• Relentless Health Value™

  • 著者： Stacey Richter
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Relentless Health Value™

著者： Stacey Richter
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  • American Healthcare Entrepreneurs and Execs you might want to know. Talking. Relentless Health Value is a weekly interview podcast hosted by Stacey Richter, a healthcare entrepreneur celebrating fifteen years in the business side of healthcare. This show is for leaders in pharma, devices, payers, providers, patient advocacy and healthcare business. It's for health industry innovators, entrepreneurs or wantrepreneurs or intrapreneurs. Relentless Healthcare Value is the show for you if you want to connect with others trying to manage the triple play: to provide healthcare value while being personally and professionally fulfilled.
    ©BD Bridges LLC, All Rights Reserved.
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あらすじ・解説

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.
©BD Bridges LLC, All Rights Reserved.
ビジネス・キャリア 政治・政府 衛生・健康的な生活 身体的病い・疾患
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エピソード
  • Encore! EP418: Mark Cuban With a PSA for CEOs and CFOs of Self-insured Employers, With Mark Cuban and Ferrin Williams, PharmD, MBA, From Scripta

    Encore! EP418: Mark Cuban With a PSA for CEOs and CFOs of Self-insured Employers, With Mark Cuban and Ferrin Williams, PharmD, MBA, From Scripta
    2024/11/21
    This show from last year was one of the most popular episodes of the past year. And it’s also extremely relevant right now, given all of the PBM (pharmacy benefit manager) goings-on, as well as ongoing litigation like the J&J lawsuit, etc. Listen to the show with Julie Selesnick (EP428) for more on that one. 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. Also, Brian Reid (EP456) in the episode from a couple of weeks ago. And he talks about how Mark Cuban’s way of communicating and framing some of the issues with the big PBMs and just all of the perverse incentives in the drug supply chain. He says this way of communicating is “the chef’s kiss.” So, besides the insights here that follow being relevant in and of themselves, there’s also some lessons just in how those issues are teed up and communicated that we all can learn from. 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 of care in ways that improve employee health and satisfaction always begins when one thing happens. There’s one vital first step. That first step is CEOs and/or CFOs or their equivalents roll up their sleeves and get involved in healthcare benefits. Why can’t much happen without you, CEOs and CFOs? Here’s the IRL: In 2023, the healthcare industry has been financialized. There is a whole financial layer in between your company and its healthcare benefits. And unless the C-suite is involved here and bringing their financial acumen and organizational willpower to the equation, your company and your employees are currently paying hundreds of thousands, maybe millions, of dollars too much and doing so within a business model that deeply exacerbates inequities. There are people out there who are very strategically taking wild advantage of a situation where CEOs/CFOs fear anything to do with healthcare in the title and don’t do their normal level of due diligence. You think it’s an accident that this whole space got so “complicated”? HR needs your help. Bottom line, if you are a CEO or CFO and you do not know everything that Mark Cuban and Ferrin Williams talk about on the pod today … wow, are you getting shellacked. Mark Cuban uses a different word. Healthcare benefits are, after all, for most companies the second biggest line-item expense after payroll. But don’t despair here, because all of this information is really and truly actionable. Others out there are cutting zeros off of their spend and actually doing it in ways that are a total win for employees as well. My guest today, Mark Cuban, is a CEO, after all; and when he looked into it, it took him T-minus ten minutes to figure out just the order of magnitude that his “trusted” benefits consultants and PBM and ASOs (administrative services only) and others were extracting from his business. He pushed back. So can you. But just another reason to dig into that financial layer wrapping around your employee health benefits right now, you might get sued by your employees. Below is an ad currently being circulated on LinkedIn by class action attorneys recruiting employee plan members to sue their employers for ERISA (Employee Retirement Income Security Act of 1974) violations. It’s the same attorneys, by the way, from those 401(k) class action lawsuits. I’ve talked to a few CEOs and CFOs who are scrambling to get ahead of that. You might want to consider doing so as well.
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    56 分
  • Encore! EP415: Some Jumbo Employers Buying Better Healthcare Outcomes While Saving 15% on Total Cost of Care, With Rob Andrews

    Encore! EP415: Some Jumbo Employers Buying Better Healthcare Outcomes While Saving 15% on Total Cost of Care, With Rob Andrews
    2024/11/14
    This encore is very relevant after the shows with Cora Opsahl (EP452), Claire Brockbank (EP453), and Marilyn Bartlett (EP450). Getting better health for the 160 million Americans covered by commercial insurance is all about rates, rights, and power. 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. So, for sure, go back and listen to those shows if you haven’t already. They are very revealing. And if you listened to this particular episode, 415, last year when it first came out, you might want to listen to it again because in the context of those earlier shows, there’s points of contemplation that might become clear. By the way, also, the show with Ann Kempski (EP444) is relevant to this end (ie, sometimes government intervention doesn’t achieve the stated goal). This is a very nuanced world that we live in, and those nuances impact Americans both clinically and also very much financially. I’m saying this partially because maternal and newborn outcomes and costs are part of this conversation. Now, in this conversation, maternity care and outcomes gets brought up mainly because a lot of employers, for a lot of them, maternity constitutes one of the highest areas of spend for both the employer and then also employees. It costs a lot to have a baby in this country. Strategy 101 does, in fact, suggest that if you look at your data and you discover outsized problems and costs in any one area, fixing those problems and costs is going to have an outsized impact on employee health and plan spend. And this is even more of a strategic consideration just given everything going on with maternal health and rising infant and mom death rates in this country. So, with that, here’s Rob Andrews, who is the CEO of the HTA, the Health Transformation Alliance, which is a group made up of jumbo employers. I had wanted to get Rob on the show ever since I heard him say at the thINc360 conference in DC. He said, “Morally abhorrent doesn’t move the needle. What moves the needle is financial implications.” This interview was my chance to ask Rob Andrews, what are these financial implications of which you speak that move needles? What kinds of financial implications are we talking about? And when that needle moves, what happens? In the show that follows, Rob says that when you improve the health of employees and dependents and actually just the health of the community, you as an employer improve your financials directly and also indirectly. But let me focus on the direct bucks out of pocket right now because … yeah, study after study shows that, for self-insured employers, if you pay for the right things and you steer to the right providers in the right care settings, a self-insured employer and the member do a whole lot better than if the employer kind of laissez-faire pays for any manner of things provided by anybody who can manage to submit a billing code—even if that billing code comes with a too-good-to-be-true discount. Rob talks about how the HTA has data to suggest that if you, as a self-insured employer, lean in on paying for the right things, readmissions go down 29%. Total cost of care is 15% lower. Drugs cost 25% less. So, none of this is theoretical, as we talk about how employers can create a win-win—better health, lower costs. There are jumbo employers in the HTA right now who are doing this. I love how Will Shrank, MD, has put it; and I’m paraphrasing, but it’s a point that keeps getting reiterated in episode after episode here on Relentless Health Value: There’s a difference between paying for what you want and just negotiating allegedly cheaper prices. Buying things is not a strategy. And that is true no matter what price you think you’re paying. Also not a strategy is buying things and then cost shifting to plan members, by the way. Strategy means addressing root causes. It’s a considered plan of action to achieve an optimized ambition. Here is the strategic stepwise that Rob offers on this: 1. Discern the difference between rumor and data. Get your data and get it objectively analyzed by an objective third party, self-insured employers. Then you have what you need to figure out the delta between the worst performers and the best performers on a risk-adjusted basis. 2. Now that you know what normal is and what good looks like, gang up and negotiate contracts that hold intermediaries accountable for outcomes and with performance guarantees. Address root causes and the excess and wasteful spend, in other words. Listen to the show with Dr. Will Shrank (EP413) for more on wasteful spend. 3. Be transparent with consumers/employers about relative quality. Educate them. You may also want to reward members who go to see those high-quality docs and/or make it expensive for them to go to the worst performers. There are lots of win-win case studies here on how well this ...
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    40 分
  • 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
    2024/11/07

    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.
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    40 分

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