EP456: Advice to Pharma at the Intersection of Product Value, Reputation, and Patient Affordability, With Brian Reid

Relentless Health Value

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Innhold levert av Stacey Richter. Alt podcastinnhold, inkludert episoder, grafikk og podcastbeskrivelser, lastes opp og leveres direkte av Stacey Richter eller deres podcastplattformpartner. Hvis du tror at noen bruker det opphavsrettsbeskyttede verket ditt uten din tillatelse, kan du følge prosessen skissert her https://no.player.fm/legal.

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Black Mirror Season 7 28:30

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We're trying something different this week: a full post-show breakdown of every episode in the latest season of Black Mirror! Ari Romero is joined by Tudum's Black Mirror expert, Keisha Hatchett, to give you all the nuance, the insider commentary, and the details you might have missed in this incredible new season. Plus commentary from creator & showrunner Charlie Brooker! SPOILER ALERT: We're talking about the new season in detail and revealing key plot points. If you haven't watched yet, and you don't want to know what happens, turn back now! You can watch all seven seasons of Black Mirror now in your personalized virtual theater . Follow Netflix Podcasts and read more about Black Mirror on Tudum.com .…

for ca. et år siden 39:30

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In this comprehensive episode host Stacey Richter sits down with Brian Reid to discuss pivotal aspects for the pharmaceutical industry. Key topics include understanding product value from the perspectives of plan sponsors, patients, and society, and the significance of benefit design in improving patient affordability.

For the show notes with all links mentinoed, visit the episode page.

If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe.

The discussion delves into the complexities of drug pricing, the roles of Pharmacy Benefit Managers (PBMs) and brokers, and the impact of healthcare consolidation on costs. Reid emphasizes the importance of transparent communication among stakeholders, the detrimental effects of cost containment strategies, and the necessity of considering policy and reputational impacts.

Throughout the conversation, examples such as the Hepatitis C drug illustrate the broader implications on drug access and affordability. Listeners are provided with critical insights into how pharmaceutical companies can better engage with ultimate purchasers to ensure patients receive necessary, cost-effective medications while navigating a changing healthcare landscape.

For the show notes with all links mentinoed, visit the episode page.

08:29 Why is it important to understand the term “value” in respect to medicine?

10:07 Why is it important to consider all the players affected by the idea of this “value”?

11:06 Who are the ultimate purchasers in Pharma?

12:23 Findings of the Kaiser Employer Health Benefits Survey.

14:52 Why does it matter that we consider what value looks like to all players affected by Pharma?

16:46 EP300 with Bruce Rector, MD.

18:38 EP448 (Part 1) with Shawn Gremminger.

20:04 What does Pharma need to do to showcase their value when PBMs are often “locked in” at the moment?

23:11 Why Brian is celebrating companies that put their prices in their press releases.

32:31 Why does Pharma have an obligation to explain their value?

33:16 EP426 with Nina Lathia, RPh, MSc, PhD.

33:39 Why is it important for Pharma to keep an eye on hospital monopoly behavior?

35:55 EP370 with Erik Davis and Autumn Yongchu.

37:44 Why Pharma needs to capitalize on alignment.

582 episoder

#Fitness #Medicine #Healthcare #Pharma #Business News #News #Stacey Richter

Relentless Health Value

EP456: Advice to Pharma at the Intersection of Product Value, Reputation, and Patient Affordability, With Brian Reid

Relentless Health Value

21 subscribers

published for ca. et år siden

Del

MP3•Episoder hjem

For the show notes with all links mentinoed, visit the episode page.

If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe.

For the show notes with all links mentinoed, visit the episode page.

08:29 Why is it important to understand the term “value” in respect to medicine?

10:07 Why is it important to consider all the players affected by the idea of this “value”?

11:06 Who are the ultimate purchasers in Pharma?

12:23 Findings of the Kaiser Employer Health Benefits Survey.

14:52 Why does it matter that we consider what value looks like to all players affected by Pharma?

16:46 EP300 with Bruce Rector, MD.

18:38 EP448 (Part 1) with Shawn Gremminger.

20:04 What does Pharma need to do to showcase their value when PBMs are often “locked in” at the moment?

23:11 Why Brian is celebrating companies that put their prices in their press releases.

32:31 Why does Pharma have an obligation to explain their value?

33:16 EP426 with Nina Lathia, RPh, MSc, PhD.

33:39 Why is it important for Pharma to keep an eye on hospital monopoly behavior?

35:55 EP370 with Erik Davis and Autumn Yongchu.

37:44 Why Pharma needs to capitalize on alignment.

582 episoder

#Fitness #Medicine #Healthcare #Pharma #Business News #News #Stacey Richter

Alle episoder

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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

for 3 dager siden35:17

35:17

So, let’s continue themes from prior episodes, most particularly the episode from last week with Christine Hale, MD, MBA ( EP471 ), which was also about high-cost claimants and just the impact that they have on the wallets of self-insured employers and any other plan sponsor. For a full transcript of this episode, click here . If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. We could have 0.5% to 1% of total plan members costing upwards of 40% of total plan dollars. And I bring this up just to highlight the magnitude of the money here. In that show from last week, we take the issue of high-cost claimants from the standpoint of the plan sponsor. Today, however, we’re gonna be looking at this from the standpoint of the hospital system. If I were gonna come up with a motto for the show today with Dr. Eric Bricker, it’s that all costs are somebody else’s revenue. And when it’s revenue and profit of the magnitude that we’re talking about with many high-cost claimants, it starts to be less of an accidental “Oh, wow! How did that CABG patient wind up in our clinic? What are the odds?” and more of a “Whoever is not steering patients is letting someone else with a big profit incentive lock down that steerage in deeply embedded ways.” But before I get too much further, let me tell you how this show came to be. And frankly, it’s beginning to get a little repetitive. But in my defense, Cora Opsahl works like a block for me; and apparently, we are both not opposed to happy hour. So, Cora started telling me that, right now, you have some pretty astute plan sponsors who know a thing or two about the magnitude of hospital spend. Total hospital costs are usually around half of most total plan spend. So, sure, you have plan sponsors doing direct contracts or really scrutinizing underlying hospital charges. Except … in contract negotiations with plan sponsors either doing direct deals or doing hospital RFPs (requests for proposal) through their carrier or just even negotiating with carriers and looking at the underlying hospital costs, hospital charges to plan sponsors in the aggregate can go up, while hospitals are still able to say, “I’m gonna be net-net 0% increase across the board,” or even “I’m gonna do a decrease.” They are able to show lower prices. Wait, what? Yep, that’s happening. I was like, “Seriously, how are they doing this?” Cora said, “You should get Dr. Eric Bricker back on the pod to explain exactly how hospitals are going about this.” Dr. Bricker did a video about it, but the show that you’re about to hear digs in hard on the playbook as well. But I’m getting ahead of myself. So, anyway, after I talked to Cora, I firm up a plan with Dr. Bricker to make a return appearance on the pod. And wouldn’t you know it, that exact same day, Kurt Christie messages me and says, “You should have Dr. Bricker come back on the pod and talk about how hospitals profit from high-cost claimants.” So, yeah … love it when a plan comes together, especially because so many of you in our tribe have, at various points, asked for a return appearance of the one and the only Dr. Eric Bricker. So, here you have it. You’ll need to listen to the show to get to the bottom of the well-honed (at this point) contracting strategy that some big, consolidated hospitals—Centers of Excellence, if you will—deploy to maximize revenue from high-cost claimants. It’s like a three-prong playbook from what I have been gathering, but yeah, if you are on the hook to pay for hospital claims, do be aware of this. It is material. Slight spoiler alert, but the playbook has to do with how hospitals negotiate with plan sponsors on their provider stop-loss contract provisions. It also has to do with how they choose to consolidate and how they engineer their chargemaster. Sounds boring, but it’s really not if you are on the hook for millions and millions of dollars as a result. Okay … so, do I really need to introduce Dr. Eric Bricker? Dr. Bricker began as an internist. He also worked in hospital finance. Then he started one of the very first, actually, healthcare navigation companies and also, kind of out of necessity, one of the first get serious about transparency initiatives. Dr. Bricker says when you help 1.8 million people navigate the U.S. health system for 11 years, you learn a thing or two. So, after he sold Compass Professional Health Services, he decided he’d use what he knew to help set people straight. And, yeah, go to Dr. Bricker’s YouTube channel AHealthcareZ, for sure, if you want to learn anything about the A to Z of healthcare. Also mentioned in this episode are AHealthcareZ ; Christine Hale, MD, MBA ; Cora Opsahl ; Kurt Christie ; Matt McQuide ; Scott Conard, MD ; John Torinus ; Robert Pearl, MD ; and Tom Nash . You can learn more at AHealthcareZ and by following Dr. Bricker on LinkedIn and at @DrEricB on X. Eric Bricker, MD, is an internal medicine physician and former co-founder and chief medical officer of Compass Professional Health Services. Compass is a healthcare navigation service that grew to 1.8 million members across 2000+ clients, including T-Mobile, Southwest Airlines, and Chili’s/Maggiano’s Restaurants. Compass was acquired by Alight Solutions in July 2018. Dr. Bricker then went on to found AHealthcareZ, which provides 400+ healthcare finance educational videos with 100,000+ subscribers/followers across YouTube and LinkedIn. Additionally, Dr. Bricker serves on the board of directors for Frontier Direct Care and provides consulting services to a variety of clients. 05:06 From a hospital revenue perspective, where do high-cost claimants fall? 08:45 How do hospitals structure their stop-loss provisions so that they ensure they’re always maximizing their revenue? 12:15 How hospitals acquire providers to steer as many patients as possible through specific service lines. 20:21 Why do carriers let hospitals get away with these rates and stop-loss negotiations? 21:06 How do Medicare Advantage and Medicare rates play into all of this? 22:00 What should a benefit consultant be doing here? 23:37 What are the keys to direct contracting? 26:22 EP468 with Matt McQuide. 27:18 EP462 with Scott Conard, MD. 27:21 Why is it important to get trusted relationships set up ahead of time? 28:04 The Company That Solved Health Care by John Torinus Jr. 28:31 EP471 with Christine Hale, MD, MBA. 28:52 EP412 with Robert Pearl, MD. 29:23 What needs to be the clinical consideration for specialists? 30:46 What is the advantage that employers have in all of this? 33:06 Dr. Bricker’s video on 32 examples of healthcare deception. You can learn more at AHealthcareZ and by following Dr. Bricker on LinkedIn and at @DrEricB on X. @DrEricB discusses #hospitalrevenue and high-cost #claimants on our #healthcarepodcast. #healthcare #podcast #changemanagement #healthcareleadership #healthcaretransformation #healthcareinnovation Recent past interviews: Click a guest’s name for their latest RHV episode! Dr Christine Hale , Nikki King , James Gelfand (Part 2) , James Gelfand (Part 1) , Matt McQuide , Stacey Richter (EP467) , Vivian Ho , Chris Crawford (EP465) , Al Lewis , Betsy Seals , Wendell Potter (Encore! EP384)…

Relentless Health Value

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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

for 10 dager siden34:41

34:41

Recently 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 beyond. They discuss the importance of trust in patient care, the financial incentives behind patient steering, and the critical role of timely and comprehensive data analysis. Dr. Hale emphasizes the need for an integrated approach to medical and pharmacy claims data to avoid expensive consequences and improve patient outcomes. She also shares strategies for plan sponsors to effectively manage high cost claimants through evidence-based care, appropriate treatment settings, and creative problem-solving, while underlining the importance of patient engagement and satisfaction. Don't miss next week's episode with Dr. Eric Bricker for a deeper dive into these topics. === LINKS === 🔗 Show Notes with all mentioned links: https://relentlesshealthvalue.com/episodes ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ X https://twitter.com/relentleshealth/ 05:22 What is a high-cost claimant, and how is the definition changing? 07:42 Why buy-and-bill pharmaceuticals can be so costly for plan sponsors. 10:19 What are plan sponsors getting wrong about this situation? 11:28 What do you need as an employer to understand your plan data fully? 13:41 EP462 with Scott Conard, MD. 17:35 What are plan sponsors currently doing that they should not being doing? 19:54 Why starting small is important. 23:02 EP468 with Matt McQuide. 25:37 What are the steps employers should take to improve their high-cost claimant spend? 31:02 EP371 with Erik Davis and Autumn Yongchu. 33:46 EP467 with Stacey. Recent past interviews: Click a guest’s name for their latest RHV episode! Nikki King , James Gelfand (Part 2) , James Gelfand (Part 1) , Matt McQuide , Stacey Richter (EP467) , Vivian Ho , Chris Crawford (EP465) , Al Lewis , Betsy Seals , Wendell Potter (Encore! EP384) , Dr Scott Conard…

Relentless Health Value

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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

for 17 dager siden35:10

35:10

In 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 freestanding emergency rooms, telehealth, and the expanded roles of nurse practitioners. The conversation also covers the complexities of maternity care and mental health services in rural areas, emphasizing the urgent need for systemic reforms to ensure equitable access to healthcare. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP470 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ X https://twitter.com/relentleshealth/ 08:14 How dire is the rural hospital situation right now? 08:33 How could freestanding ERs be a potential solution for rural hospitals? 09:56 Advice from CHQPR: Rural hospitals should not be forced to eliminate inpatient care. 11:22 Why is broadband a roadblock to telehealth as a solution for rural health access? 14:52 What are other potential rural health access solutions? 15:37 The “hot potato” of nurse practitioners in the healthcare world. 16:34 “The number of residencies for physicians each year is not increasing, but the population … is increasing.” 20:28 EP312 with Douglas Eby, MD, MPH, CPE, of the Nuka System of Care. 22:00 What’s the issue with maternity care in rural America? 24:09 “As healthcare becomes more and more specialized, [the] ability to treat high-risk cases is better, but access gets worse.” 27:57 How is mental health care affected in rural communities? 28:29 “Rural communities are trying very hard to hang on to what they have.” 29:52 “When you look at the one market plan that’s available in a rural community, you probably can’t afford it.” 31:37 What’s the single biggest challenge to moving to a model that incentivizes keeping people healthy? 32:32 “The easiest low-hanging fruit … is having national Medicaid and have that put under the same hood as Medicare.”…

Relentless Health Value

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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

for 24 dager siden30:36

30:36

In 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 consolidation and inflated prices through facility fees and markups. Gelfand provides insights into how HSA reforms currently in Congress could expand the scope of preventive care covered before deductibles are met, benefitting both employers and employees. The conversation also touches on the challenges high deductible health plans pose and the potential benefits of codifying recent IRS guidance to allow greater flexibility in pre-deductible coverage. The discussion underscores the importance of plan sponsors staying ahead of Medicare policies to avoid higher costs. === LINKS === 🔗 Show Notes with all mentioned links: https://relentlesshealthvalue.com/episodes ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ X https://twitter.com/relentleshealth/ 05:42 What does Medicare site-neutral payments mean? 08:59 How do markups play into the dynamics here? 09:52 Upcoming episode with Christine Hale, MD, MBA. 10:36 What does the “narrow” start for these changes mean? 11:42 What action steps should plan sponsors be taking? 13:01 What options do plan sponsors have in highly consolidated markets? 14:27 EP371 with Erik Davis and Autumn Yongchu. 14:53 EP448 ( Part 1 and Part 2 ) with Shawn Gremminger. 15:46 Will this bill potentially make changes to HSA plans? 17:40 Why has the thinking behind healthcare usage changed since the inception of HSAs? 18:42 INBW41 with Stacey. 23:24 How are preventive care and first-dollar coverage connected within the context of HSAs? 25:48 Why would it be difficult to completely get rid of a high-deductible health plan and offer HSAs without them?…

Relentless Health Value

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EP469 (Part 1): The Impact on Plan Sponsors of Medicaid Cuts, With James Gelfand, JD 25:42

for 24 dager siden25:42

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In 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: reducing waste, fraud, and abuse; implementing work requirements; reeling in provider taxes; and addressing the 'Cornhusker Kickback' from the ACA. The conversation also delves into how state governments and hospitals might respond to these cuts and suggests actions for plan sponsors to mitigate potential impacts. The episode is part one of a two-part series, with the second episode covering Medicare site neutral payments and HSA reforms. === LINKS === 🔗 Show Notes with all mentioned links: https://relentlesshealthvalue.com/episodes ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ X https://twitter.com/relentleshealth/ 05:22 What’s happening with Medicaid cuts? 06:47 What are the four main things congress is actually looking at in cutting Medicaid? 09:12 What is the Cornhusker Kickback? 16:46 What should plan sponsors be doing right now to prepare for these potential Medicaid cuts? 20:04 What’s going to happen to hospitals with these proposed Medicaid cuts? 20:48 EP464 with Al Lewis. 23:41 How does hospital consolidation affect the potential future with these Medicaid cuts?…

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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

for 4 weeks siden34:39

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In 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 the healthcare marketplace, and Matt’s three major misconceptions about health plan membership. Matt also presents real-life examples of how engagement significantly impacts health outcomes, emphasizing that relationships and trust are paramount. The episode concludes with practical strategies for employers to enhance engagement and manage employee health effectively. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP468 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ X https://twitter.com/relentleshealth/ You can learn more at Synergy Healthcare and by following Matt on LinkedIn . Matt McQuide is the founder and CEO of Synergy Healthcare, a role he has held since launching the company in 2012. Under his leadership, Synergy has made significant strides in improving member health, enhancing the health insurance experience and the financial integrity of health plans. 06:28 What are Matt’s three common assumptions that employers make about member engagement? 07:08 “Health is actually hard.” 08:19 Why is it important to meet people when their need for healthcare sparks their interest in their health? 11:29 “It didn’t take much … it just takes time.” 13:53 Why are relationships and trust more important today for employee health and member engagement? 16:04 Do people actually want optimal health? 17:44 Why is it important to meet people where they are today? 22:38 “Employers don’t want to fix healthcare.” 24:10 Why it’s important to remember that claims are real people. 24:38 Quote from Steve Schutzer, MD, about EP463 with Betsy Seals. 26:44 How do you solve the “middle way”?…

Relentless Health Value

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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

for 5 weeks siden23:09

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In 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 primary care leads to skyrocketing ER costs, which now account for 6% of total healthcare spending. Key points include the systemic issues driving this trend, the incentives misalignments within hospitals and insurance carriers, and the importance of establishing trust and relationships in primary care. The episode also discusses perspectives from healthcare professionals and thought leaders on potential solutions to realign healthcare incentives and improve patient outcomes. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP467 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social/ ✭ X https://twitter.com/relentleshealth/ 02:16 Connecting the dots between the last six shows. 05:34 EP466 with Vivian Ho, PhD. 05:53 EP463 with Betsy Seals. 05:56 EP384 with Wendell Potter. 14:38 Where does the primary care through line connect to carriers? 17:13 Health Affairs study showing ER cost increases. 19:19 Kevin O’Leary’s Health Tech Nerds newsletter. 19:40 EP407 with Vivek Garg, MD, MBA. 20:47 How are hospital board directors affecting hospital price increases and why? 21:49 Upcoming episode with Matt McQuide. Also mentioned in this episode are Matt McQuide ; Christine Hale, MD, MBA ; Kenny Cole, MD ; Al Lewis ; John Lee, MD ; Rushika Fernandopulle, MD ; Scott Conard, MD ; Vivian Ho, PhD ; Betsy Seals ; Wendell Potter ; Tim Denman ; François de Brantes, MBA ; Jeff Charles Goldsmith, PhD ; Mick Connors, MD ; Primary Care for All Americans ; Rob Andrews ; Alex Sommers, MD, ABEM, DipABLM ; Ann Lewandowski ; Steve Schutzer, MD ; Sergei Polevikov, ABD, MBA, MS, MA 🇮🇱🇺🇦 ; Kevin O’Leary ; Health Tech Nerds ; Vivek Garg, MD, MBA ; Suhas Gondi, MD, MBA ;…

Relentless Health Value

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EP466: What Is Rising Faster, Insurance Premiums or Hospital Prices? With Vivian Ho, PhD 36:12

for 6 weeks siden36:12

36:12

Healthcare 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? What’s the biggest driver of premium increases? (Spoiler: It’s hospital prices.) Are hospital price hikes justified by rising costs—or is something else at play? Dr. Ho shares data-backed insights on hospital consolidation, executive incentives, and how health system pricing impacts self-insured employers and plan sponsors. If you’re a healthcare executive or a jumbo employer managing benefits, this episode is a must-listen. === LINKS === 🔗 Show Notes with all mentioned links:https://relentlesshealthvalue.com/episodes ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter:https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar:https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcastshttps://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ X https://twitter.com/relentleshealth/ 05:12 Are insurance premiums going up?05:59 What is the disparity between cost of insurance and wage increases?06:21 LinkedIn post by Byron Hugley.06:25 Article by Michael Strain.06:46 How much have insurance premiums gone up for employers versus employees?09:06 Chart showing the cost to insure populations of employees and families.10:17 What is causing hospital prices and insurance premiums to go up so exponentially?12:53 Article by (and tribute to) Uwe Reinhardt.13:49 EP450 with Marilyn Bartlett, CPA, CGMA, CMA, CFM.15:28 Are razor-thin operating margins for hospitals causing these rising hospital prices?16:56 Collaboration with Marilyn Bartlett and the NASHP Hospital Cost Tool .19:47 What is the explanation that hospitals give for justifying these profits?23:16 How do these hospital cost increases actually happen?27:06 Study by Zack Cooper, PhD.27:50 Who typically makes up a hospital board, and why do these motivations incentivize hospital price increases?30:12 EP418 with Mark Cuban and Ferrin Williams, PharmD, MBA.33:17 Why is it vital that change start at the board level?…

Relentless Health Value

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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

for 7 weeks siden34:15

34:15

The 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 significantly overcharge for drugs that are available much cheaper through cash-pay options like Mark Cuban's Cost Plus Drugs. Crawford explains how Aggregate Discount Guarantees, a common contracting mechanism, often fail to control spread pricing effectively and instead may lead to higher costs for plan sponsors and employees. The episode also covers how RxSaveCard can help employers and employees access these lower cash prices, circumventing the inflated costs from traditional PBMs. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP465 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ X https://twitter.com/relentleshealth/ 07:12 EP365 with Scott Haas. 07:17 EP397 with Paul Holmes. 07:19 EP439 with Luke Slindee, PharmD. 07:20 EP379 with AJ Loiacono. 07:44 What is the Aggregate Discount Guarantee? 13:49 Why do the divergent list prices and the perverse incentives prevent the Aggregate Discount Guarantee from really limiting cost spread? 17:55 Why is it important for plan sponsors to check these drug cost prices, and how can employers check them? 23:56 What drives cost lower, and why does it change everything? 25:09 How does RxSaveCard work? 25:44 EP461 with Chris Crawford. 30:01 Do you need a PBM’s permission to use RxSaveCard? 30:37 How does it look for employers/employees to use the RxSaveCard? 32:39 EP356 with Ge Bai, PhD, CPA.…

Relentless Health Value

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EP464: ER Visits Now 6% of Total Plan Spend. Is It Upcoding or What? With Al Lewis 31:40

for 8 weeks siden31:40

31:40

Emergency 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 sponsors struggle to negotiate fair ER rates. Plus, Al shares actionable strategies for employers to push back against inflated charges. If you want to understand the hidden forces behind escalating ER bills, this is a must-listen. You can find the charts and links mentioned in the show notes in the link below. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP464 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ X https://twitter.com/relentleshealth/ 00:00 Introduction 08:32 What is going on in ER visits, and how big of a deal is the total spend? 10:16 Why is the price of ER visits going up when it should be going down? 11:59 What is the major source of unexpected medical debt? 13:27 What is code creep, and why is it happening? 16:26 Why are plan sponsors unable to negotiate emergency room services? 19:22 EP415 with Rob Andrews. 25:53 Why is it important not to agree to consent when you go in to visit the ER? 27:47 EP386 with Al Lewis. 31:28 What steps can plan sponsors take to be proactive about limiting ER spending for their employees? You can learn more at quizzify.com and by emailing al@quizzify.com . You can also follow Al on LinkedIn . Recent past interviews: Click a guest’s name for their latest RHV episode! Betsy Seals , Wendell Potter (Encore! EP384) , Dr Scott Conard , Stacey Richter (INBW42) , Chris Crawford , Dr Rushika Fernandopulle , Bill Sarraille , Stacey Richter (INBW41) , Andreas Mang (Encore! EP419) , Dr Komal Bajaj…

Relentless Health Value

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EP463: Medicare Advantage Policies—Which Will Stay and Which Will Go Now? With Betsy Seals 35:11

for 9 weeks siden35:11

35:11

In this episode of Relentless Health Value, host Stacey Richter engages with Betsy Seals, CEO and co-founder of Rebellis Group, to analyze the future of key Medicare Advantage policies amidst a changing political landscape. They delve into four critical areas: 1. Medicare Advantage Stars Program: Examining potential changes due to recent lawsuits and the new administration’s stance on quality measures. 2. Risk Adjustment and Government Oversight: Discussing the focus on recouping improper payments and how oversight might evolve. 3. Use of Artificial Intelligence: Considering appropriate oversight for AI applications in prior authorization processes and ensuring they benefit patient care. 4. Agent and Broker Oversight: Exploring increased scrutiny over marketing practices and the dissemination of accurate information to beneficiaries. Betsy emphasizes the importance for Medicare Advantage plans to prioritize patient value, maintain compliance, and proactively utilize data to navigate these evolving policies. This discussion provides valuable insights for stakeholders aiming to understand the future of Medicare Advantage. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP463 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ X https://twitter.com/relentleshealth/ 05:09 Will the Star Ratings program stay in this new administration? 08:08 How will the lawsuits against CMS policies play out with this new administration? 10:24 Why is it hard for Medicare Advantage plans to survive, let alone thrive? 16:22 How does AI directly impact beneficiary lives? 21:38 What’s going on now with the override payments? 27:08 How is non-collaboration going to impact Medicare beneficiaries moving forward? 31:45 Why is it important to become more technologically savvy in compliance?…

Relentless Health Value

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Encore! EP384: How Shareholders Impact Carrier Behavior, Exactly and Specifically, With Wendell Potter 35:01

for 10 weeks siden35:01

35:01

In this episode, Stacey Richter explores how the demands of shareholders influence the actions of publicly traded health insurance companies with guest Wendell Potter. Drawing from Milton Friedman’s assertion that a business’s primary responsibility is to its shareholders, we examine the implications of this philosophy in the healthcare sector. The discussion highlights concerns about fraud allegations among major insurers and the lack of open competition due to market consolidation. We delve into the concept of the “medical loss ratio,” a key metric for investors, and how it pressures insurers to prioritize profits, often at the expense of patient care. Our guest, Wendell Potter, a former health insurance executive turned advocate for healthcare reform, provides insider insights into these dynamics. He discusses the challenges insurers face in controlling costs, the impact of rising premiums, and the broader consequences for patients and the healthcare system. This episode offers a critical look at the intersection of corporate interests and patient care, shedding light on the systemic issues that arise when profit motives drive healthcare decisions. All mentioned links can be found in the show notes. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/Encore384 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ X https://twitter.com/relentleshealth/ 08:31 What is the medical loss metric? 11:33 “The reality is, insurers have been jacking up premiums … for a long time.” 12:48 “It’s a short-term game.” 15:39 “You’re seeing that these companies are not doing a very good job … of controlling costs because they don’t have the incentive.” 20:19 EP366 with Kevin Schulman, MD. 22:45 How do payers ensure that they’re controlling utilization? 25:53 “It’s death by a thousand cuts.” 31:51 “Just like independent practice physicians are endangered, so are community pharmacists.” 33:17 Who runs our healthcare system?…

Relentless Health Value

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EP462: Managing Populations of Whole, Actual People Who Are Not the Sum of a Bunch of Different Body Parts, With Scott Conard, MD 33:35

for 11 weeks siden33:35

33:35

This podcast today is with Dr. Scott Conard, founder of Converging Health. You might remember him from the earlier episode ( EP391 ). First of all, I enjoyed how it came to be. Brian Uhlig, an employee benefit consultant of some acclaim, came to me and offered to sponsor a show for someone else. Not himself. I gotta say, it’s stuff like this that warms my heart. It’s this village that we have here, this tribe of Relentless folks trying so hard to stand up for and help patients. So, thanks again to Brian Uhlig. Right now, Dr. Conard is doing a bunch of work with Mike Adams from 7-Eleven, helping their plan members. A lot of this work is centered on and about a few pretty striking but very common insights that many plan sponsors will find in their own data. It turns out about 70%, give or take, of people who wind up costing the plan whatever the high-cost threshold is in any given plan year. These higher-cost claimants didn’t fall out of the sky unexpectedly, 70% of them. They were actually high risk but low cost in prior years. So, the trick is to find these individuals and help them not fall into the high-risk and high-cost part of the graph. If the goal is how to best manage a population of members, a lot of that is, again, identifying high-risk patients who are currently in the low-cost zone, who, any given plan year, are gonna go out of that zone and get into the high-cost area. So, if we’re thinking about best practices to avoid this, I’m gonna run through Dr. Conard’s list that we mostly run through in the show that follows. Lastly, we touch a little bit in the show today on community-run primary care. This is a community paying for primary care for community members, just like they pay the fire department and the police department. There’s a town in Rhode Island doing this that Dr. Conard talks about today. In fact, Michael Fine, MD, is part of this effort in Rhode Island. === LINKS === 🔗 Show Notes with all mentioned links and articles: https://cc-lnk.com/EP462 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ X https://twitter.com/relentleshealth/ 07:10 How do we think about data wrongly, and how does that affect our healthcare spend in regard to population health? 09:43 What needs to be done with population health data once it’s collected. 14:48 Community in Rhode Island doing effective proactive care. 16:09 EP449 with Marty Makary, MD, MPH. 16:44 A real, successful case study. 24:08 How do we define high-cost patients? 24:14 What do we know about high-cost patients in regard to population health spend? 29:02 Why avoiding prevention in primary care only harms yourself in the future.…

Relentless Health Value

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INBW42: A Philosophical Rabbit Hole of Considerations for Plan Sponsors and Others 27:39

for 12 weeks siden27:39

27:39

In this inbetweenisode Stacey Richter dives into the complexities of benefit design in American healthcare. Highlighting insights from recent episodes with Bill Sarraille ( EP459 ) and upcoming episode with Scott Conard, MD, Richter explores the impact of cost containment measures and the moral hazard of insurance, emphasizing the importance of creating balanced and efficient benefit plans that align with plan values and avoid unintended consequences. She discusses the challenges and implications of high deductible health plans and copay maximizers/accumulators, urging plan sponsors to strive for pareto optimality and practical solutions. This episode is a call to carefully consider patient behavior, healthcare utilization, and the broader impacts of financial incentives in healthcare. Going black and white or over-indexing to prevent outlier kind of stuff is probably not gonna end well. Not seeking a middle way can easily result in a solution that is possibly worse than the problem. Moral hazard is actually a thing. There are lots of implications to patients not being able to distinguish high-value and low-value care. But if we know this, then, philosophically at least, how do we conceptualize a solve? What should we be doing? If we’re not doing black and white, what does the gray in the middle look like? === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/INBW42 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Follow on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Follow on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ X https://twitter.com/relentleshealth/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social 00:00 Introduction to the Rabbit Hole 04:05 Where did Stacey’s rabbit hole spiral start? 05:40 What is the moral hazard of insurance? 09:31 EP358 with Wayne Jenkins, MD. 12:49 Why isn’t moral hazard mitigated in insurance? 18:16 EP459 with Bill Sarraille. 20:51 “How do we conceptualize a solve?” 22:24 Why should we be striving for Pareto optimality? 25:20 What is the theory of second best?…

Relentless Health Value

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EP461: Pick Only One, Plan Sponsors: Do You Want to Control GLP-1 Volume or Control GLP-1 Unit Cost? With Chris Crawford 22:42

for 13 weeks siden22:42

22:42

This episode with Chris Crawford, CEO of RxSaveCard, is not about the when, why, or how of GLP-1s for weight loss or best-practice prescribing. This episode very, very specifically is about the how and why of the pickle plan sponsors get themselves into often enough where if they impose formulary restrictions to limit the volume of meds that they are paying for, then unit prices go up, which is a thing for GLP-1s. And this is critical just given how the costs associated with GLP-1s for weight loss contribute to some pretty significant increases in pharmacy trend for plan sponsors who choose to cover the GLP-1s for weight loss. Chris Crawford and Stacey Richter discuss the challenges plan sponsors face with the rising costs of GLP-1 medications for weight loss. They explore how plan sponsors’ efforts to manage pharmacy trends often result in a tradeoff: lowering unit costs by increasing volume or vice versa. Chris also introduces a potential solution leveraging the growing cash marketplace, where employers can bypass traditional PBM contracts to achieve cost savings. Tune in for actionable insights into the perverse incentives in the pharmacy supply chain and innovative ways to navigate them. (Continued below the links) === LINKS === 🔗 Show Notes with all mentioned links: hhttps://cc-lnk.com/EP461 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ X https://twitter.com/relentleshealth/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social Bottom line, there are some really impactful and not frequently delved into perverse incentives at play here. And we’re gonna talk about these today. And these are really key for anybody on or about the pharmacy supply chain in the U.S. to know about. This is very actionable insight. So, again, there’s an unfortunate tradeoff, as it stands right now, for many plan sponsors. Lower your volume and raise the unit price or vice versa. This episode is sponsored by RxSaveCard , and a big thanks for that. I really appreciate RxSaveCard for its financial support because this episode covers a really important topic that we probably would have covered anyway over here at Relentless Health Value. And so, RxSaveCard standing up and offering their financial support to cover it was a really nice thing to do. And I thank them for their generosity. 07:57 What are the two pieces going on with GLP-1 PBM prices and rebates for employers? 10:00 Is the cash price for these name brand drugs currently less than the rebated PBM price? 11:49 Why does the rebate for GLP-1s disappear if employers try to put restrictions on who can receive access to these drugs? 15:07 Where does RxSaveCard come in to play here? 19:55 “We exist to save people money.” 20:45 EP456 with Brian Reid. 21:16 EP356 with Ge Bai, PhD, CPA. 21:37 EP439 with Luke Slindee, PharmD.…

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Relentless Health Value « » EP456: Advice to Pharma at the Intersection of Product Value, Reputation, and Patient Affordability, With Brian Reid

EP456: Advice to Pharma at the Intersection of Product Value, Reputation, and Patient Affordability, With Brian Reid

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EP456: Advice to Pharma at the Intersection of Product Value, Reputation, and Patient Affordability, With Brian Reid