory, should be friends/BFFs working...
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Here’s a quote from Ann M. Richardson, MBA. She wrote it on LinkedIn, and I love it:
Quiet the noise that doesn’t add value.
Surround yourself with intelligent and respectful people who can deliver endless opportunities.
Celebrate brilliance and new beginnings.
Together...
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For a deep dive into the way back backstory here, listen to the show with Dea Belazi, PharmD, MPH. That’s episode 293, and it’s entitled “Game Theory Gone Wild,” because gone wild is what has happened with pharma manufacturer co-pay assistance programs.
Don’t forget that the original intent of the first chess move here was by...
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Listen to this show as either a follow-on or a prequel to the shows with Mark Cuban and Ferrin Williams, PharmD, MBA (EP418) and Ge Bai, PhD, CPA (EP420). And if you’re interested in this “what’s going on in the world of PBMs, pharmacies, and employers” topic, also listen to the show with Joey Dizenhouse coming out on January 11, 2024. If you n...
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I thought I would encore this show after coming back from the 2023 NODE Conference held in the Microsoft building in New York City, which I always enjoy. NODE stands for Network of Digital Evidence. Why is evidence so important?
Here’s the NODE answer to this question: It is so smart purchasing decisions can be made by consum...
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Why did I decide to encore this episode where Cora Opsahl from 32BJ spends 29 minutes talking about the importance of getting your data if you are an employer or a union health fund? Let me quote Jeff Hogan with some light edits here. Jeff wrote about the “outsized role” that employer data and intentional analytics can and will play. This is em...
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I want to kick off this show with a clip from episode 415 with Rob Andrews, wherein he so very eloquently sets the stage here:
We think that one of the core problems here is that too many intermediaries and providers in the system, their compensation is not in any way dependent on the outcome. So, let’s think about this NICU ...
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This show is a very natural follow-on to episode 418 with Mark Cuban and Ferrin Williams, PharmD, MBA. This show is the how, as in, “How did everything that we talked about in the earlier show wind up the way it did?” And it also proves it … with data.
I gotta say I never quite understood the finer points of the rationale of ...
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Are you on the board of directors of a company? Or are you a shareholder of a publicly traded company? Or are you a CEO or a CFO who reports to a board of directors or these shareholders? Well, this show is for you. And it’s about how the healthcare industry has become financialized at the same time that providing health benefits has become the...
Why did I decide to encore this show about being customer-centric and transforming or innovating at a very large organization? Well, two main reasons.
First reason can be neatly summed up by this recent Tweet from Rik Renard, which I have edited slightly to suit my own purposes. Here’s the Tweet: “The Achilles’ heel for most healthcare [innovators] is overlooking the role of change management. ...
CEOs and CFOs … hey, this show is for you. Let’s start here:
What do all of these numbers have in common: $140,000, $3 million, $35 million, and $3 billion?
These are all actual examples of how much employers, unions, and some public entities saved on healthcare benefits for themselves and their employees. The roadmap to saving 25% on pharmacy spend and/or 15% on total cost o...
There are two big reasons why I decided to encore this show with Dan Mendelson from Morgan Health at this exact moment in time.
1. It’s a great show (one of our most popular shows in the last year, actually) with lots of keen insights for self-insured employers—and by self-insured employers, I mean HR folks, of course, but also CEOs and CFOs. That was foreshadowing for my second reason.
Yeah, it’s a fact that the vast majority of past and present provider and payer relationships are not exactly collaborative. They may better be described as fairly adversarial, actually—especially when viewed through the lens of provider organizations trying really hard to find a payment model that will enable them to do better by their patients and deliver better outcomes.
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