Podcast appearances and mentions of Brian Reid

In this episode, we interview Brian Reid, the founder of Reid Strategic and the creator and editor of our favorite industry newsletter, the Cost Curve. Brian shares his journey to create the Cost Curve and how he navigates the onslaught of information to identify the most important issues of the day. We also get his take on what he calls the highest “importance-to-attention” healthcare stories, highlighting critical topics that are undercovered related to their significance. We also get the opportunity to understand his perspectives on the threats to innovation, the risks to patient affordability programs, and what all of us should be doing to be better healthcare consumers. Brian Reid- Reid Strategic Cost Curve Newsletter Martin Shkreli & Daraprim BioPharma Dive: Biotech and Pharma Industry News GLP-1s Net Price– “a drug’s net price equals the actual revenues that a manufacturer earns from a drug after rebates, discounts, and other reductions” Source: Drug Channels Armamentarium Pharmacy Benefit Managers (PBMs) Mark Cuban Pharmacy Psuedo-Generic Medication CVS Cordavis Quallent Nuvalia Biosimilars Lilly Direct Novo 340B Drug Pricing Program Copay maximizers AFPs Questions or comments?Email us at comments@prescriptionforbetteraccess.com.Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

Pippa speaks to Brian Reid from Night Sky Zombies about their first album and their new song Killer Whale.See omnystudio.com/listener for privacy information.

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 ===

If you have zero clue what co-pay maximizers and/or co-pay accumulators are and the financial incentives involved for PBMs (pharmacy benefit managers) and plan sponsors here, after you're done listening to this episode, go back and listen to the show with Joey Dizenhouse (EP423). Also, the episode called “Game Theory Gone Wild” with Dea Belazi, PharmD, MPH (EP293). Both these shows could fill in some blanks. 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. Here's the micro mini of the co-pay maximizer/accumulator deal. These are vehicles that are designed by vendors who are also sometimes called maximizers or sometimes they're also PBMs. But these programs are designed to get as much money out of Pharma as possible in the form of co-pay support. So, here's how the maximizers are supposed to maximize plan sponsors getting pharma money. Say, for some drug, the pharma company has, I don't know, $12,000 max in co-pay support available to patients in total per year. Pharma does always cap the dollars that are available for patients. So, in this hypothetical, $12k a year is available. What a forthright or well-run maximizer will do is figure out, you know, if there's $12k max available, then they'll set a co-pay—so there's variable co-pays for patients—so they'll set a patient co-pay of, like, $1000 a month, which adds up to $12k over 12 months of the year. Get it? Every single month, the patient has a $0 co-pay, but the plan maximizes the dollars that the plan gets. Or, you know, maybe they'll charge $1,025 a month so the patient has some small “skin in the game,” and the plan sponsor just banked $12k. Sounds great, right? Well, sure, when it works as promised … and we'll get to this in a moment. Accumulators, on the other hand, have no such “Hey, let's make sure the patient actually gets their meds” guardrails. They hear that the Pharma is offering $12k, and the accumulator vendor and their plan sponsor clients also are like, “Cool, let's get that money as fast as possible.” So, they make the co-pay for that drug, I don't know, like hypothetically $3000. Great, now the patient runs out of that co-pay money in May. And don't forget and/or let me inform you, for both maximizers and accumulators, dollars paid by the Pharma generally don't count to the plan deductible for the patient. So now, the patient walks into the pharmacy, if in an accumulator or in a poorly run maximizer program, they walk into the pharmacy in May and are told that if they want their drug, they're gonna need to pay the $3000 co-pay that was set out of pocket every month until they reach their deductible. With some of these co-pay maximizer/accumulator plans, the plan sponsor may be a little bit out of the loop relative to what is actually going on here. The plan sponsor may think that members are doing fine—you know, they're getting their drug every month—so they may be surprised to learn about this running out of money in May issue. And what is true more often than it's not true, this $3000 or whatever—hundreds or thousands of dollars—payment due co-pay, the patient learns about it at the pharmacy counter or while trying to get chemo. It comes as a complete surprise, the fact that they owe three grand or whatever. What patient just shrugs and pays up in that moment because they happen to have their entire deductible or thousands of dollars lying around and at the ready? What a shock to find this out at the pharmacy counter or at the infusion clinic. Some of these maximizer programs are also starting to veer back into accumulator zones, like they're doing things such as saying that the member must pay their out-of-pocket max or their deductible or 30% of the cost of the drug, right, like some number before the plan will allow the patient to use the co-pay reimbursement program to begin with. So, there's other things that are emerging right now, which, again, cause the patient to have a very, very large out of pocket in order for them to get a drug which they have been prescribed and—ostensibly, at least—need. Allegedly, and sometimes for sure, dollars raked in from Pharma make it across the PBM/maximizer, vendor, middleman trench all the way over to the plan sponsor. For sure, especially for the administrative only maximizer vendors … yeah, you're gonna have the dollars actually making it to the plan sponsor. But sometimes the vendor running these programs is paid spread, right? So, the more expensive the drug and the richer the co-pay card program, the more the vendor will make because they take a percentage of savings. So, the more expensive, the more savings, therefore, the more the vendor is gonna make. In these cases where the vendor is paid a spread, can I take Perverse Incentives for $600, Alex? Right? But in sum, again, there's a lot to this conversation with Bill Sarraille, so please do listen to the whole thing. Bill offers five main pieces of advice, so I'm just gonna cover them right here up front—spoiler alert, I guess, but just to keep them all in one place. 1. Look into what is going on with a maximizer and/or accumulator program. First of all, is the plan sponsor paying spread? And also, how are these programs being marketed to members and how aggressively? Because there are a lot of plan sponsors having way more negative impact than they suspect they are. So, that's point of advice #1: Really look into actually what is happening on the grounds with some of these programs. 2. Eliminate surprise. Any plan sponsor listening, and Brian Reid also says this very crisply in an episode a month or so ago (EP456). If a plan sponsor wants to do stuff like this—like force a patient to pay hundreds or thousands of dollars out of pocket—if at any point during the year they are gonna wind up with thousands of dollars in co-pay or coinsurance to get their Crohn's disease med or cancer med or whatever, be really up front about this at least. It's really important if we really want to make sure that patients are taking maintenance meds and getting the medications that they're prepared for the reality that, at a certain point during the year, they are going to have a really big bill. 3. There is legal risk here. So also, Bill's advice is check into whether accumulators and/or maximizers are unlawful under the ACA (Affordable Care Act) and/or by deceptive practices rules when maximizers or accumulators are teed up as a benefit. And it, again (reference point of advice #2), it's not explained that dollars they get from Pharma will be taken by the plan and not applied to the patient deductible. I was just reading about the crazy aggressive marketing tactics that some of these vendors are using to get members to sign up and … yeah, definitely look into deceptive practice rules. 4. If it's utilization management that we're trying to achieve here, then your utilization manager should be utilization managing. These maximizers are not meant to impact utilization management. Patients really cannot differentiate, as per study after study, it's very difficult for patients to differentiate high-value from low-value care or meds. So, pretty much the impact of having a patient with thousands or hundreds of dollars of out-of-pocket spend to get a med isn't going to be to ensure that the right people are taking the right med. Point is, use the right tool for the right job. So, if we're trying to keep patients away from low-value meds, the tool for that is utilization management. Also be aware, if the PBM says it cannot do utilization management or you'll lose your rebates and/or is pushing into a maximizer accumulator program to do this instead, that's kind of a clue that they cannot do it because they are taking money from Pharma to not have any restrictions on a drug. Read the article in the New York Times (you're welcome) about how PBMs took secret payments for the free flow of opioids, and Chris Crawford also talks about this sort of same-ish thing in an upcoming show relative to GLP-1s. But if you're trying to do utilization management, then do utilization management. 5. Use our understanding of this whole goings-on as a rationale or a way to tamp down perverse incentives. We want to wind up with patients getting charged a percentage of net prices, not a percentage of some wildly inflated list price with this whole accumulator maximizer contributing to, you know, just more wildly inflated list prices so the co-pay programs can be bigger and someone can make even more money off of the percentage of savings. And plan sponsors addicted to rebates now have another bucket of cash. Like, this is just another example of how perverse incentives pervade the system. And we should certainly be aware of that. Bill Sarraille was a healthcare attorney for many years. He retired from his law firm on the first of last year, and now he's doing the things he wanted to do before but couldn't because his billable rate was too high. Bill is teaching at the University of Maryland Law School and doing some regulatory consulting, etc. He's working with a variety of patient groups. Also mentioned in this episode are University of Maryland Francis King Carey School of Law; Joey Dizenhouse; Dea Belazi, PharmD, MPH; Brian Reid; Chris Crawford; Marilyn Bartlett; Scott Haas; Paul Holmes; and Tom Nash. You can learn more at University of Maryland Francis King Carey School of Law and by following Bill on LinkedIn. You can also sign up for his Substack.   Bill Sarraille is a professor of practice at the University of Maryland Francis King Carey School of Law, a regulatory consultant, and a retired senior member of the Healthcare Practice group at Sidley Austin LLP. Bill is a nationally recognized expert in healthcare, life sciences, drugs, medical devices, and patient access to treatments. He is widely known for his expertise in a broad array of healthcare matters, including rare disease treatment access barriers, pharmaceutical pricing, Anti-Kickback Law compliance, the 340B program, and managed care and PBM issues. During his years practicing law, Bill was recognized repeatedly by The Best Lawyers in America in both healthcare law and administrative law. He was also consistently listed as a leader in the field of healthcare law in Chambers USA: America's Leading Lawyers for Business. Bill also serves as the general counsel of the charity the Pharmaceutical Coalition for Patient Access, as an advisor to multiple patient advocacy groups on patient access issues, a compliance advisor to a coinsurance patient assistance foundation, and as the director of a rare disease society and Kalderos, Inc., a health IT firm with a focus on effectuating pharmaceutical discounts and rebates.   09:31 What should plan sponsors be aware of right now? 14:01 What is the justification for maximizers, and why is this at odds with the purpose of insurance? 18:05 Where does the issue of “fairness” land within cost containment? 20:00 Brian Reid's LinkedIn post on insurance company access challenges. 21:30 What are the real legal issues presented by some of these co-pay maximizers and co-pay accumulator programs? 27:06 How are these programs creating perverse incentives? 29:28 EP450 with Marilyn Bartlett, CPA, CGMA, CMA, CFM. 32:16 “If you're covered by the ACA, I think this is unlawful.” 32:57 What advice does Bill have in regard to these programs? 33:49 What potential litigations does Bill see coming in the near future in regard to these co-pay maximizers and co-pay accumulator programs? 38:38 EP365 with Scott Haas. 38:45 EP397 with Paul Holmes.   You can learn more at University of Maryland Francis King Carey School of Law and by following Bill on LinkedIn. You can also sign up for his Substack.   @HCLAWComment discusses #costcontainment on our #healthcarepodcast. #healthcare #podcast #pharma #healthcareleadership #healthcaretransformation #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Stacey Richter (INBW41), Andreas Mang (Encore! EP419), Dr Komal Bajaj, Cynthia Fisher, Stacey Richter (INBW40), Mark Cuban and Ferrin Williams (Encore! EP418), Rob Andrews (Encore! EP415), Brian Reid, Dr Beau Raymond, Brendan Keeler  

Are you on the board of directors of a company? Or are you a shareholder of a publicly traded company? Or are you a CEO or a CFO or in-house counsel who reports to a board of directors or these shareholders? Well, this show is for you. And it's about how the healthcare industry has become financialized at the same time that providing health benefits has become the second-biggest line item after payroll for most companies. We talked about that in a recent encore with Mark Cuban (EP418) also, as well as the show with Cora Opsahl (EP452) and Claire Brockbank (EP453) from 32BJ. 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, this encore with Andreas Mang is really timely. And even if you've listened to the show when it originally aired a year ago, you may want to take another listen, because in the context of these recent shows, this one really slots right in there. And also, by the way, the one with Julie Selesnick (EP428) from last year talking about the legal jeopardy currently in play. So, this show isn't really about health benefits; it's about the business that these health benefits have become and how, if the CEO or CFO of an employer is not intimately involved in the financial layer wrapping around health benefits, then the company is getting really taken advantage of by those entities who are intimately familiar with the financial layer surrounding those healthcare benefits. And the employees of that company also are getting equally taken advantage of. This is not a case where paying more or less results in better or worse employee health or healthcare. It is a case where not minding the shop in the C-suite means that financial actors just take more of the pie and nobody wins but them. Employer loses; employee loses. Andreas Mang, my guest today, kicks off this interview talking about the conversation that will go down between himself and any CEO whose company gets bought by Blackstone. So, if you're a CEO and you're aspiring for this to happen, yeah … heads up. But he says it's kind of an unnatural act to dig into anything that smells like health benefits or health insurance. Some may not even realize that this whole financial layer has developed that sits above the healthcare benefits themselves. And they also may not think that there's anything that's possible that can be done. As far as both of these points are concerned, Andreas Mang gives a list of, as he calls them, easy things a C-suite can do to save 10% while improving employee satisfaction and health. Saving 10% or more, this can be a really big number. A lot of this is just enforcing purchasing discipline that is being used elsewhere. Here's Andreas's list recapped: 1. Have CFO engagement throughout the year. (We talked about that with Mark Cuban also.) 2. Be self-insured once you have reached a certain size. (Andreas gets into this in more detail during the show itself.) 3. Be very, very careful who you hire as your broker or benefits consultant. There are five things that need to be true: ·      They have the experience to do the job. ·      Flat-fee model compensation ·      No product pushing ·      Fees at risk (30% or more) ·      Simple termination provisions 4. Do carrier/ASO/TPA RFPs once every three years or thereabouts. 5. Do dependent eligibility audits. (Cora Opsahl talked a lot about this also in an earlier episode [EP372].) 6. Leverage pharmacy coalitions and stop-loss collectives. (In the show itself, Andreas offers some warnings because some of these coalitions and collectives are great and some are not.) But bottom line, just keep in mind, as Mark Cuban said (EP418), those that are taking your money, your company's money, are advantaged when you are confused. Where there's mystery, there's margin. If you can't convince 'em, confuse 'em and all that. This is a business strategy. Healthcare should not be this complicated. But yet, it has become so; and anyone who doesn't realize that is letting themselves and their employees really get taken advantage of. Unknown unknowns are not benign. As I have said several times already, Andreas Mang is my guest today. He is a partner at Blackstone, the private equity and alternative asset manager. His job is helping portfolio companies manage their U.S. healthcare benefits for their employees. Also mentioned in this episode are Blackstone, Mark Cuban, Cora Opsahl, Claire Brockbank, Julie Selesnick, Lauren Vela, and Tom Nash.   You can learn more at Blackstone and by connecting with Andreas on LinkedIn.   Andreas Mang is senior managing director, portfolio operations, and chief executive officer of Equity Healthcare, where he is involved in managing medical benefits spend across the Blackstone portfolio. Andreas brings 20 years of healthcare experience to Equity Healthcare, having held various roles in healthcare finance, operations, and strategy. Prior to joining Blackstone, Andreas was the vice president responsible for national provider network operations at CareCentrix, a PE-backed, leading home health benefit-management company. At Blue Cross Blue Shield of Massachusetts, he held a variety of roles, including a leadership role identifying and implementing administrative cost savings opportunities throughout the organization and ultimately designing a new corporate business model. In addition, he held roles as the manager of strategic financial planning at Harvard Pilgrim Health Care and was a senior consultant with Deloitte Consulting's Strategy and Operations group in Boston. Andreas has a bachelor's degree in healthcare management and policy from the University of New Hampshire and an MBA from the University of Rochester's Simon School of Business Administration. He currently serves on the board of DECA Dental.   04:55 Why Andreas starts every conversation with the question, “How's your healthcare company?” 07:38 Why is it important, as a self-insured employer, to treat your business as a small healthcare company? 09:16 Why is it unnatural for companies to be providing health insurance? 10:47 What can be achieved when there is alignment between employers and insurers? 12:41 What things can a company do to reduce spend by 10%? 14:14 Why is it better to have CFO engagement in the benefits plan throughout the year? 16:25 Why does self-insurance save 5% to 9% for companies automatically? 18:14 “The funding isn't a healthcare thing; it's a CFO thing.” 18:27 Why is it vital to have a reliable, trustworthy broker? 25:12 When is the last time your company has RFP'd their health plan? 27:39 Why does changing a health plan feel scary but is necessary? 28:31 What is a dependent eligibility audit? 31:20 Why are employers better together? 34:34 How do employers truly get a flat-fee model with brokers?   You can learn more at Blackstone and by connecting with Andreas on LinkedIn.   Andreas Mang of @blackstone discusses the financialization of #healthcarebenefits in our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Dr Komal Bajaj, Cynthia Fisher, Stacey Richter (INBW40), Mark Cuban and Ferrin Williams (Encore! EP418), Rob Andrews (Encore! EP415), Brian Reid, Dr Beau Raymond, Brendan Keeler, Claire Brockbank, Cora Opsahl

I'm putting a meme in the show notes. It's my second meme ever, so I'm clearly on a roll. As you can see, it's a picture of two kids taking a test; and the one kid is cheating off the other kid. It's a How to Do Spread Pricing test, and the kid with carrier has his eyes all over the PBM kid's test. 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. Look, this is a thing now, medical spread. And similar to how PBM spreads adds up to millions, billions of dollars, medical spread is not change in the couch cushions. Did you see the lawsuit against Cigna? Cynthia Fisher mentions it in the conversation that follows. Spoiler alert, here's the numbers: Self-insured employer paid $4 million for a claim. In this case, there's a slide on this Cynthia Fisher gave me, by the way, if you want to see all this written out. So, the employer pays $4 million. The provider was paid—drumroll, please—$876,000. I'm pausing so that sinks in: $4 million paid by the employer; $876,000 of that makes it across the trench to the provider. What happened, you may be wondering, to the $3.2 million in the middle there that the self-insured employer wrote a check to their carrier for? If I'm the employer, I think I would sort of want to know where the $3.2 million went, because … yeah. I think anyone would be hard-pressed to explain how a prudent fiduciary is managing to pay millions of dollars of its plan members' money for services that actually cost a fraction of that. And this is just one claim. But you came here for a show about transparency. Why, you may be wondering, am I talking about medical spread pricing? It's not a super far leap, so many of you are probably there already; but let me quote Chris Deacon. She wrote, “As these conglomerates expand control over healthcare delivery and administration, radical transparency is our only bulwark. Patients and employers deserve to know exactly what they're paying for, without hidden fees disguised as care costs.” I don't think anyone would say that transparency alone is sufficient to transform healthcare, but it's definitely a start for sure. So, yeah … transparency. The reason why lawsuits about overpayments, big ones—and there's a bunch of them afoot right now, not just that Cigna one—but the reason that these are going down in the first place is because hospital prices and carrier prices are now somewhat available. And we have some plan sponsors—the ones who are worried about fiduciary duty, at least—these plan sponsors are able to cobble together the math to catch a glimpse of how much money is vanishing. Dollars they and their members are paying for medical claims that never make it to the care team providing the care. And who is shocked? Are you shocked? I'm not shocked. Let me read a sentence from a carrier contract that Justin Leader sent me the other day. Section 6.3: “Claim administrator's compensation for its services under the agreement shall include the difference between the net claim payments reimbursed to the claim administrator by the employer and the net amounts paid to providers by the claim administrator.” Translation: We are allowed to add spread pricing. We are able to arbitrage. We are able to mark up (or whatever you want to call it) by any amount we want, and you, plan sponsor, just signed up to pay for it. So, that happened. Listen to episode 433 with Justin Leader, by the way. The show is called “The Mystery of the Weekly Claims Wire,” otherwise known as the Not Transparent Weekly Claims Wire. So, look … transparency: We can talk about it in terms of medical prices. We can talk about transparency in terms of contracts. And actually also in terms of quality, but we don't get into that today. Bottom line, plan sponsors need enough access to billing data and hospital prices to calculate how much the middle folks are taking in spread, which is, as aforementioned, quite a thing. For more actual data on the magnitude of spread pricing goings-on, ask Dan Ross. That's my suggestion. He's got spreadsheets he can show you of how much plan sponsors are paying and how much providers are charging and how much is going missing in the middle. For even more on this, read the recent Owens & Minor lawsuit that just got filed, which is just a case study in how hard some of these middlemen/carrier entities are working to obscure and hide what they are doing. Because, yeah, sunshine is a great disinfectant, and that's what transparency is. Sunshine. Here's another interesting link from Chris Deacon. I say all this to say, this is the kind of transparency that Cynthia Fisher and I talk about in the show today: contract transparency, bill charges transparency, and hospital or medical price transparency for plan sponsors. We do not get into today consumers or patients using price information to shop, just FYI. We also do not get into, really, price convergence, which is what happens when hospital and carrier prices become available in a market and is often brought up on or about conversations about transparency. Okay, I will say just one thing about price convergence. There was some chatter in anti-transparency press releases from parties mostly that didn't want to be transparent at all, no way no how. But there was some talk a couple of years ago that if contracted prices became transparent, the healthcare industry would raise their prices to match the highest in the market and the result would be rising healthcare prices and greater total costs. That turns out, it seems, to be false. There's a study that shows that the bottom of the market (those with the cheapest prices) do, in fact, raise their prices but not as much as the top of the market lowers theirs. So, there is actually net savings. Read about the Turquoise Health study and an article that Forrest Xiao and team posted that shows this, and it's the first study of its kind, at least that I have seen. Okay, so contract transparency, data transparency, that's what's on deck to discuss today with Cynthia Fisher, as I have mentioned several times already, who has a long history as an entrepreneur in the healthcare space. So, Cynthia Fisher gets U.S. healthcare, and she gets being a plan sponsor and a fiduciary. She is founder and chairman of PatientRightsAdvocate.org, as well as Power to the Patients. Her focus is on ensuring that all healthcare shows prices up front so that we can have accountability and integrity in billing and at any point of care. Cynthia has said early and often that transparency protects the ultimate purchasers of healthcare—meaning plan sponsors, plan members, and patients—from overcharges, spread pricing, or otherwise. Where there's mystery, there is margin, as Anthony Ciaccia has said often. Cynthia's call to action is as follows, but listen to the show to hear her say it more eloquently. C-suites, CFOs, in-house counsel use purchasing discipline that your company probably uses elsewhere in the procurement of health benefits.  Cynthia Fisher also says as part of the call to action, refuse to sign blank checks to the healthcare industry and refuse anti-audit provisions. She also has a call to action for the accounting industry to stop ignoring auditing the health plans. And this matters just given the bald-faced fact right now that overcharges are party sized. Let me wrap up with this: There's a lot of brute force tactics out there being deployed by some plan sponsors that effectively keep plan members from getting the care they need because they are functionally uninsured. I've done multiple shows on this, and I link to some of them below. I just can't help to think, some of this brute force, you know, high-deductible health plans and some pretty savage cost containment strategies, might be unnecessary if middleman excess profits were eliminated. Well, I say this with some evidence, actually. Andreas Mang (EP419) was on the pod. He talked about saving 15% or more by being smart about contracts and plan assets at the financial and purchasing level. Brian Uhlig … was talking to him the other day. He was telling me he saved $80 million just doing contracts right. Also Claire Brockbank (EP453) talks about this; Cora Opsahl (EP452), too, from 32BJ. Those are two recent shows, again, about how much money can be saved by only signing contracts that ensure transparency. Also mentioned in this episode are Patient Rights Advocate, Chris Deacon, Justin Leader, Dan Ross, Forrest Xiao, Anthony Ciaccia, Andreas Mang, Brian Uhlig, Claire Brockbank, Cora Opsahl, Mark Cuban, and Mark Cuban Cost Plus Drug Company.   You can learn more at PatientRightsAdvocate.org.    Cynthia A. Fisher is founder and chairman of PatientRightsAdvocate.org, a nonprofit organization seeking healthcare price transparency, giving power to American consumers—patients, employers, and unions—to lower their costs of care and coverage through a functional marketplace and choice. Cynthia is best known for her pioneering work as founder and CEO of ViaCord, Inc., a leading price-transparent umbilical cord blood stem cell banking company which she started in 1993. In 2000, she co-founded and was president of the cellular medicines company ViaCell, Inc., of which ViaCord became a division. ViaCell went public in 2005, was acquired by PerkinElmer, and exists today under the ViaCord brand. Cynthia also serves on the public company boards of the Boston Beer Company, Inc. and Easterly Government Properties, Inc. She serves on the Florida Council of 100 and the board of the National Park Foundation, and she previously served on the board of directors of Water.org. Cynthia holds an MBA from Harvard Business School and a bachelor's and honorary Doctorate of Science degree from Ursinus College.   09:03 What is the goal of PatientRightsAdvocate.org? 10:28 Is American competitiveness being affected by healthcare spend? 13:47 Why is transparency a root cause to healthcare costs? 15:11 What's going on across the country to empower transparency in healthcare? 19:31 “I think people are fed up.” 21:22 The Cigna lawsuit in California. 26:36 How do employers navigate contracts against anti-steering? 28:54 EP419 with Andreas Mang. 29:33 EP452 with Cora Opsahl and EP453 with Claire Brockbank. 29:45 EP433 with Justin Leader.   You can learn more at PatientRightsAdvocate.org.   Cynthia A. Fisher of @PtRightsAdvoc discusses #medicalspreadpricing and #contracttransparency on our #healthcarepodcast. #healthcare #podcast #pharma #healthcareleadership #healthcaretransformation #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Stacey Richter (INBW40), Mark Cuban and Ferrin Williams (Encore! EP418), Rob Andrews (Encore! EP415), Brian Reid, Dr Beau Raymond, Brendan Keeler, Claire Brockbank, Cora Opsahl, Dan Nardi, Dr Spencer Dorn (EP451)  

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. Now, for my HR professional listeners, considering that some of what Mark Cuban says in the pod that follows is indeed a little spicy, let me just recognize that the struggle is real. There are multiple competing priorities out there in the real world, for sure. And bottom line, because of those multiple competing priorities out there in the real world, it's really vital that everybody work together up and down the organization in alignment. Lauren Vela talks a lot about these realities here in episode 406. This is a longer show than normal, but it's also like a show and a half. Mark Cuban talks not only about his work with Mark Cuban Cost Plus Drugs, which is a company that buys drugs direct from manufacturers and sells them for cost plus 15%, a dispensing fee, and shipping. It's kind of crazy how so often that price is cheaper, sometimes considerably cheaper, than the price that plan members would have paid using their insurance—and the price that the plan is currently paying the PBM. Most Relentless Health Value Tribe members (ie, regular listeners of this show) will already know that, but what is also fascinating that Mark talks about is what he's doing with his own businesses and the Mavericks on other fronts, like dealing with hospital prices. In this show, we also talk the language of indie pharmacies, fee-only benefits consultants, TPAs (third-party administrators), PBMs, and providers doing direct contracting. There are, in fact, entities out there trying to do the right thing; and Mark acknowledges that. Ferrin Williams, PharmD, MBA, who is also my guest today, is chief pharmacy officer at Scripta and an expert in pharmacy benefits. She adds some great points and some context to this conversation. Scripta is partnering with Mark Cuban Cost Plus Drugs. Scripta has a neat Med Mapper tool and also services to help employees find the lowest costs for their prescriptions. If you are a self-insured employer, for sure, check out Scripta. Here are links to other shows that you should listen to now if you are inspired to take action. I would recommend the shows with Paul Holmes (EP397); Dan Mendelson (EP385); Andreas Mang (EP419); Rob Andrews (EP415); Cora Opsahl (EP372); Lauren Vela (EP406); Peter Hayes (EP346); Gloria Sachdev, PharmD, and Chris Skisak, PhD (EP390); and Mike Thompson (EP389). Also Mark Cuban mentions in this show the beverage distributor L&F Distributors. Thanks to Ge Bai, Andreas Mang, Lauren Vela, Andrew Gordon, Andrew Williams, Cora Opsahl, Kevin Lyons, Pat Counihan, David Dierk, Connor Dierk, John Herrick, Helen Pfister, Kristin Begley, AJ Loiacono, and Joey Dizenhouse for your help preparing for this interview. Also mentioned in this episode are Mark Cuban Cost Plus Drug Company; Scripta Insights; Julie Selesnick; Brian Reid; Paul Holmes; Dan Mendelson; Rob Andrews; Peter Hayes; Gloria Sachdev, PharmD; Chris Skisak, PhD; Mike Thompson; and Scott Conard, MD. You can learn more at Mark Cuban Cost Plus Drug Company and Scripta Insights. You can also connect with Scripta and Ferrin on LinkedIn.   Mark Cuban has been a natural businessman since the age of 12. Selling garbage bags door to door, the seed was planted early on for what would eventually become long-term success. After graduating from Indiana University—where he briefly owned the most popular bar in town—Mark moved to Dallas. After a dispute with an employer who wanted him to clean instead of closing an important sale, Mark created MicroSolutions, a computer consulting service. He went on to later sell MicroSolutions in 1990 to CompuServe. In 1995, Mark and longtime friend Todd Wagner came up with an internet-based solution to not being able to listen to Hoosiers basketball games out in Texas. That solution was Broadcast.com—streaming audio over the internet. In just four short years, Broadcast.com (then Audionet) would be sold to Yahoo! Since his acquisition of the Dallas Mavericks in 2000, Mark has overseen the Mavs competing in the NBA Finals for the first time in franchise history in 2006—and becoming NBA World Champions in 2011. Mark first appeared as a “Shark” on the ABC show Shark Tank in 2011, becoming the first ever to live Tweet a TV show. He has been a star on the hit show ever since and is an investor in an ever-growing portfolio of small businesses. Mark is the best-selling author of How to Win at the Sport of Business. He holds multiple patents, including a virtual reality solution for vestibular-induced dizziness and a method for counting objects on the ground from a drone. He is the executive producer of movies that have been nominated for seven Academy Awards: Good Night and Good Luck and Enron: The Smartest Guys in the Room. Mark established Sharesleuth, a research and investigation Web site to uncover fraud in financial markets, and endowed the Electronic Frontier Foundation's Mark Cuban Chair to Eliminate Stupid Patents, an effort to fight patent trolls. Mark gives back to the communities that promoted his success through the Mark Cuban Foundation. The Foundation's AI Bootcamps Initiative hosts free Introduction to AI Bootcamps for low-income high schoolers, starting in Dallas. Mark also saved and annually funds the Dallas Saint Patrick's Day Parade, the largest parade in Dallas and a city institution. In January 2022, he started Mark Cuban Cost Plus Drug Company as an effort to disrupt the drug industry and to help end ridiculous drug prices because every American should have access to safe, affordable medicines. Ferrin Williams, PharmD, MBA, is chief pharmacy officer of Scripta. With 15+ years' experience in the pharmacy industry, Ferrin brings a unique perspective to Scripta that spans the retail pharmacy, pharmacy benefit manager (PBM), and broker/consulting sectors. Her expertise ranges from pharmacy operations and services to innovative clinical programs, pharmacy audit, alternative payer funding, and specialty drugs. As chief pharmacy officer, Ferrin leads the company's clinical strategies organization responsible for devising innovative cost-containment strategies for prescription drugs, ensuring Scripta clients, members, and their providers are provided with best-in-class clinical insights and tools. Ferrin earned her bachelor's, Doctor of Pharmacy, and MBA degrees from the University of Oklahoma.   06:29 What was Mark Cuban's own journey as a self-insured employer with Cost Plus Drug Company? 07:44 What did Mark find when he decided to go through and look through his company's benefit program? 09:12 “When you think it through, you start to realize that money is being spent primarily by your sickest employees.” —Mark 10:02 How do you get CEOs and CFOs of self-insured employers to realize that their sickest employees are the ones subsidizing their checks? 13:00 What is the role of insurance in healthcare? 14:30 “If you can't convince them, confuse them and hide it.” —Mark 15:24 The reality behind getting a rebate check. 16:21 Why are rebates going away, and why isn't that changing PBM earnings? 19:05 How do you get CEOs and CFOs to dig into their benefits plan? 20:59 Does morally abhorrent move the needle? 21:33 “What we're trying to do is just simplify the [healthcare] industry.” —Mark 24:19 What's been changing in consumer behavior? 25:04 “Transparency is a huge part of building that trust.” —Ferrin 25:19 Why CEOs and CFOs really have the power to change healthcare. 32:29 What are Cost Plus Drugs' plans to expand? 39:21 Where is the future of the prescription drug market going? 42:09 What will happen to the prescription drug market in 10 to 20 years? 48:40 The wake-up call self-insured employers should be acknowledging now. 52:02 Where is the real change in the healthcare industry going to come from?   You can learn more at Mark Cuban Cost Plus Drug Company and Scripta Insights. You can also connect with Scripta and Ferrin on LinkedIn.   @mcuban and Ferrin Williams provide advice for #CEOs and #CFOs of #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #valuebasedcare #healthcareoutcomes   Recent past interviews: Click a guest's name for their latest RHV episode! Rob Andrews (Encore! EP415), Brian Reid, Dr Beau Raymond, Brendan Keeler, Claire Brockbank, Cora Opsahl, Dan Nardi, Dr Spencer Dorn (EP451), Marilyn Bartlett, Dr Marty Makary  

This show is going to be a little bit different because what we're going to do today is offer some advice to those who may work at a pharma company. But before we get into this advice portion of the discussion, let's start here. 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. Probably we're gonna have people listening to this episode who maybe are not in our normal tribe of Relentless Health Value listeners. While there are, for sure, regular listeners who work at pharma companies, there might be some newbies on the scene here. And to you, I say welcome. I hope that you feel right at home here. You know what, though? Many of us, including myself often enough, are slightly uncomfortable. Because this is the place where we all kind of look at ourselves in the mirror. We all live in glass houses, after all—everyone in the healthcare industry. There's no devils and no angels here. And the trick is maximizing the good and minimizing the not so good so that we all wind up with the highest net positive possible for patients. So, around here, we do not shy away from saying what needs to be said so that we all can find a way forward to serve the patient. We cannot solve problems, after all, that we have not taken a cold, hard look at. Yeah. So, today I am speaking with Brian Reid. I have been very much looking forward to speaking with Brian Reid, who many may know from his really great newsletter and really insightful LinkedIn posts. Brian Reid's advice, which he delivers in the episode that follows in sum. Spoiler alert here, but I also will say that he is much more eloquent than me, and the nuances are a thing. So, please do listen to the whole show. But Brian's piece of advice number one for Pharma (and really any product or service frankly), but piece of advice number one is this: Get a really solid bead on what value means—not just to PBMs (pharmacy benefit managers) or contract pharmacies or wholesalers who are middlemen but to the ultimate purchasers, the ones whose wallets the money is actually coming out of to pay the bill. Meaning, plan sponsors, such as self-insured employers or unions, patients themselves or members, and taxpayers. Again, how does value accrue to the ultimate purchasers like plan sponsors, patients/members, or taxpayers? Everybody else in the drug supply chain, let's be clear, is in the middle pushing money around that came out of somebody else's wallet. These middlemen have their own interests that may, for sure, may or may not be aligned with the interests of the ultimate purchasers. Getting value realized by patients will depend on understanding what the value is to these ultimate purchasers and then not getting derailed by any middleman who may not be so aligned. As a sidebar on this number one piece of advice, the whole “what's your value” and influence coloring this value equation made by ultimate purchasers is the prevailing beliefs of these ultimate purchasers, relative to Pharma, how they perceive the pharma industry. Whether it's earned or not—and this is not what we're gonna discuss today—but earned or not, Pharma does not have a great reputation with these folks right now. And this matters. Brian has a lot to say on this topic, which is fascinating. So, you should listen. Number two piece of advice that Brian Reid delivers in the podcast that follows that we talk about: Consider inching into the fray around benefit design. Rightfully so, there's always a lot of talk about patient affordability at pharma companies; but if I was gonna point to one thing that impacts affordability more than anything else, it'd be benefit design. There's only a small, underfunded cadre right now of folks out there (Mark Cuban aside, actually); but there's only a really small number of folks who never have any money who are really helping plan sponsors understand the impact on patients of some of the choices that they are making. I mean, personally, I could think of 10 things to do right off the top of my head that could help plan sponsors not get inadvertently screwed in this realm alone, just thinking they're saving money when, in reality, they are harming patients and not saving money. There's probably a lot of opportunities to communicate these kinds of things that are really win-win collaborations. Number three piece of advice that we talk about in the conversation that follows with Brian Reid: Keep an eye on hospital consolidation and vertical integration in the payer space. Consolidation raises prices and impedes patient affordability. This is as per study after study after study. Consolidation raises prices and sometimes considerably. Here's a part B to this third piece of advice about consolidation. There's sometimes wild swings in prices at different large, consolidated health systems in the exact same geography. Listen to the show with Cora Opsahl (EP452) for more about how their health plan, as just one example, saved $30 million a year just pushing a huge expensive health system, consolidated one, out of their network and navigating patients to more affordable sites of care. This matters to pharma companies because hospital system prices are currently crushing in many areas of the country, really impacting patient affordability. But there are better or worse options from an affordability standpoint in some of these geographies. To state the obvious, if an infusion of the same drug costs 10 times more if a patient shows up in one care setting versus another, that latter place, not affordable for patients. And by the way, that is not hyperbole of any kind. There are plenty of examples where literally an infusion of the same drug, same dosage will cost 10 times more if a patient goes one place versus another. But, again, it's not affordable. The patient cost share might be 10 times higher if it's coinsurance, if the patient goes to that latter place. And that latter 10x more of the cost place also just added 10x the cost to the PAP program or the foundation debit column. All of this is really relevant to Pharma. And just to pile on here because now I'm on a roll, another reason why this matters, these striking price variations between care settings, if we're talking about product value, and if the price the patient or the plan sponsor is paying is 10x the cost of the ingredients, nobody's doing that math and separating out the cost of ingredients from the, you know, total cost of the infusion. It is one lump sum number. So, if we're defining value as outcomes divided by cost and now the cost to the plan sponsor is 10x, product value just got reduced by 10x. Just in case anyone is confused here, and you probably know this, but many forget that the whole ASP (average selling price) plus 6% provider reimbursement—so, if that's what you're thinking and you're wondering how the 10x transpires—that ASP plus 6% provider reimbursement is only for Medicare kinds of plans. Hospitals can and do negotiate much higher reimbursements for commercial plans, and those carriers that have commercial lines of business and also MA (Medicare Advantage) books of business even allegedly actually negotiate higher commercial reimbursements so that they can get lower Medicare Advantage rates. Right, and you can see why, because the MA dollars are coming out of their own capitated pockets, whereas the commercial rates are being paid for by the ultimate purchasers, the plan sponsors. Also mentioned in this episode are Reid Strategic; Mark Cuban; Cora Opsahl; Bruce Rector, MD; Shawn Gremminger; Nina Lathia, RPh, MSc, PhD; Autumn Yongchu; Erik Davis; and Marty Makary, MD, MPH. Additional related episodes: EP380 with Mark Miller, PhD, on pharma communications. EP371 with Erik Davis and Autumn Yongchu on buy and bill versus pharmacy bagging. EP426 with Nina Lathia, RPh, MSc, PhD, on cost containment versus value-based drug purchasing. EP435 with Dan Mendelson from Morgan Health on how employers should consider pharma purchasing. EP365 with Scott Haas on PBM contracts and drug rebates. EP293 with Dea Belazi, PharmD, MPH, from AscellaHealth on co-pay cards, co-pay accumulators, and co-pay maximizers.   You can learn more by subscribing to Brian's newsletter and by following him on LinkedIn.   Brian Reid has nearly three decades of experience in healthcare journalism, public affairs, and public relations with a specialty in explaining the economics of the healthcare system. He is the founder of Reid Strategic, a communications consultancy, and a senior fellow at the Center for the Evaluation of Value and Risk in Health (CEVR) at Tufts Medical Center. At Reid Strategic, Brian counsels industry leaders on the best way to communicate on complex policy, access, pricing, and reimbursement issues in ways that critical audiences can understand. Brian's core belief is that we can't build a better healthcare system until everyone understands the system we have today. Reid Strategic offers communications strategy and execution around corporate, brand, and policy challenges, from prelaunch approaches to lifecycle management. Prior to founding Reid Strategic, Brian built and led Real Chemistry's Value+Access Communications practice, the largest such group dedicated to issues of value. Brian has written extensively for a range of audiences. At Reid Strategic, he publishes the daily Cost Curve newsletter; and his past experience includes coverage of the health science/policy beat for Bloomberg News, creation of patient education materials for the National Institutes of Health, and features in publications ranging from the Washington Post to Nature Biotechnology to Men's Health. He has a bachelor's degree in biology and political science from Emory University and a master's degree from the Columbia University School of Journalism.   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.   You can learn more by subscribing to Brian's newsletter and by following him on LinkedIn.   Brian Reid, of Reid Strategic, discusses #pharma and #patientaffordability on our #healthcarepodcast. #healthcare #podcast #financialhealth #primarycare #patientoutcomes #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Dr Beau Raymond, Brendan Keeler, Claire Brockbank, Cora Opsahl, Dan Nardi, Dr Spencer Dorn (EP451), Marilyn Bartlett, Dr Marty Makary, Shawn Gremminger (Part 2), Shawn Gremminger (Part 1), Elizabeth Mitchell (Summer Shorts 9)  

Listen back to Paul Cooney, Brian Reid and JOHN HARTSON as they talk all things Scottish football. 

Introducing Small Business Series on Truth in Texas Banking Podcast. Small businesses are important as they support our local communities by creating jobs, putting money back into the local economy, and they reflect the culture and needs of their neighborhoods. We are excited to introduce to you Janal and Brian Reid with ServeWay Heating and Air Conditioning. ServeWay is a one-stop shop that provides the highest quality of heating and air conditioning services along with outstanding customer service. ServeWay's mission is to uphold a standard of integrity bound by fairness, honesty, and personal responsibility through the service they provide.

Jack Curtin & Brian Reid discuss how Brian got on DGK, Jack leaving DGK for Skate Mental then going back to DGK, Jack & Brian skating for New Balance, Jack's New Balance Pulaski shoe, how Jamie Thomas has Jack's back, maneuvering in the industry as an older skater, Brian going pro for DGK, Jack barfing up burgers that Lutzka bought him and much more! Timestamps 00:00:00 Brian Reid & Jack Curtin 00:01:39 Eggs (the spot) 00:01:56 How does Jack stay young? 00:03:30 How did Jack and Brian meet 00:04:13 How Brian got on DGK 00:05:48 Jack's New Balance Pulaski shoe 00:08:33 Jack leaving DGK for Skate Mental then going back to DGK 00:18:28 Maneuvering in the industry as an older skater 00:20:53 Brian going pro 00:31:45 The return of iconic spots 00:36:32 Getting hooked up by New Balance 00:42:25 The DC tour days 00:46:49 Jack on Fallen Footwear 00:54:07 Jamie Thomas has Jack's back 00:55:41 Zero x DGK fresh til death tour 00:56:20 Jack going to japan with FTC 01:05:29 Tampa contests 01:06:18 Jack barfing up burgers that Lutzka bought him 01:12:31 Kelly "the man skater" Hart 01:19:36 Jack getting on Lucky Skateboards 01:26:31 Brian in the Raw video 01:32:03 Basmati Brian 01:34:54 Brian plays the sax 01:36:42 How did Brian find skateboarding 01:41:25 Kelly immortalized 01:47:10 The NB we got now commercial with Jack Learn more about your ad choices. Visit megaphone.fm/adchoices

It may be international break but there's still plenty of football to be played in West London as Brentford Women prepare to take on Ashmount Leigh in the league in a match which will see them continue their quest for promotion from the London and South East Division 1 league. And what a huge match it is gearing up to be with the team playing for the second time ever at Brentford's GTech Community Stadium with a crowd of over 6000 fans expected Getting themselves vibezd up for the match was Ali Mullalley, Billy TheBee Grant and Dave Laney Lane shooting the breeze over the B Team. On todays show:

Ireland is one of the most advanced convenience and roadside retail locations globally and is famous for the high-quality fresh products it delivers every day in its stores. As the energy transition comes to Ireland, how will this develop in some of the roadside sites of the future? In this episode, hosts Dan Munford and food-to-go specialist manufacturer Brian Reid, CEO of Deli Lites chat with Brian Donaldson, CEO of Maxol Group and Thomas Ennis, Owner, Thomas Ennis Group (SPAR). Watch the full video interview at https://www.globalconveniencestorefocus.co.uk/video/54-thomas-ennis-spar-brian-donaldson-maxol-and-brian-reid-deli-lites. With special guests: Brian Donaldson, CEO of Maxol Group and Thomas Ennis, Owner, Thomas Ennis Group (SPAR) Hosted by: Dan Munford and Brian Reid, CEO of Deli Lites

In this episode, host Andy Reid talks with a fellow Scotsman about nonprofit work on both sides of the Atlantic. Our guest this time is Brian Reid, the manager of the ARCH, a Resettlement Program for men in Glasgow, Scotland. Andy discusses with Brian the similarities and differences of The Arch to similar establishments in NY and the driving force within us all to help people. The ARCH Resettlement Centre is an independent service, offering a 10-module support programme over 26 weeks in order that men who are in need are able to sustain their own tenancy when presented to social housing for consideration.

2.00" We start with an amazing simple, but amazing successful, business - making sandwiches in Warrenpoint, Co. Down. From one sandwich bar Brian Reid and his wife Jackie have built an international business supplying sandwiches across the island of Ireland, the UK, Europe, the Middle East and now they have their eyes set on the USA - where Jackie initially got her sandwich making idea. But sending sandwiches to the US - the world capital of sandwiches - sounds a bit like shipping coals to Newcastle. However, Brian has made DeliLites into something very special and incredibly, with their secret ingredients, their sandwiches have a shelf life of up to a year. So that's why he's looking for business partners in the US along with someone with deep pockets (and industry knowledge ideally) to fund that expansion. And we're not talking about loose change...they're looking for tens of millions of Euro. AND, they're developing their business to become a B Corporation.Of course, all of this didn't happen overnight, and speaking of overnight, listen to Brian about how, for ten years, he left his Sandwich HQ at 1am every morning, headed to Dublin dropping off sandwiches on the way, avoiding Dublin's gridlock by travelling in the middle of the night, and then home to Warrenpoint by 9am. That's what TeamGBS calls a gruelling schedule.DeliLites has expanded from a two person team now, employing 250 people currently and having just got £500k funding from InvestNI they're looking for another 50 people across all disciplines to help with their push into the UK where there's a Brexit opportunity as UK sandwich makers can't find workers to make sandwiches there. It's a fantastic story, including Brian's explanation as to what motivates him, and why Gary Vaynerchuk is his 'hire in a heatbeat'.25.00" Aonghus Shortt has a PhD in Power System Engineering, which led him initially to work in wind energy. However, Aonghus's career took a complete about turn when he tried to help his then girlfriend, now wife, with digestion issues, as she suffered from irritable bowel syndrome, or IBS, a condition that affects about 1 billion people worldwide. Out of this concern for his girlfriend, FoodMarble was born to make a small palm sized device, not unlike a personal breathalyser. FoodMarble analyses the gases on the breath and can help 'read' what foods are causing digestion problems. It could be a world-winning business and having already sold 30,000 devices, and raised €5.5 million, the FoodMarble team are looking for fresh funds to bring the product, along with further planned innovation, to the waiting and suffering public.Aonghus's 'hire in a heartbeat'? Grace Gifford Whittle aka his wife, the reason the whole business was started initially. Awww, that's nice! Hosted on Acast. See acast.com/privacy for more information.

Welcome to Medical Rehab Matters. In the weeks since this podcast began, we've learned a lot inpatient medical rehabilitation and about podcast production, including that it's not always possible to include everything we record. In this episode, we're going to present some of the things we couldn't earlier – from our episodes on stroke, cancer, and amputation. We hope you enjoy this episode and it inspires you to go back and listen to the full episodes on these topics. Guests: Dr. Vish Raj, a cancer rehab specialist at Carolinas Rehab, and Sarah Mullan, an occupational therapist and Manager of Cancer Rehabilitation at the Levine Cancer Institute. Dr. Michael Stubblefield, Director of Cancer Rehab at Kessler. Roseann Sdoia, who lost her leg in the Boston Marathon Bombing in 2013,  David Crandell, MD, Medical Director of the Amputee Program at Spaulding in Boston. Scott Riddle, Vice President of Orthotics, Prosthetics and Bionics at Mary Free Bed. Dr. Jaclyn Barcikowski from Moss Rehab, Dr. Argye Hillis, Director of the Center of Excellence in Stroke Detection and Diagnosis, at the Sheikh Khalifa Stroke Institute, Brian Reid, a patient who suffered a stroke in May 2020, and his wife Veronica. Cohosts Dr. Robert Krug, immediate past chairman of the AMRPA Board and Vice President of Medical Affairs for Mary Free Bed Rehabilitation Hospital Advisory Group and Patricia Sullivan, AMRPA director of communications.

The first episode of Medical Rehab Matters addresses stroke and inpatient medical rehabilitation. Stroke impacts approximately 800,000 people in the U.S. each year and more than two-thirds of them receive inpatient rehabilitation services after they're released from the hospital. Stroke is the leading cause of long-term disability and the fourth leading cause of death. About one quarter of inpatient medical rehabilitation patients are there because of a stroke.  Our guests include Joel Stein, MD, Professor of Rehabilitation and Regenerative Medicine at Weill Cornell Medical College,  Physiatrist-in-Chief at New York-Presbyterian Hospital, and Professor and Chair of the  Department of Rehabilitation Medicine at the Columbia University College of Physicians and Surgeons; Argye Hillis,  MD, Director, Center of Excellence in Stroke Detection and Diagnosis, Sheikh Khalifa Stroke Institute  Professor of Neurology at Johns  Hopkins Medicine; Jaclyn Barcikowski, MD, MossRehab, Associate Program Director Residency Training Program; and Brian Reid, who experienced a stroke in spring 2020. Cohosts: Patricia Sullivan, director of communications for the American Medical Rehabilitation Providers Association and Robert Krug, MD, who is the immediate past chairman of the AMRPA Board and Vice President of Medical Affairs for the Advisory Group for Mary Free Bed Rehabilitation Hospital.

We're here to Love! SALT - TEA PODCAST - Season 3 - Episode 3! Join us as we talk about the music Industry and the journey of being a producer. Make sure to check out the people in the podcast! Brian's IG - @chefb_reid Matthew 6:33 - But seek first the kingdom of God and His righteousness, and all these things shall be added to you! --- Support this podcast: https://anchor.fm/aaron-banka/support

STK600 contender Simon Reid drops by for a chat with our host Dave Neal that covers his career to date. They talk about the chances he's had, the successes and what it's like to be a rider with a famous father (double world F2 Champion and multiple TT winner and Northern Irish legend, Brian Reid). We also cover his 'date' with Rihanna... yes, THAT Rihanna! Hosted on Acast. See acast.com/privacy for more information.

Francisco Aravena revisó las principales tendencias del día y conversó con Brian Reid, investigador Residente del Centro de Investigación en Ecosistemas de la Patagonia (CIEP).

Brian Reid is a Community Engagement Coordinator with the Family Care Network. He called in to First Look with Andy Morris to talk about National Mentor Month and how you can be a part of it.

Brian Reid is a Community Engagement Coordinator with the Family Care Network. He called in to First Look with Andy Morris to talk about National Mentor Month and how you can be a part of it.

In this episode Seán had the pleasure of speaking with Mr Brian Reid of Deli Lites. Brian speaks about the importance of culture in Deli Lites and what he focuses on as a Leader. This is a fantastic episode and very inspirational to listen to Brian speak about his vision and passion for his team.

Pippa speaks to Brian Reid from the NightSky Zombies. See omnystudio.com/policies/listener for privacy information.

From a dad driving his son to gigs, to an icon of the Chippenham music scene, Brian Reid joins us on this week's Sheer Isolation Podcast. He talks about being roadie/manager for Roads To Nowhere, how we fell into presenting a weekly radio show in the town, and gives us a taste of his 'poison pen-letter' poetry. We've also got two amazing tracks out of Bristol thanks to Mac Lloyd (ex-Sell Your Sky) and the Erotic Secrets of Pompeii. The Sheer Isolation podcast is made weekly to promote the music scene in Wiltshire and the West of England. It's created by Kieran Moore (Sheer Music) and Jon Ponting (4014 Project; The Late Gig). We send our thanks to all contributors who've helped us piece this together. Musicians are very welcome to send us videos to feature and any news or streaming dates... sheerisolation@gmail.com

Today we're going to honor Larry Tesler, who died on February 17th, 2020. Larry Tesler is probably best known for early pioneering work on graphical user interfaces. He was the person that made up cut, copy, and paste as a term. Every time you say “just paste that in there,” you're honoring his memory. I've struggled with how to write the episode or episodes about Xerox PARC. It was an amazing crucible of technical innovation. But they didn't materialize huge commercial success for Xerox. Tesler was one of the dozens of people who contributed to that innovation. He studied with John McCarthy and other great pioneers at the Stanford Artificial Intelligence Laboratory in the 60s. What they called artificial intelligence back then we might call computer science today. Being in the Bay Area in the 60s, Tesler got active in war demonstrations and disappeared off to a commune in Oregon until he got offered a job by Alan Kay. You might remember Kay from earlier episodes as the one behind Smalltalk and the DynaBook. They'd both been at The Mother of All Demos where Doug Englebart showed the mouse, the first hyperlinks, and the graphical user interface and they'd been similarly inspired about the future of computing. So Tesler moves back down in 1970. I can almost hear Three Dog Night's Mama Told Me Not To Come booming out of the 8track of his car stereo on the drive. Or hear Nixon and Kissinger on the radio talking about why they invaded Cambodia. So he gets to PARC and there's a hiring freeze at Xerox, who after monster growth was starting to get crushed by bureaucracy, so was in a hiring freeze. Les Earnest from back at Stanford had him write one of the first markup language implementations, which he called Pub. That became the inspiration for Don Knuth's TeX and Brian Reid's Scribe and an ancestor of JavaScript and PHP. They find a way to pay him, basically bringing him on as a contractor. He works on Gypsy, the first real word processor. At the time, they'd figured out a way of using keystrokes to switch modes for documents. Think of how in vi or pico, you switch to a mode in order to insert or move, but they were applying metadata to an object, like making text bold or copying text from one part of a document to another. Those modes were terribly cumbersome and due to very simple mistakes, people would delete their documents. So he and Tim Mott started looking at ways to get rid of modes. That's when they came up with the idea to make a copy and paste function. And to use the term cut, copy, and paste. Thee are now available in all “what you see is what you get” or WYSIWYG interfaces. Oh, he also coined that term while at PARC, although maybe not the acronym. And he became one of the biggest proponents of making software “user-friendly” when he was at PARC. By the way, that's another term he coined, with relation to computing at least. He also seems to be the first to have used the term browser after building a browser for a friend to more easily write code. He'd go on to work on the Xerox Alto and NoteTaker. That team, which would be led by Adele Goldberg after Bob Taylor and then Alan Kay left PARC got a weird call to show these kids from Apple around. The scientists from PARC didn't think much of these hobbyists but in 1979 despite Goldberg's objections, Xerox management let the fox in the chicken coup when they let Steve Jobs and some other early Apple employees get a tour of PARC. Tesler would be one of the people giving Jobs a demo. And it's no surprise that after watching Xerox not ship the Alto, that Tesler would end up at Apple 6 months later. After Xerox bonuses were distributed of course. At Apple, he'd help finish the Lisa. It cost far less than the Xerox Star, but it wouldn't be until it went even further down-market to become the Macintosh that all of their hard work at Xerox and then Apple would find real success. Kay would become a fellow at Apple in 1984, as many of the early great pioneers left PARC. Tesler was the one that added object-oriented programming to Pascal, used to create the Lisa Toolkit and then he helped bring those into MacApp as class libraries for developing the Mac GUI. By 1990, Jobs had been out of Apple for 5 years and Tesler became the Vice President of the Newton project at Apple. He'd see Alan Kay's concept of the digital assistant made into a reality. He would move into the role of Chief Scientist at Apple once the project was complete. There, he made his own mini-PARC but would shut down the group and leave after Apple entered their darkest age in 1997. Tesler had been a strong proponent, acting as the VP of AppleNet and pushing more advanced networking options prior to his departure. He would strike out and build Stagecast, a visual programming language that began life as an object-oriented teaching language called Cocoa. Apple would reuse the name Cocoa when they ported in OpenStep, so not the Cocoa many developers will remember or maybe even still use. Stagecast would run until Larry decided to join the executive team at Amazon. At Amazon, Larry was the VP of Shopping Experience and would start a group on usability, doing market research, usability research, and lots of data mining. He would stay there for 4 years before moving on to Yahoo!, spreading the gospel about user experience and design, managing up to 200 people at a time and embedding designers and researchers into product teams, a practice that's become pretty common in UX. He would also be a fellow at Yahoo! before taking that role at 23 and me and ending his long and distinguished career as a consultant, helping make the world a better place. He conceptualized the Law of Conservation of Complexity, or Tesler's Law, in 1984 states that “Every application has an inherent amount of irreducible complexity. The only question is: Who will have to deal with it—the user, the application developer, or the platform developer?” But One of my favorite quotes of his “I have been mistakenly identified as “the father of the graphical user interface for the Macintosh”. I was not. However, a paternity test might expose me as one of its many grandparents.” The first time I got to speak with him, he was quick to point out that he didn't come up with much; he was simply carrying on the work started by Englebart. He was kind and patient with me. When Larry passed, we lost one of the founders of the computing world as we know it today. He lived and breathed user experience and making computers more accessible. That laser focus on augmenting human capabilities by making the inventions easier to use and more functional is probably what he'd want to be known for above all else. He was a good programmer but almost too empathetic not to end up with a focus on the experience of the devices. I'll include a link to an episode he did on the 99% Invisible episode in the show notes if you want to hear more from him directly ( https://99percentinvisible.org/episode/of-mice-and-men ). Everyone except the people who get royalties from White Out loved what he did for computing. He was a visionary and one of the people that ended up putting the counterculture into computing culture. He was a pioneer in User Experience and a great human. Thank you Larry for all you did for us. And thank you, listeners, in advance or in retrospect, for your contributions.

Brian Reid & Volunteer Mentor Shari Robischotti came by to talk about being a Mentor... and what it means to a child in need.

Homelessness? The ARCH Resettlement Centre, Glasgow, Scotland introduces to the world, homelessness as experienced by people living and working in the most deprived communities of Glasgow and the West of Scotland.  Your host, Brian Reid, who is the manager of a commisioned supported accommodation project in the heart of Glasgow, will guide you through the myriad of heartbreaking tales and stories as told by people with lived experience. Brian, along with a dedicated staff team, work with and support men, from many different backgrounds and social settings, who all have one thing in common; they have been or are currently experiencing homeless; they have nowhere to call a home or a place of their own. How does this come about in a first world country in the 21st Century? What can be done to change this; what can be done to help those who are in need of a home? Why do people become homeless? What are the causes of homelessness and can these be eradicated? What is homelessness? Join us each week in discussing the causes, the harmful effects, the choices (good/bad), the attitudes (good/bad), the solutions to ending the scourge of homelessness and to also rejoice in the positive stories and outcomes of the men who have been successful in breaking the cycle.

Today’s guest are an unlikely due of a documentary film maker and a master cicerone. Doug Tivola is the director of Brewmaster - a documentary that tries to weave together the varied and often dissociated threads in the beer world - like big and small, amateur and pro, nostalgic and new wave —and the results are at times flattering to the beer industry and at time a bit embarrassing to have reflected back. At times both overly simple and complex, naive and incisive. If a documentary serves as a mirror, then this one is perhaps a funhouse mirror that makes us all a little uncomfortable for different reasons. Alongside him in this interview is one of the documentaries primary characters - Brian Reid - a master cicerone who works for MillerCoors as an educator. The film tracks his journey into failure as he attempts to be one of the dozen or so folks in the wold to achieve master status - which after the shooting of the film he actually does go on to accomplish. MillerCoors was a sponsor of the film - which began as a sort of ode to Pilsner - specifically Pilsner Urquell. But as the shooting and storytelling commenced, Tivola kept chasing down other storylines - so the results get pretty far from the original intent and capture a collage of sorts - featuring moments with Urquell’s Vaclav Berka, Brooklyn Brewery’s Garret Oliver, Chicago’s Randy Mosher and Cicerone’s Ray Daniels, Dogfish Head’s Sam Calagione, among other sort of founding fathers of the craft beer narrative we’ve heard form so often. And that is maybe my biggest critique of the film - and full disclosure, I appear in the documentary for a few moments myself - but the talking heads in this story are perhaps a bit predictable and lack the diversity of opinions and experiences from the wider set of folks that work in and help shape the craft brewing world today. So the documentary is perhaps already a bit of a time capsule that way. But Brian’s story in the film is the one I enjoyed the most, largely because it was real struggle, playing out in front of the audience in real-time. It wasn’t someone reminiscing about the glory days with a marketing narrative - in fact, most of what Brian goes through in this film objectively sucks. It’s brutal. And the film doesn’t capture much int he way of success - as I mentioned, obtaining the level of master happens after the film concludes - so it’s a great portrait of how difficult and unrewarding working on beer can often be despite all the hard work that goes in to it. And for that reason - I think having these two together for the interview is the best way to chat about the film.

We discuss GX1000's "Roll Up" Video, Sierra Fellers - Bones Wheels, D3 designer Brian Reid calls out Under Armour & Dave Mayhew over A$AP Rocky Collab, Adidas Skateboarding /// Shen City Peaks, Thank You Skateboards Promo Video, Volcom's “GTXX - DOWN SOUTH IN HELL” Video, Huf Worldwide Presents // HUF 002, Zion Wright's "Jupiter Rising" Real Part, T-Funk & Zach Allen "Baker" Part, Supreme “Blessed”, Urban Outfitters now sells skateboards, Apple ear pods and much more!

Whistler Council Candidate Brian Reid Brian has lived in Whistler since 1992 and has worked at his current job at WRM Strata Management for the past 17 years. For him, Whistler is more than just a home, “This is where my family of friends is and this is the place most dear to my heart.”

Brian Reid and Rita Glaze launch "Redeeming Value," W2O Group's bi-weekly examination of health system value, drug pricing, reimbursement, patient access and more.  In the first episode, Reid and Glaze discuss the value conversation -- and lack thereof -- at the J.P. Morgan Healthcare conference last month. 

Get beyond the eyeball grabbing headlines, the ever present three bullet summaries and hear some well thought out perspectives to help guide conversations and decisions in your workplace retirement plans.  Our guest today, Brian Reid, the Chief Economist at the Investment Company Institute or ICI, shares that goal and provides some great food for thought for you.  He addresses some recent stories you might have come across such as “Are 401(k) Plans A Failed Experiment”, and were “Employees Better off Under Pension Plans”.  He also provides some context on the other side of the conversation we had a few episodes ago about State Run Retirement Plans.  As I said in that episode, not everyone is convinced that they are ready for prime time.  Now, you may or may not agree with all of his points, but what I really appreciated is that Brian is armed with research, facts and he does a great job keeping the conversation engaging and thought provoking!   Guest Bio Brian K. Reid is chief economist at the Investment Company Institute (ICI). Reid oversees the Institute’s statistical collections and its research on the US and global funds, financial markets, US retirement market, and investor demographics. His research and analysis focuses on financial institutions and markets, investor trends, and the impact of regulation on funds, their investors, and the markets. Before joining the Institute, Reid worked as a staff economist in the Monetary Affairs Division at the Federal Reserve Board. Reid graduated from the University of Wisconsin–Madison with honors and holds a PhD in economics from the University of Michigan.    401(k) Fridays Podcast Overview Struggling with a fiduciary issue, looking for strategies to improve employee retirement outcomes or curious about the impact of current events on your retirement plan? We've had conversations with retirement industry leaders to address these and other relevant topics! You can easily explore over fifty prior on-demand audio interviews here. Don't forget to subscribe as we release a new episode each Friday!

Hosts: Steve Goodman, Pat Richard, Michel de Rooij, Serkan Varoglu, Johan Veldhuis, John Cook, Michael van Horenbeeck, and Tim Harrington. Guests: Andrew Higginbotham, Brian Reid, and Jeff Guillet. Microsoft kills off the MCM/MCSM and MCA programs. Download or subscribe to this show at TheUCArchitects.com. For additional show notes, visit the summary page for this episode. Running time: 01:28:50