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Relentless Health Value: Daily Summaries Delivered
by Stacey Richter
Welcome to Relentless Health Value, the podcast for those working in the belly of the beast to fix our fundamentally broken healthcare system. If you are a self-insured employer, plan sponsor, benefits consultant, clinician, a C-suite executive or anyone in the business of healthcare tired of the "transformational theater" and marketing fluff, you have found your tribe. The U.S. healthcare system isn't a rational market; it's a game of Pachinko where perverse incentives reign, and as we always say, where there's mystery, there's margin. Hosted by Stacey Richter, we relentlessly hunt down the administrative "inches" of waste and expose the hidden fees draining the $5.6 trillion healthcare sector. We transform wonky healthcare theory into ruthlessly practical, actionable insights. Whether it's demanding radical transparency, navigating complex PBM contracts, or buying actual healthcare instead of illusory discounts, our mandate is simple: If it results in a net positive for patients, we do it.
Latest Episodes
The most recent episodes — sign up to get AI-powered summaries of each one.
- 1 weeks ago8 min
The One Question to Test if a TPA Is Actually Independent, With Kimberly Carleson
Is Your TPA Truly Independent? The One Claims Audit Question to Ask, With Kimberly Carleson (EP534) The Red Flag Question That Reveals Whether a TPA Works for Your Plan or for the Network. Episode 534. What's a practical, speedy way to assess whether a TPA (third-party administrator) is truly independent and willing to protect the plan sponsor's interests, versus being captive to network contracts, carrier relationships, or other conflicts of interest? In this Ask Me Anything, Stacey Richter puts that question to Kimberly Carleson, CEO of US Beacon, one of the nation's most established independent medical and pharmacy claims compliance and integrity review firms. Her answer is a big kahuna of a tell: ask whether the TPA will let someone come in and independently review your claims — and listen closely to the response. WHAT YOU'LL LEARN ✅ The one question that quickly exposes whether a TPA is truly independent: "Can we have someone come in and independently review our claims?" ✅ Why a TPA answering "We have network contracts that restrict that" is a red flag — it means they are working for the network, not the plan ✅ What a TPA should hand over without hesitation when a plan sponsor asks for an independent claims audit: all claims data, including billed, paid, and allowed charges ✅ How blocking language in TPA and network contracts — restrictions on accessing data or contacting providers — can stop a plan from independently reviewing its own claims and payments ✅ How an "independent" TPA can still be beholden to a network, renting that network and acting the same way any BUCA would ✅ Why labels like "transparent" and "independent" aren't proof, and why due diligence matters: talk is cheap WHY THIS MATTERS Plan sponsors who go self-funded want to do their own thing and bring in their own vendors, not end up "self-funded in name only," as Jonathan Baran calls it. But irrespective of what a partner calls itself, it's still really important to validate what you hear. A TPA's willingness to let you bring in your own auditor — with access to the data and no blocking language in its network contracts — is a fast way to find out whether it works for the plan or for the network. And as Kimberly says, if you can't bring in who you want to bring in, there's something they don't want you to see. MENTIONED IN THIS EPISODE EP518 with Claire Brockbank: Apple Podcasts | Spotify | Other Apps Website: US Beacon Kimberly Carleson on LinkedIn === LINKS === 🔗 Show Notes with all mentioned links: Show Notes ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 🎤 Follow us on Apple Podcasts 🎤 Follow us on Spotify 📺 Subscribe to our YouTube channel === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 00:00 Introduction to this episode. 01:19 The conversation with Kimberly Carleson. 02:24 The one question to tell if a TPA is independent. 03:30 Breaking down the thought process behind this question. 05:59 How an independent TPA can still be beholden to a network. 06:48 Why it's so important to do due diligence.
- 2 weeks ago37 min
Level Funding Is Self-funding: 5 Avoidable Contract Risks, With Frank Pennachio
Level-Funded Health Plan Risks: ERISA Contract Traps, Stop-Loss Gaps, and Surplus Fine Print. Episode 533. An employer with a fully insured plan told Stacey Richter his renewal this year was 69% — his broker negotiated it down to 50%, which she's not sure she'd classify as a victory. Level funding looks like a lifesaver in that spot, but as Frank Pennachio, author of The Silent Danger and a health insurance veteran with nearly 40 years of experience, explains, level funding is self-funding, with all the fiduciary risk that comes with it. Frank walks through five avoidable contract risks that level-funded plan sponsors fall into regularly, from embedded ERISA violations to stop-loss misalignment to surplus fine print. WHAT YOU'LL LEARN ✅ Why level funding is self-funding — it feels like a fully insured plan because of the flat monthly payment, but the plan sponsor carries the risks and benefits of self-funding, including fiduciary responsibility ✅ How third-party administrator (TPA) and administrative services only (ASO) agreements can embed ERISA violations the moment they're signed, and why ERISA allows personal assets to be exposed ✅ How stop-loss misalignment leaves the plan sponsor on the hook when plan promises, like eligibility for employees on approved leave, aren't reimbursed under the stop-loss contract ✅ The surplus fine print: incurred but not reported (IBNR) factors, service fees Frank has seen as high as 30%, and surplus returned as an invoice credit instead of a check ✅ Why claims data access promised up front can get signed away, and why fiduciaries must pay prudent fees — like a $50,000 charge to reprice one hospital bill ✅ Four action items: never sign a contract as is, educate the plan sponsor team, run a legit RFP, and pick a broker or EBC with experience and financial alignment WHY THIS MATTERS With renewals like 69% and 50%, there's a lot of desperation out there for a lifesaver, and level funding is being sold as one. But as Frank Pennachio quotes Thomas Sowell, "There are no solutions, there are only trade-offs," and the goal is for plan sponsors to pick the trade-offs they want rather than desperate ones. The cost increases will sting, Frank says, and they won't likely bankrupt most companies, but the risks you unknowingly assume could. MENTIONED IN THIS EPISODE Website: The Silent Danger, Frank Pennachio's book Website: The Silent Danger courses from Frank Pennachio EP478 with Andreas Mang and Jon Camire (Part 1): Apple Podcasts | Spotify | Other Apps EP479 with Andreas Mang and Jon Camire (Part 2): Apple Podcasts | Spotify | Other Apps LinkedIn Post by Kimberly Carleson LinkedIn Post by David Goldfarb on stop-loss cost trends EP512 with Doug Aldeen: Apple Podcasts | Spotify | Other Apps EP457 with Cynthia Fisher: Apple Podcasts | Spotify | Other Apps Study: Survey by Kaiser Family Foundation EP453 with Claire Brockbank: Apple Podcasts | Spotify | <a href= "https://pod.link/892082003/episode/MWU
- 3 weeks ago37 min
Why Avoidable ER Visits Aren't the Real Cost Problem: Revisiting Our 2016 Interview With HHS Nominee Chris Klomp
Emergency Department High Utilizers and Real-Time Care Coordination, With Chris Klomp (Episode 532) Today we are dipping into the archives for an essential replay from 2016, one decade ago, featuring Chris Klomp back when he served as CEO of Collective Medical, and now nominated to serve as deputy secretary of the Department of Health and Human Services (HHS), a nearly $2 trillion federal health apparatus. In this conversation, Klomp explains why emergency medicine is only 2 to 4% of total U.S. healthcare cost, so avoidable ED spend can't be more than about 0.8 to 0.9% of total spend, and why the emergency department is still the natural choke point for finding complex, high-risk patients. Listening back is a rare, candid preview of the operational philosophy which may now shape Chris Klomp's view on health policy. WHAT YOU'LL LEARN ✅ Why Klomp said in 2016 that emergency medicine is only 2 to 4% of total U.S. healthcare cost, versus about 6% for plan sponsors now ✅ How the ED works as a "clearinghouse" for physical, mental, behavioral, and social complexity, and why the goal is the right care setting, not stopping the visit (EMTALA) ✅ How a Pacific Northwest clinical group used real-time data and coordinated care plans to cut hospital readmission rates by close to 40% ✅ Klomp's four building blocks: real-time data (starting with an ADT feed, since claims data runs 90 to 180 days late), risk analytics, communication inside the EHR workflow, and community-wide collaboration ✅ How whole-person care took "Ron" from 23 ED visits in a month across seven hospitals to 3 at peak, and why 78% of ED high utilizers have physical, mental, and behavioral health comorbidities WHY THIS MATTERS With the nomination of Chris Klomp to serve as deputy secretary of HHS, all eyes are kind of on how he plans to manage a nearly $2 trillion federal health apparatus. The emergency department is a critical choke point through which complex, often high-risk patients inevitably pass. Not dealing effectively with these larger community issues costs everyone more than dealing with them effectively would cost, and if the country had done more of what Klomp describes ten years ago, it makes you wonder how things would be different now. MENTIONED IN THIS EPISODE EP467 with Stacey Richter: Apple Podcasts | Spotify | Other Apps EP495 with Mick Connors, MD: Apple Podcasts | Spotify | Other Apps EP464 with Al Lewis: Apple Podcasts | Spotify | Other Apps Study: Research from Peter Smulowitz, MD, MPH; Leah Honigman, MD; and Bruce Landon, MD, MBA EP322 with Monica Lypson, MD, MHPE: Apple Podcasts | Spotify | Other Apps EP473 with Kenny Cole, MD: Apple Podcasts | Spotify EP391 with Scott Conard, MD: Apple Podcasts | Spotify | Other Apps === LINKS === 🔗 Show Notes with all the mentioned links and article: Show Notes ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the <a href= "https://relentlesshealthvalue.com/join-the-relen
- Sep 30, 202638 min
EP531: Slaying the Three-Headed Monster of Health Plan Networks, With Evan Anderson
Discount Illusions, Billing Errors, and Site-of-Care Markups: A Carrier Network Primer for Employers with Evan Anderson of Handl Health. Episode 531. Whatever the plan was at the very beginning, the big status quo carrier networks have evolved into what Stacey Richter calls a three-headed monster: the contractual illusion of discounts, payment integrity nobody with skin in the game is allowed to check, and wild site-of-care price swings inside the very same network. Stacey talks with Evan Anderson of Handl Health, where he works on product strategy, general strategy, and operations, about how fee-for-service networks got here and what self-insured employers, brokers, and TPAs can do around the edges right now. Consider it a primer — a survey of the general map of the landscape, with breadcrumbs to many past episodes for anyone ready to take a deep dive. WHAT YOU'LL LEARN ✅ Why a discount off a chargemaster price is "an optical illusion" — including the 2023 Health Affairs finding that at roughly half of hospitals, the discounted cash price is lower than the insurer-negotiated rate ✅ How old mainframe adjudication systems, obtuse contracts, and double-digit billing error rates make payment integrity nearly impossible to verify — because where there's mystery, there's margin ✅ How site-of-care differentials drive runaway spend, from hospital multipliers as high as 13X to $135 vs. $13,560 for the exact same infusion drug — both in-network ✅ Why switching carrier networks, even with your own claims file and transparency data, is a shrinking lever as prices regress toward the mean ✅ Three around-the-edges moves: direct contracting for advanced primary care and Centers of Excellence, steerage and tiering that include site-of-care tiers, and bundled episodes of care aggregated into alternative health plans ✅ How the broker/EBC role is shifting from network shopper to plan orchestrator WHY THIS MATTERS These networks are, lest we forget, built on a fee-for-service model that structurally aligns incentives in ways that are a lot of times misaligned with members and plan sponsors. As Evan puts it, cut one head off and the body grows it back — that body being decades of opacity (gag clauses were only banned by the CAA in 2021) and intermediaries paid in ways indifferent or positively correlated to higher spend. For plan sponsors facing extreme increases, knowing the real price, the quality, and what was actually billed is how you start chipping away at the status quo. MENTIONED IN THIS EPISODE EP505 with Ahilan Sivaganesan, MD: Apple Podcasts | Spotify | Other Apps EP434 with Benjamin Schwartz, MD, MBA: Apple Podcasts | Spotify | Other Apps Website: Handl Health Handl Health on LinkedIn Evan Anderson on LinkedIn Article: Katy Talento, ND, ScM, on a post-network world LinkedIn Post by Mark Cuban LinkedIn Post by Craig Gottwals Study: Health Affairs, hospital cash prices vs. negotiated prices EP482 with Preston Alexander: Apple Podcasts | Spotify | Other Apps EP480 with Kimberly Carleson: Apple Podcasts | Spotify | Other Apps EP521 with Andrew Tsang: <a href= "ht
- Sep 23, 202637 min
A Wildly Underappreciated Point: Overpaying for Infusions Means Overpaying for Stop-Loss Coverage, With Jake Velie and Keith Hartman, RPh
The Hidden Link Between Expensive Infusions and Rising Stop-Loss Renewal Premiums. Episode 530. When an infusion claim lands on a self-insured plan's high-cost claims report, it's tempting to treat the price tag as fixed — but the exact same infusion drug can cost 10 times more depending on where a member receives it, and every expensive claim that breaches a stop-loss attachment point can push next year's premium higher or get that member's claim lasered off coverage entirely. In this episode, Stacey Richter talks with Jake Velie, founder, chairman, and CEO of National Integrative Health (NIH), and Keith Hartman, RPh, NIH's chief strategy officer, about the direct — not dotted — line between overpaying for infusions and overpaying for stop-loss coverage, and the four pillars plan sponsors need to actually pull off site-of-care optimization. WHAT YOU'LL LEARN ✅ Why there's a direct, not dotted, line between expensive infusion claims and rising stop-loss renewal premiums — and how breaching an attachment point can get a claim lasered off coverage ✅ How the opacity of J-codes and Q-codes on the medical benefit hides how much margin is built into an infusion's billed cost, unlike the more visible pharmacy-benefit claims data ✅ Why the exact same infusion drug can cost 10 times more depending on where a member receives it ✅ The four pillars of a real site-of-care optimization program: deep clinical oversight, proactive pre-cert intervention, plan design and financial incentives, and member/influencer engagement ✅ Why a vague "denied" fax in the pre-cert process leaves prescribing clinicians in the dark and can sabotage a site-of-care redirect before it starts ✅ How home infusion can be used as a site-of-care option even when an anticompetitive hospital contract otherwise restricts steering WHY THIS MATTERS Stop-loss coverage is usually a self-insured plan's single biggest expense, yet Stacey Richter points out that the typical reaction to an expensive infusion claim is to treat it like an unalterable fate. The same infusion can cost 10 times more depending on where a member gets it, and every claim that breaches a stop-loss attachment point pushes premiums higher or risks getting the claim excluded from coverage. As medical and pharmacy trend keeps climbing, knowing how to steer members toward lower-cost, clinically appropriate sites of care is becoming a core skill for plan sponsors — not knowing how is turning into a problematic knowledge gap. MENTIONED IN THIS EPISODE EP529 with Eric Bricker, MD: Apple Podcasts | Spotify | Other Apps EP370 with Erik Davis and Autumn Yongchu: Apple Podcasts | Spotify | Other Apps EP468 with Matt McQuide: Apple Podcasts | Spotify | Other Apps Website: National Integrative Health EP501 with Ivana Krajcinovic, PhD: Apple Podcasts | Spotify | Other Apps EP508 with Lee Lewis: Apple Podcasts | Spotify | Other Apps EP480 with Kimberly Carleson: Apple Podcasts | Spotify | Other Apps EP523 with Suhas Gondi, MD, MBA: Appl
- Sep 16, 202639 min
How Stark Law, Stipends, and Noncompetes Drive Hospital Consolidation, With Eric Bricker, MD
The Chain Reactions Wrecking Healthcare Affordability: Facility Fees, Stark Law, and Noncompetes. Episode 529. Why do hospital facility fees keep pace with inflation while professional fees fall behind—and how did a law meant to stop kickbacks end up fueling a stipend economy instead? Stacey Richter talks with Eric Bricker, MD, founder of AHealthcareZ and former co-founder and chief medical officer of Compass Professional Health Services, about two action/reaction chains reshaping healthcare affordability: the facility-versus-professional-fee gap, and the Stark Law's unintended stipend economy driving hospital consolidation. Along the way: a $48,126 hospital charge for the same appendectomy that pays a surgeon $609, the AMA's $300 million CPT-code business, and how Tryon Medical Group in Charlotte, North Carolina, won back 90% of its patients by leaving its hospital employer. WHAT YOU'LL LEARN ✅ How separate physician "professional fee" and hospital "facility fee" billing streams have diverged so far that Medicare pays a surgeon $609 for an appendectomy while the hospital's published charge for it runs $48,126 ✅ Why the Stark Law's ban on hospitals paying physicians for referrals gave rise to "stipends"—flat annual payments that can range from $1 million to $50 million depending on hospital size, and how physician consolidation in fields like anesthesiology has pushed those stipends higher ✅ How "site unneutral" payment gaps incentivize hospitals to buy independent physician practices and shift services like echocardiograms into hospital settings to capture higher fees for identical care ✅ Why noncompete clauses trap physicians in incentive structures misaligned with patient care—and how Tryon Medical Group in Charlotte, North Carolina, sued to leave its hospital employer and kept over 90% of its patients ✅ Why self-insured employers (covering roughly 60% of Americans) and physicians organizing beyond fragmented specialty lines are healthcare's "two sleeping giants" ✅ Practical alternatives already in use: employer direct contracting, direct primary care subscriptions, and fixed-fee specialty models like the LA urology group paid on subscription for prostate cancer care WHY THIS MATTERS These two chain reactions—the facility-versus-professional-fee gap, and a well-intentioned law that quietly created a stipend economy—aren't abstract policy trivia. Together they drive the hospital consolidation and site unneutral payment schemes squeezing employers, taxpayers, and patients alike. As Stacey frames it, understanding how these action/reaction chains work is what it takes to reverse their direction toward more affordable, higher-quality care. The fix isn't waiting on Washington: it's employers and physicians—healthcare's two sleeping giants—using their leverage, whether through direct contracting, ending noncompetes, or simply voting with their feet. MENTIONED IN THIS EPISODE Dr. Eric Bricker's YouTube Channel and his site AhealthcareZ.com EP519 with Lisa Rosenbaum, MD: Apple Podcasts | Spotify | Other Apps LinkedIn Post by Payerset Instagram Reels by Elisabeth Potter, MD, on the AMA: Video 1, Video 2 Instagram Post by Graham Walker, MD EP437 with Brian Klepper, PhD: Apple Podcasts | Spotify | Other Apps EP472 with Eric Bricker, MD: Apple Podcasts | Spotify | <a href= "https://pod.link/892082003/episode/NDdiNDdiZjEtODdlNS00N2QyLWIxNDktO
- Sep 9, 202638 min
EP528: The Current State of Primary Care—Inevitable or Fixable? Will It Be Private Equity to the Rescue? With Yashaswini Singh, PhD
Hello, all you Relentless Tribe members. Here's the backstory for this episode. Remember episode 519 with Lisa Rosenbaum, MD, where we played a high-stakes kind of game show called "Is the Current State of Primary Care an Absolute Inevitability, or Is It a Needless, Suboptimal Inefficiency?" In that conversation, Dr. Rosenbaum, who was my contestant, made a compelling point. She said that if we want to fix primary care, we probably have to pay our primary care clinicians more. We need to invest in them and level up teams and infrastructure. 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. Now, if you have listened to Relentless Health Value for any length of time, you know you can count on me for a rant any given Tuesday about ceasing to pay way too much to corporatized consolidated, for example, health systems, especially the ones that already have quite robust endowments and huge real estate portfolios. Their crocodile tears do not move me. Same with other corporate intermediaries. Sharks with great PR departments. But yeah, it's hard to argue that our frontline primary care clinicians are chronically underfunded and relatively underpaid. So, when private equity enters the primary care chat with bags of capital, I could think, "Great! Primary care is finally gonna get the investment that it deserves." But riddle me this: If private equity gets in the mix and there's now more money flowing, will primary care actually get better? Or will the doctors and other clinicians on the ground and the patients they care for become, I don't know, pawns in just one more healthcare inflationary business model? Said another way, is the capital actually gonna build sustainable whole-person care, or is it just corporate arbitrage in a different Halloween costume? So, when I heard health economist Dr. Yashaswini Singh had just completed a whole bunch of research into private equity investing in primary care, I was on it like white on rice. I wanted to find out if this professional capital will actually or actually has been translating to better outcomes for patients or not. And to find out, I put Dr. Singh through the exact same three-category game show categories that I went through with Dr. Lisa Rosenbaum but specifically relative to private equity, PE-backed primary care clinics. So, with Dr. Rosenbaum, we talked about primary care kind of writ large and the inevitabilities and the kind of decimation of primary care that we see across the country. This show today is specifically … so, same three categories, which, let me remind you, are these three that we tackle: Cognitive atrophy amongst clinicians. That's what we talk about first, the de-skilling of primary care. Secondly, primary care becoming referral machines as a, is that inevitable? And then thirdly, we examine transactional fragmentation versus continuity of care. So, for each of these categories we go through, is it inevitable that this is gonna happen; or is this something that potentially, if a practice is purchased by private equity, can be avoided? <
- Sep 2, 202623 min
Why Should a Plan Sponsor Care About the 340B Charity Program? With Shawn Gremminger
How the 340B Drug Discount Program Quietly Raises Costs for Self-Insured Employers. Episode 527. Why should a self-insured employer care about the 340B charity program? That's the single question Stacey Richter puts to Shawn Gremminger, president and CEO of the National Alliance of Healthcare Purchaser Coalitions, in this episode—and his answer traces four ways the $68 billion program quietly drives up what employers and plan sponsors pay for drugs and medical care. From supercharged hospital consolidation to disappearing PBM rebates, Gremminger lays out why 340B, once treated as a niche topic, now sits squarely at the center of the drug pricing debate. WHAT YOU'LL LEARN ✅ Why 340B—now the second-largest drug purchasing program in the country at roughly $68 billion a year—matters directly to self-insured employers, not just to pharma and hospitals ✅ How 340B-driven hospital consolidation pushes up prices for all services, not just drugs, since hospital spend typically makes up 55–58% of total employer health plan costs ✅ Why 340B hospitals tend to mark up drugs even more aggressively than non-340B hospitals, and why 340B clinics disproportionately prescribe higher-priced drugs over cheaper alternatives ✅ How the Inflation Reduction Act's drug price caps are reportedly pushing some 340B entities to nonmedically switch patients toward non-IRA, higher-margin drugs ✅ Why employers lose access to PBM-negotiated rebates entirely whenever a drug is purchased through the 340B channel instead of the traditional channel ✅ Why Shawn Gremminger argues employers, purchasers, and policymakers need to stop treating 340B as a separate, carved-out issue from the broader drug pricing debate WHY THIS MATTERS Hospital spend already makes up more than half of a typical self-insured employer's healthcare costs, and 340B's distortions—inflated markups, prescribing skewed toward higher-priced drugs, and vanishing rebates—flow straight into that spend. A recent study found that for every point increase in hospital prices, non-healthcare employers respond by cutting payroll and jobs for middle-class workers. As 340B has grown from a niche $5–10 billion program into a $68 billion one, treating it as someone else's problem is no longer an option for anyone trying to understand or control drug pricing. MENTIONED IN THIS EPISODE Article: Brian Reid's Cost Curve Weekend newsletter, on pharma-hospital data-requirement lawsuits LinkedIn Post by Peter Hayes Article: "Reforming 340B to Serve the Interests of Patients, Not Institutions," by Anthony DiGiorgio, DO, MHA Article: "How a Company Makes Millions Off a Hospital Program Meant to Help the Poor," New York Times EP448 (Part 1 and Part 2) with Shawn Gremminger: Apple Podcasts | Spotify | Other Apps Study: Zack Cooper, PhD, on rising healthcare prices driving unemployment and job losses LinkedIn Post by Shawn Gremminger === LINKS === 🔗 Show Notes with all mentioned links ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 🎤 Follow us on Apple Podcasts 🎤 Follow us on Spotify 📺 Subscribe to our YouTube channel === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ <a href="https:/
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About Relentless Health Value
Welcome to Relentless Health Value, the podcast for those working in the belly of the beast to fix our fundamentally broken healthcare system. If you are a self-insured employer, plan sponsor, benefits consultant, clinician, a C-suite executive or anyone in the business of healthcare tired of the "transformational theater" and marketing fluff, you have found your tribe. The U.S. healthcare system isn't a rational market; it's a game of Pachinko where perverse incentives reign, and as we always say, where there's mystery, there's margin. Hosted by Stacey Richter, we relentlessly hunt down the administrative "inches" of waste and expose the hidden fees draining the $5.6 trillion healthcare sector. We transform wonky healthcare theory into ruthlessly practical, actionable insights. Whether it's demanding radical transparency, navigating complex PBM contracts, or buying actual healthcare instead of illusory discounts, our mandate is simple: If it results in a net positive for patients, we do it.
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