Great ep. of @relentleshealth.bsky.social with Elizabeth Mitchell discussing why PBGH embarked on its big #healthcare cost and quality transparency project and how the findings are empowering employers with comparative price info buff.ly/VhXa290 #healthcare #healthpolicy #healthecon

We just dropped this fantastic episode with Elizabeth Mitchell from the Purchaser Business Group on Health (PBGH). It's a must listen for self-insured employers. Check out the show notes for a link to the PBGH Health Care Data Demonstration Project covering... cc-lnk.com/EP491

When buyers and sellers don’t both know the price before the transaction, can we really call it a market? Sometimes hospital “razor-thin margins” reflect true financial strain. But sometimes, they reflect the absence of a competitive marketplace...

In today’s continuation of the Mission/Margin series, we dig into a key question: What happens when clinical organizations balance mission with financial sustainability? Dan Greenleaf, CEO of Duly, who believes mission can drive margin, breaks mission down into four measurable quadrants... (1/2)

Reflecting deeply on my latest discussion with the insightful @mcuban.bsky.social and Cora Opsahl. We explored the real-world impacts of high deductible health plans and the potential of direct contracting to simplify healthcare. #HealthcareLeadership cc-lnk.com/EP488

Former Police Detective Kevin Lyons, now Executive Director at the NJ State PBA, joins the show to investigate the three biggest barriers preventing the public sector from securing better, more affordable health benefits. (1 of 3)

Why do #HealthcareCosts keep rising, even when everyone’s “saving”? Discounts, rebates, and shared savings may not be cutting costs at all. We pick up this thread in the latest episode, digging into why the discount might just sit at the center of the healthcare flywheel. cc-lnk.com/EP483-Part1

Remember that episode with Dr. Eric Bricker (EP472) about hospitals boosting revenue through stop-loss contract provisions while claiming “0% increase”? This week, Kimberly Carleson joins me to uncover even more ways health systems may increase the revenue taken from plan sponsors. cc-lnk.com/EP480

I sat down with Peter Hayes to answer a huge question—what are the real forces of change in #healthcare? Peter has spent decades on the front lines of benefits strategy, healthcare reform, & system transformation. In this episode, we try to step back and look at the big picture. (continued)

Private equity has invested over $1 trillion in U.S. #healthcare in the past decade. This week I spoke with Yashaswini Singh, PhD, of Brown, a leading researcher tracking the corporate transformation of medicine. “You’ve seen one private equity strategy, you’ve seen one private equity strategy.”

This is such a fantastic article by Craig Gottwals, distilling the conversation we had with Dr. Eric Bricker into such an actionable format. www.linkedin.com/pulse/whale-...

This week, Dr. Eric Bricker and I examine how hospitals profit off of high-cost claimants. You’ll hear how big systems use a 3-prong playbook involving chargemasters, stop-loss contracts, and “net-zero” pricing sleights of hand. The motto for this one? All costs are somebody else’s revenue...

Ever wondered how Medicaid cuts impact rural hospitals? In this episode, Stacey Richter and Nikki King explore the financial struggles these hospitals face and discuss solutions like telehealth and nurse practitioners. We cover why having a good payer mix essential, and... (continued)

What do Medicaid cuts mean for employers? James Gelfand, from ERIC, joins us to explore this issue on our latest episode. -Proposed Medicaid changes could spark state-level tax increases. -Your workforce might be impacted by Medicaid enrollment shifts. -Hospitals might respond with price hikes.

Primary Care Is an Investment—Everything Else Is a Cost Emergency room visits now account for 6% of total plan sponsor spend—and that’s an insane number. So here’s the big question: Why are patients turning to the ER for care that should be handled in primary care settings? (continued)

Are your health insurance premiums rising faster than inflation? Yes. Are employees paying an even bigger portion of those rising premiums? Also yes. That’s the double whammy hitting employees right now—higher absolute costs AND a bigger slice of the burden. But why? (continued in thread)

Ever heard of a $50 drug costing $10,000 through insurance? Sounds absurd, right? Yet, this exact scenario is at the center of a lawsuit involving J&J’s pharmacy benefits plan and a large PBM. This week in this #healthcarepodcast I spoke with Chris Crawford of RxSaveCard. Continued in thread...

6% of total #healthcare plan spend is now going to ER visits. That’s a huge number. On the latest episode of Relentless Health Value Podcast, Al Lewis discusses why ER costs are skyrocketing. Here’s what we unpack: (see more in the thread below)

In this podcast episode with Dr. Scott Conard we discuss how advanced primary care and data insights can help avoid high-cost claims by identifying high-risk members before they reach the costly threshold. Continued below in the thread... Listen or read the article: cc-lnk.com/EP462

Navigating the rabbit hole of healthcare cost management! In this episode and article, we tackle the delicate balance between moral hazard and patient care. What steps should plan sponsors take to ensure high-value care? #HealthEconomics #PlanSponsors #MoralHazard cc-lnk.com/INBW42

A Personal Charter for Change Healthcare is complex. Every action carries trade-offs. Here’s my charter: 1️⃣ Prioritize net positives for patients. 2️⃣ Focus on immediate, meaningful impact. 3️⃣ Collaborate—it takes a village to transform healthcare. (Continued)

If you’re on a board or are part of a C-suite team—this episode is for you. We explore how healthcare has become deeply financialized, turning employee health benefits into a business. Andreas Mang, partner at Blackstone, lays out a roadmap for CFOs, CEOs & leaders to take control. Continued...

Staffing shortages affect everyone—clinicians, patients, and plan sponsors. Burnout and poor outcomes are just the start. The missing piece? Cultural alignment. This episode with Dr. Komal Bajaj, we explore how trust & shared values foster trust and retention. How's your org addressing shortages?

For yesterday’s episode we made a meme about medical spread pricing. Listen to latest Relentless Health Value episode with Cynthia Fisher where we discuss spread pricing and what Cynthia thinks we need to do about it. cc-lnk.com/EP457

The $3.2 Million Question: In a recent lawsuit, a self-insured employer paid $4m for a medical claim. Sounds big, right? Here’s the kicker: The provider who actually delivered the care was paid $876k. $3.2m vanished into the middle. Where did that $3.2m go? Continued in comments...