Podcasts about healthcare costs

Erica Campbell walked away from corporate life, took a hard left from the British Embassy, and found her calling writing checks for families nobody else sees. As Executive Director of Pinky Swear Foundation, she doesn't waste time on fluff. Her team pays rent, fills gas tanks, and gives sick kids' parents the one thing they don't have—time. Then, breast cancer hit her. She became the patient. Wrote a book about it. Didn't sugarcoat a damn thing. We talk about parking fees, grief, nonprofit burnout, and how the hell you decide which families get help and which don't. Also: AOL handles, John Hughes, and letters from strangers that make you cry. Erica is part Punky Brewster, part Rosie the Robot, and part Lisa Simpson—with just enough GenX Long Island sarcasm to make it all land. This one sticks.RELATED LINKSPinky Swear FoundationThe Mastectomy I Always Wanted (Book)Erica on LinkedInThink & Link: Erica Campbell“Like the Tale of a Starfish” - Blog Post“Cancer Diagnosis, Messy Life, Financial Support” - Blog PostFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Kevin Brucher discusses the complexities of retirement spending, market analysis, and the importance of planning for various financial scenarios. He emphasizes the need for retirees to understand their spending patterns, the psychological barriers to spending, and the creation of a 'fun fund' to enjoy retirement without financial anxiety. The conversation also touches on the impact of healthcare costs, inflation, and the current market uncertainties, urging listeners to consider risk management strategies. Call 800-975-6717. Visit Silver Leaf Financial to learn more.See omnystudio.com/listener for privacy information.

Jesse answers a range of listener questions on topics including estate planning, life insurance, financial benefits of marriage, tax strategies for high earners, healthcare in retirement, and investing during economic uncertainty. He explains that heirs to traditional IRAs must pay income tax on withdrawals, while taxable accounts benefit from a step-up in basis, and argues that whole life insurance is generally a poor investment choice for most people. He outlines how married couples enjoy more financial advantages due to shared costs, tax benefits, and retirement perks, though singles benefit from greater autonomy. A high-earning listener weighing Roth versus traditional retirement contributions is advised to consider tax-bracket arbitrage in retirement or hedge with a 50/50 split. Jesse also dives into healthcare planning, covering employer plans, HSAs, COBRA, ACA subsidies, and Medicare, while stressing the complexity and importance of planning for long-term care. On investing, he cautions against trying to time recessions and emphasizes aligning investment strategies with individual goals, risk tolerance, and time horizons. Key Takeaways:• Traditional IRAs require heirs to pay income tax on withdrawals within 10 years, but this is deferred tax, not a penalty. • Whole life insurance is generally more expensive and offers lower returns than term insurance plus independent investing. • Married couples often benefit financially from economies of scale and joint tax advantages. Single individuals have greater financial control and simpler planning but may miss out on some systemic benefits for couples. • Healthcare planning is a critical but often overlooked aspect of retirement financial planning. Jesse discusses ACA, COBRA, and HSAs. • Short-term market volatility can be misleading; experiencing real losses helps build long-term investing discipline. • Selling stocks to avoid recession dips is risky because market recoveries often precede economic improvements, resulting in missed gains. Key Timestamps:(00:00) Question 1: Whole Life Insurance (17:47) Question 2: Financial Pros and Cons of Being Single vs. Married (27:19) Question 3: Roth vs. Traditional Accounts (37:54) Question 4: Planning for Healthcare Costs in Retirement (42:31) Maximizing HSA Growth with a Strategic Loophole (45:08) COBRA and ACA for Early Retirees (53:48) Medicare: Breaking Down the Basics (01:03:02) Question 5: Investment Strategies During Economic Uncertainty Key Topics Discussed:The Best Interest, Jesse Cramer, Wealth Management Rochester NY, Financial Planning for Families, Fiduciary Financial Advisor, Comprehensive Financial Planning, Retirement Planning Advice, Tax-Efficient Investing, Risk Management for Investors, Generational Wealth Transfer Planning, Financial Strategies for High Earners, Personal Finance for Entrepreneurs, Behavioral Finance Insights, Asset Allocation Strategies, Advanced Estate Planning Techniques Mentions:https://bestinterest.blog/is-benefits-hacking-genius-or-immoral/ Deep Risk: How History Informs Portfolio Design by William J. Bernstein More of The Best Interest:Check out the Best Interest Blog at bestinterest.blog Contact me at jesse@bestinterest.blog The Best Interest Podcast is a personal podcast meant for education and entertainment. It should not be taken as financial advice, and is not prescriptive of your financial situation.  

Turning 65 and thinking about retirement? One of the biggest retirement expenses you'll face is healthcare—and Medicare doesn't cover everything. In this retirement video, we break down what you need to know about healthcare planning at retirement, including Medicare basics, out-of-pocket costs, and smart strategies to protect your retirement savings.**Schedule your free virtual consultation, click here: https://pearlwealthgroup.com/contact/ or use our calendar link: https://calendly.com/pearlwealthgroup/discoverycall ****Buy My Book: Can I Really Retire https://www.amazon.com/shop/drewblackstoncrc/list/2FDRXX3LFUXQ8?ref_=aipsflist **❌ **Please make sure you talk with your CPA, Financial Advisor, Retirement Planner, or Investment Advisor Representative, before implementing any content from this channel. All videos are for informational and educational purposes only. None of the content, comments, responses, information, or any other item on this channel constitutes financial advice or recommendations. Please call Pearl Wealth Group at 813-807-5060 to go through your Retirement Income, Retirement Investments, or Retirement Plan in more detail.** ❌

Allyson with a Y. Ocean with two Ls. And zero chill when it comes to changing the face of cancer care. Dr. Allyson Ocean has been quietly—loudly—at the center of every major cancer breakthrough, nonprofit board, and science-backed gut punch you didn't know you needed to hear. In this episode, she joins me in-studio for a conversation two decades in the making. We talk twin life, genetics, mitochondrial disease, and why she skipped the Doublemint Twins commercial but still ended up as one of the most recognizable forces in oncology. We cover her nonprofit hits, from Michael's Mission to Let's Win Pancreatic Cancer to launching the American Jewish Medical Association—yes, that's a thing now. We get personal about compassion in medicine, burnout, bad food science, and microplastics in your blood. She also drops the kind of wisdom only someone with her résumé and sarcasm can. It's raw. It's real. It's the kind of conversation we should've had 20 years ago—but better late than never.RELATED LINKS:– Dr. Allyson Ocean on LinkedIn– Let's Win Pancreatic Cancer– NovoCure Leadership Page– Michael's Mission– American Jewish Medical Association– The POLG Foundation– Cancer Buddy App (Bone Marrow and Cancer Foundation)– Dr. Ocean at OncLiveFEEDBACK:Like this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Brian Calley, President/CEO of the Small Business Association of Michigan, shares details of the latest survey on business owner's top concerns.See omnystudio.com/listener for privacy information.

Brian Calley, President and CEO of Small Business Association of Michigan (SBAM). Small business survey: Surge in health care costs responsible for hiring limitations

Sponsored by Invivyd, Inc.Nobody wants to hear about COVID-19 anymore. Especially not cancer patients. But if you've got a suppressed immune system thanks to chemo, radiation, stem cell transplants—or any of the other alphabet soup in your chart—then no, it's not over. It never was. While everyone else is getting sweaty at music festivals, you're still dodging a virus that could knock you flat.In this episode, Matthew Zachary and Matt Toresco say the quiet part out loud: many immunocompromised people may not even know they have options beyond vaccines. Why? Because the system doesn't bother to tell them. So we're doing it instead. We teamed up with Invivyd to help get the word out about tools other than vaccines that can help prevent COVID-19. We break down the why, the what, and the WTF of COVID-19 risk for cancer patients and why every oncologist should be talking about this.No fear-mongering. No sugarcoating. Just two guys with mics who've been through it and want to make sure you don't get blindsided. It's fast, funny, and furious—with actual facts. You've got more power than you think. Time to use it.RELATED LINKSExpand Their OptionsInvivydMatt Toresco on LinkedInOut of Patients podcastFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Send us a textEmployers struggle with rising healthcare costs, and their usual approach is to work with a bevy of vendors, including insurers, provider networks, point solution providers, and HR supply chain vendors. But these vendors are awfully hard to optimize and costs seem to keep on climbing.In this episode of the HealthBiz Podcast, David Neikrug, CEO of Optimatum Solutions, joins host, David E. Williams, to explain how poor vendor management fuels rising employer healthcare costs and what to do about it.

Missed margins and repeat surgeries drive up healthcare costs and stretch critical resources. OCT technology offers a path to smarter imaging and fewer reoperations, cutting costs while improving outcomes. Dr. Sanjay Juneja hosts Adrian Mendes, CEO of Perimeter Medical Imaging AI, to unpack how intraoperative OCT can drastically lower re-excision rates in breast cancer surgery. They explore the ripple effect this has on healthcare economics - from reduced OR time and insurance payouts to stronger patient survival rates. You'll learn how data-backed imaging aligns both clinical and financial priorities.

Kevin Brucher discusses the financial surprises that can arise during retirement, emphasizing that expenses may not remain fixed. He explores the current market turbulence, the implications of national debt, and the importance of having a solid financial plan. The conversation also covers healthcare costs, Medicare options, long-term care considerations, and strategies for managing retirement expenses. Kevin stresses the need for retirees to be proactive in their financial planning to ensure a stable and secure retirement. Call 800-975-6717. Visit Silver Leaf Financial to learn more.See omnystudio.com/listener for privacy information.

We've normalized debt, student loans, car payments, credit cards, and convinced ourselves it's just the cost of adulthood. But what if it's actually the biggest barrier to the life you want? In this episode, I break down why most of us are drowning in consumer debt, how we got here, and what it really takes to climb out.For more go to: www.scottmlynch.comEpisode resources:100 books that have shaped my thinking the mostLevel up your life by joining my Patreon where you'll get exclusive content every week and more badass offerings (rips t-shirt in half, Hulk Hogan style, and runs around the room). And/or…Unlock practical and tactical insights on how to master your mindset and optimize your happiness directly to your inbox.If you're a glutton for punishment and want more swift kicks in the mind follow me on social:InstagramYouTubeLeave a review and tell me how I suck so I can stop doing that or you can also tell me about things you like. I'd be okay with that, too.Produced by ya boi.Past guests on The Motivated Mind include Chris Voss, Captain Sandy, Dr. Chris Palmer, Joey Thurman, Jason Harris, Koshin Paley Ellison, Rudy Mawer, Molly Fletcher, Kristen Butler, Hasard Lee, Natasha Graziano, ⁠David Hauser⁠, Cheryl Hunter, Michael Brandt, Heather Moyse, Tim Shriver, and Alan Stein, Jr.

EPISODE DESCRIPTIONLisa Shufro is the storyteller's storyteller. A musician turned innovation strategist, TEDMed curator, and unapologetic truth-teller, Lisa doesn't just craft narratives—she engineers constellations out of chaos. We go way back to the early TEDMed days, where she taught doctors, scientists, and technocrats how not to bore an audience to death. In this episode, we talk about how storytelling in healthcare has been weaponized, misunderstood, misused, and still holds the power to change lives—if done right. Lisa challenges the idea that storytelling should be persuasive and instead argues it should be connective. We get into AI, the myth of objectivity, musical scars, Richard Simmons, the Vegas healthcare experiment, and the real reason your startup pitch is still trash. If you've ever been told to “just tell your story,” this episode is the permission slip to do it your way. With a bow, not a violin.RELATED LINKSLisa Shufro's WebsiteLinkedInSuper Curious ArchiveEight Principles for Storytelling in InnovationStoryCorps InterviewCoursera Instructor ProfileWhatMatters ProjectFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Let us know what you think about Health Affairs podcasts at communications@healthaffairs.org. If you have 30 minutes to spare, let us know and we'll set up a 30-minute chat for the first 20 listeners that reach out. Coffee will be on us.On May 13, A Health Podyssey's Rob Lott chatted with Andrew Ryan of Brown University about his paper in the May 2025 edition of Health Affairs that explores how Rhode Island's affordability standards impacted hospital prices and insurance premiums. Order the May 2025 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone.

This week on CodeWACK! Medicare for All is back in the spotlight! With two new bills recently introduced in Congress, what makes these proposals different from earlier versions— and why are some advocates feeling hopeful, even in the current political climate? What would a truly public, universal health care system look like, and how could it help curb the soaring costs, corporate greed, and bureaucracy plaguing our current system? To unpack this, we spoke with Rachel Madley, Director of Policy and Advocacy at the Center for Health and Democracy. A former health policy advisor to Congresswoman Pramila Jayapal — lead sponsor of the House Medicare for All bill — Rachel helped shape and reintroduce the landmark legislation in 2023. She's also a former FDA staffer and holds a PhD in Microbiology and Immunology from Columbia University, where she was active in both Physicians for a National Health Program and Students for a National Health Program. Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.

On this conversation, Steve and Derrick discuss the complexities of retirement planning, particularly in the context of divorce and widowhood. They emphasize the importance of proper financial planning to mitigate the impact of life changes on wealth and standard of living. The discussion also touches on the financial lessons learned from high-profile individuals like Shaquille O'Neal and the necessity of professional guidance for effective financial management. Additionally, they address the unique challenges faced by small business owners and the importance of having a solid exit strategy. Get Your Complimentary Retirement Analysis Social Media: Facebook I Twitter See omnystudio.com/listener for privacy information.

In this episode, Dr. Preston Cherry breaks down why Health Savings Accounts (HSAs) are a powerful tool—not just for today's medical bills but for building your retirement nest egg. With big tax perks and long-term flexibility, HSAs can do more than you think. Learn how to use them smartly now and in retirement.Takeaways:• Triple Tax Advantage• Max Out Contributions• Invest for Growth• Cover Future Healthcare• No Expiration DateWant to learn more? Connect with us below!Stay informed and inspired! Join our FREE wealth & well-being newsletterDo you want confidence & clarity? Check out our award-winning wealth advice servicesGrab Your Copy of Dr. Cherry's book ‘Wealth In The Key of Life'Disclosure: episodes are educational only, not advice. Review our disclosures here: https://www.concurrentfp.com/disclosures/

In this episode of Retire Fit Radio, Nathan Fort discusses the surprising positivity among retirees, with 72% reporting that their retirement is going better than expected. The conversation explores five key strategies that successful retirees are implementing, including building multiple income sources, locking in predictable income, and consolidating accounts for better financial clarity. Additionally, the hosts address potential red flags for retirement, such as living paycheck to paycheck and managing high-interest debt, emphasizing the importance of having a clear understanding of expenses and a solid financial plan. If you have any questions concerning your retirement call Nathan Fort 800-890-5008 or click here to visit our website. Retiring, Planning, Saving, Healthcare, 401K, Roth, TaxesSee omnystudio.com/listener for privacy information.

This conversation delves into the various stages of retirement, emphasizing the importance of proactive planning and understanding the emotional transitions that retirees face. The hosts, Bobby Futch, Tanner Moore, and Tom McDermott discuss the significance of pre-retirement planning, the excitement of the honeymoon phase, the potential disenchantment that can follow, and the importance of finding stability in retirement. They highlight the need for a solid financial plan to navigate these stages successfully and encourage listeners to seek professional guidance to ensure a smooth transition into retirement. If you have any questions about your retirement planning call Guardian Investment Advisors 800-517-1575 or click here to visit our website. Planning, Retiring, Saving, 401K, IRA, TSP, 403B, TaxesSee omnystudio.com/listener for privacy information.

Tripp Limehouse discusses essential strategies for successful retirement planning, emphasizing the importance of working with a fiduciary, consolidating retirement accounts, maximizing contributions through catch-up strategies, and building a balanced investment mix. The discussion highlights how these strategies can lead to a more secure and enjoyable retirement experience, as evidenced by the 72% of retirees who report that their retirement is going better than expected. The conversation also covers the necessity of estate planning and addresses listener questions regarding retirement strategies. Visit Limehouse Financial to learn more. Call 800-940-6979See omnystudio.com/listener for privacy information.

Former Congresswoman Abigail Spanberger made a campaign stop in ruby red Hanover County Wednesday morning. The Democratic gubernatorial candidate was there to discuss her plans to address healthcare costs, but she found more than just the press and local supporters. Brad Kutner has more.

What happens when you blend the soul of Mr. Rogers, the boldness of RuPaul, and just a pinch of Carrie Bradshaw? You get Sally Wolf.She's a Harvard and Stanford powerhouse who ditched corporate media to help people actually flourish at work and in life—because cancer kicked her ass and she kicked it back, with a pole dance routine on Netflix for good measure.In this episode, we unpack what it means to live (really live) with metastatic breast cancer. We talk about the toxic PR machine behind "pink ribbon" cancer, how the healthcare system gaslights survivors when treatment ends, and why spreadsheets and dance classes saved her sanity. Sally doesn't just survive. She rewrites the script, calls out the BS, and shows up in full color.If you've ever asked “Why me?”—or refused to—this one's for you.RELATED LINKS:Sally Wolf's WebsiteLinkedInInstagramCosmopolitan Essay: "What It's Like to Have the 'Good' Cancer"Oprah Daily Article: "Five Things I Wish Everyone Understood About My Metastatic Breast Cancer Diagnosis"Allure Photo ShootThe Story of Our Trauma PodcastFEEDBACK:Like this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.com.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Join us as Joanna Strober, CEO of Midi Health, reveals how virtual care platforms are addressing the significant gap in women's midlife healthcare. Discover how treating menopause symptoms properly reduces long-term health complications, lowers healthcare utilization costs, and improves workplace productivity. Hear firsthand how this digital health pioneer is partnering with major health systems and employers to deliver measurable clinical outcomes that benefit patients, providers, and payers alike.Joanna Strober, CEO, Midi HealthMegan Antonelli, Chief Executive Officer, HealthIMPACT

Analyzing Trump's plan to roll back soaring drug prices for Americans; Sports bras eliminate bounce but may take a toll on women's backs; RFK Jr. targets the chemicals in our food; Do Americans really eat more animal protein than any other of the world's nations? Causes and treatments for pulmonary hypertension.

Blanchard Valley Health System CEO Myron Lewis explains his concern about state and federal proposals that he says would put patients' care at risk (at 14:05) --- As we head into the season of fun in the sun, it's time for a reminder about the dangers of skin cancer... and new technology that could make treatment more accessible and less invasive (at 25:27) --- For the 10th year, Bayer is the presenting sponsor of country music superstar Luke Bryan's Farm Tour, raising awareness for the issue of food insecurity and the challenges faced by the people who put meals on our table (at 46:23)

Have you ever thought about the transition every woman faces in life? Menopause is a topic that often goes unspoken, yet it's a journey every woman will experience. Today, we're diving into this subject with Dr. Terri-Ann Samuels, a committed urogynecologist focused on empowering women during this pivotal stage. Learn why understanding and valuing yourself during this time can redefine your future. Join us as Dr. Samuels sheds light on embracing menopause with wisdom and dignity. Key Questions Answered 1. What is a urogynecologist? 2. Why did Dr. Samuels choose this field? 3. Why is talking about menopause still difficult for many women? 4. What are some common symptoms of menopause? 5. Do most women recognize menopause symptoms, or do others have to point it out to them? 6. What is the Women's Health Initiative (WHI) and how did it affect hormone therapy? 7. Why did Dr. Samuels decide to spend more time with each patient? 8. How does Dr. Samuels view menopause in terms of lifestyle and health planning? 9. What are some new vocabulary terms women might use to better discuss menopause? Timestamped Overview 00:00 Normalizing Menopause Conversations 04:30 Common Menopause Symptoms 08:50 Navigating Life Transitions 11:49 Healthcare Costs and Patient Struggles 14:41 Empowering Women's Health Awareness 19:12 Barriers to Breast Cancer Screenings 22:26 Men's Hormonal Health Acceptance Evolution 24:39 Understanding Pelvic Discomfort 27:03 Reviving Innate Sexuality 29:19 Sure, please provide the text you need a title for. Connect with Dr. Samuels HERE, and subscribe to The Menopod wherever you get your podcasts. Support The Rose HERE. Subscribe to Let’s Talk About Your Breasts on Apple Podcasts, Spotify, iHeart, and wherever you get your podcasts.See omnystudio.com/listener for privacy information.

In this special episode recorded live at The College's Horizons 2025 conference, Lindsey Lewis, MBA, CFP®, ChFC®, managing director and chair of the American College Center for Women in Financial Services, speaks with healthcare professional turned financial educator Carolyn McClanahan, CFP® on how financial professionals can work with clients to maximize their healthcare benefits and avoid costly mistakes. They also discuss the unique challenges facing women in situations where spouses require long-term care or other financial considerations, as well as important elements to focus on in planning with clients such as Medicare/Medicaid, deductibles, tax implications, and more. Find all episodes now at TheAmericanCollege.edu/Shares.

Dr. Bill Hennessey, Chief Integrity Officer for CareGuide, joins JMN with details on a study suggesting that 1 in 3 people can't afford health insurance or associated costs for care, prescriptions, etc. His organization advocates price negotiations, and he has tips for how patients can mitigate costs by using resources other than hospitals for care processes.

Most Americans put health problems wrecking their finances high on the list of things…

Are you one of the many Californians who needs mental healthcare but can't access it due to costs? If you're covered under UMR Insurance, you can get affordable, high-quality care at Mission Connection. Call (866) 833-1822 or visit https://missionconnectionhealthcare.com/umr-insurance/ to learn more. Mission Connection City: San Juan Capistrano Address: 30310 Rancho Viejo Rd. Website: https://missionconnectionhealthcare.com/

In Episode 474 of 'Relentless Health Value', host Stacey Richter interviews Dr. Yashaswini Singh, an economist and assistant professor at Brown University, about the growing influence of private equity (PE) in healthcare.  The conversation delves into the corporate transformation of medicine, highlighting the potential misalignment between business interests and patient care. Dr. Singh discusses the diverse strategies PE firms use to drive profitability, such as increasing negotiated prices, consolidating market share, employing real estate leasebacks, and emphasizing performance metrics that may not align with patient benefits.  The episode also examines the significant impacts these strategies have on physicians, including increased turnover and changes in practice patterns, as well as the broader implications for patients and communities. Dr. Singh stresses the importance of informed leadership, education, policy enforcement, and transparency to ensure that private investments ultimately benefit healthcare systems without compromising patient care. === LINKS ===

The Met Gala is coming up, and so is "The Debt Gala," which parodies celebrity culture and Avant Garde fashion to raise money and awareness about the issues surrounding healthcare costs. Debt Gala co-founder Molly Gaebe and comedian, writer and actor Joyelle Nicole Johnson, who got involved through her own experiences with medical debt, discuss the event, and the issue it's meant to highlight.

Ever wonder how healthcare actually works? What insurance should you actually get? And what even is an HSA? In this week's episode of Networth and Chill, Vivian explores the intersection of healthcare and financial wellbeing. She demystifies HSAs, FSAs, and the hidden costs of insurance plans while offering practical strategies for negotiating medical bills and avoiding debt traps.  Follow the podcast on Instagram and TikTok! Check out the resources mentioned in the episode! https://www.fairhealthconsumer.org/ https://www.costplusdrugs.com/ https://www.goodrx.com/ https://health.amazon.com/ https://www.fighthealthinsurance.com/ Got a financial question you want answered in a future episode? Email us at podcast@yourrichbff.com Thank you to our sponsors: Amazon Learn more about your ad choices. Visit podcastchoices.com/adchoices

In this episode, Tudor and Tim Murtaugh discuss the implications of the Biden pill penalty, a provision in the Inflation Reduction Act that negatively impacts the pharmaceutical industry and healthcare costs. They explore how this legislation discourages the development of cheaper, more effective medications, leading to increased healthcare costs and lost life years. The conversation also touches on the role of China in pharmaceutical development, the unintended consequences of legislation, and the importance of intellectual property laws in protecting creators. The Tudor Dixon Podcast is part of the CLay Travis & Buck Sexton Podcast Network. For more visit TudorDixonPodcast.comSee omnystudio.com/listener for privacy information.

POTUS Folds and You Need to Know Why✅ Subscribe to Jae's Corner on Substack: https://bit.ly/3u8TR8sWe dive into back-to-back tariff reversals in under a week, exposing how Washington's 90-day pause, funding maneuvers, and bond-dollar breakdowns are reshaping global finance. Tune in for the poker-style folding strategy you need—and stick around for cost-control tips on healthcare and retirement. Don't forget to like, subscribe, and follow Jae's Corner!In This Video00:00:00 Fault Framing & Double Reversals00:01:00 90-Day Pause & Tariff Exceptions00:03:00 Tariffs Funding Tax Cuts & Political Control00:06:00 Stocks for Show, Bonds for Dough Explained00:08:00 Bond Market & Dollar Defy Traditional Flows00:11:00 Euro's Big Figure Move: Global Alarm Bell00:16:00 Poker Decision Analogy: Folding Over Fighting00:19:00 Fed's Watchful Restraint Amid Market Tumult00:21:00 Why Elections Can't Solve This Economic Crisis00:30:00 Healthcare Costs & Retirement Realities

This episode of Relentless Health Value features Dr. Kenny Cole from Ochsner Health System. The discussion emphasizes the critical role of trusted relationships and excellent primary care teams in keeping patients out of the emergency room, thus reducing healthcare costs. Stacey Richter revisits this conversation to highlight the importance of care teams building trust with patients and the concept of primary care as an investment in health and wellness. The episode outlines four key points for delivering great primary care, including accountability for outcomes, belief in clinical goals, standardized care flows, and building patient trust. Dr. Cole also discusses the real-world challenges and strategies for achieving clinical and financial success in primary care. The episode serves as a guide for plan sponsors, clinicians, and healthcare executives looking to improve primary care delivery and align it with financial viability. The discussion is further enriched with insights on digitizing care pathways and the importance of measuring and sharing best practices to achieve high standards of care.I Stacey revisits, in a take two, this episode with Dr. Kenny Cole because she's listening to it this time with a new focus. That focus is the theme that keeps coming up over and over and over again on Relentless Health Value these past few months. === LINKS ===

How One Leader Came Out of Retirement to Transform Home Healthcare Jasper Freeman, Director of National Accounts at SC Pharmaceuticals, didn't just return to medical sales—he came back with a mission to change it. In this episode, Jasper shares how he helped launch Ferosix, a revolutionary heart failure treatment designed to keep patients out of the hospital and improve care at home. But that's just the beginning. We dive into: The untold story of Pharmacy Benefit Managers (PBMs) and their massive influence over drug pricing and access Why the insurance-sales-patient triangle is the key battleground in healthcare innovation What the U.S. can learn from other countries about lowering costs and improving care Bold reform ideas—from slashing med school tuition to rethinking drug distribution This is a rare, behind-the-scenes look at the business of healthcare, guided by someone who's lived it at the highest levels. If you're in medical sales—or trying to break in—this episode is a masterclass on what's next and how to lead the change. Connect with Jasper: LinkedIn Connect with Me: LinkedIn Love the show? Subscribe, rate, review, and share! Here's How » Want to connect with past guests and access exclusive Q&As? Join our EYS Skool Community today!

The American healthcare system is complex, but two of the most urgent cost drivers offer places to start exploring possible reforms: prescription drug pricing and how providers are paid. In this episode, we examine the conflicting incentives at the heart of the U.S. healthcare system between insurers, providers, pharmaceutical companies, and patients. These competing priorities shape everything from access to care to drug affordability. Through conversations with healthcare experts, we unpack the role of Pharmacy Benefit Managers (PBMs) and compare fee-for-service and capitated payment models. PBM diagram referred to in the podcast: https://www.healthcarehuddle.com/p/drug-supply-chain. Healthcare policy articles by ScriptsPro CEO and journalist Ken Perez: https://www.hfma.org/author/ken-perez/.

In Episode 472, Stacey Richter speaks with Dr. Eric Bricker about the impactful strategies hospital systems use to maximize revenue from high-cost patients. They explore the financial complexities and contracting tactics that enable hospitals to profit significantly from a small percentage of high-cost claimants. Key points include the negotiation of provider stop-loss contract provisions, strategic adjustment of charge masters, and the intentional steerage of patients to high-revenue service lines. This episode highlights the intricacies of hospital finance and the hidden mechanisms that drive healthcare costs for self-insured employers and other plan sponsors. We could have 0.5% to 1% of total plan members costing upwards of 40% of total plan dollars. And I bring this up just to highlight the magnitude of the money here. In that show from last week, we take the issue of high-cost claimants from the standpoint of the plan sponsor. Today, however, we're gonna be looking at this from the standpoint of the hospital system. If we were to come up with a motto for the show today with Dr. Eric Bricker, it's that all costs are somebody else's revenue. And when it's revenue and profit of the magnitude that we're talking about with many high-cost claimants, it starts to be less of an accidental “Oh, wow! How did that CABG patient wind up in our clinic? What are the odds?” and more of a “Whoever is not steering patients is letting someone else with a big profit incentive lock down that steerage in deeply embedded ways.”  === LINKS ===

CrowdHealth is revolutionizing healthcare by creating a community-funded alternative to traditional insurance, where members pay cash for medical services at significantly lower rates while maintaining high-quality care.KISMETWhile most would assume large insurance companies like UnitedHealthcare (the 7th largest company by revenue globally) would negotiate the best rates, CrowdHealth members are actually securing medical procedures at about 50% of what insurance companies pay - typically around 130-140% of Medicare rates compared to insurance companies' 250-300%.EPISODE SUMMARYIn this compelling interview, Andy Schoonover, founder of CrowdHealth, explains how his company is disrupting traditional healthcare financing. After a personal experience with insurance denying coverage for his daughter's medical procedure, Schoonover discovered that paying cash for healthcare services often costs significantly less than using insurance. CrowdHealth now serves 10,000 members who fund each other's healthcare needs, having processed 20,000 bills over three years. Members typically pay half what traditional insurance costs, without networks or complex paperwork. The company has successfully handled major medical events, including a $1 million emergency that was negotiated down to $200,000. CrowdHealth is also pioneering a new approach to wellness by offering discounts to metabolically healthy members, creating financial incentives for maintaining good health. The community aspect encourages members to make cost-conscious healthcare decisions, as they're helping fellow members rather than faceless insurance companies.Contact info for Andy SchoonoverInvitee Email: andy@joincrowdhealth.comTwitter: https://x.com/JoinCrowdHealthInstagram: @joincrowdhealthWebsite: www.joincrowdhealth.comLinkedIn: CrowdHealthSend Dr. Ovadia a Text Message. (If you want a response, include your contact information.) Dr. Ovadia can not respond here. To contact his team please email team@ifixhearts.com Joburg MeatsKeto/Carnivore-friendly meat snacks. Tasty+Clean. 4 ingredients. Use code “iFixHearts” to save 15%. Chances are, you wouldn't be listening to this podcast if you didn't need to change your life and get healthier. So take action right now. Book a call with Dr. Ovadia's team. One small step in the right direction is all it takes to get started. Stay Off My Operating Table on X: Dr. Ovadia: @iFixHearts Jack Heald: @JackHeald5 Learn more: Stay Off My Operating Table on Amazon Take Dr. Ovadia's metabolic health quiz: iFixHearts Dr. Ovadia's website: Ovadia Heart Health Jack Heald's website: CultYourBrand.com Theme Song : Rage AgainstWritten & Performed by Logan Gritton & Colin Gailey(c) 2016 Mercury Retro RecordingsAny use of this intellectual property for text and data mining or computational analysis including as training material for artificial intelligence systems is strictly prohibited without express written consent from Dr. Philip Ovadia.

Prof. Jon Stone, Dr. Laura Strom, and Meagan Watson discuss functional seizures and healthcare costs related to the functional seizure program at the University of Colorado. Show reference: https://www.neurology.org/doi/10.1212/CPJ.0000000000200393 

Tripp Limehouse discusses the current economic climate, focusing on recession fears and their implications for retirement planning. They emphasize the importance of having a solid financial plan, especially during market volatility. Tripp introduces the Green Line Principle as a safe money strategy to help retirees navigate uncertain times. The conversation also covers risk tolerance, market corrections, and the need for expert guidance in financial planning. The conversation also includes listener questions about qualified charitable distributions and inherited annuities, emphasizing the need for personalized financial advice. Visit Limehouse Financial to learn more. Call 800-940-6979See omnystudio.com/listener for privacy information.

Prof. Jon Stone talks with Dr. Laura Strom and Meagan Watson about changes in total emergency department and inpatient visits and costs before and after referral to a specialized, comprehensive functional seizure treatment clinic. Read the related article with Neurology® Clinical Practice. Disclosures can be found at Neurology.org.   

Can the gender of your surgeon influence your outcome after surgery? New research says yes. In this episode of BackTable Urology, Dr. Christopher J.D. Wallis, a prominent urologic oncologist and health services researcher in Toronto, joins guest host Dr. Casey Seideman for a pivotal conversation at the intersection of surgical outcomes, gender, and health equity. This episode was developed in collaboration with the Society of Women in Urology (SWIU). --- SYNPOSIS Drawing from extensive studies and meta-analyses, Dr. Wallace highlights a significant mortality benefit for patients treated by female surgeons. The episode explores how these findings have sparked discussions on surgeon practices, patient care, and gender equity in medicine. Dr. Wallace also shares personal experiences to underline the importance of diversity and inclusive practices in healthcare. Finally, the two urologists discuss challenges faced when supporting diversity efforts and opportunities for future progress. --- TIMESTAMPS 00:00 - Introduction 04:01 - Personal Experience with Gender Bias in Surgery 07:05 - Groundbreaking Data on Surgeon Sex and Patient Outcomes 12:23 - Long-Term Outcomes and Consistency in Data 14:14 - Hypotheses and Underlying Reasons for Better Outcomes with Female Surgeons 20:18 - Impact on Healthcare Costs and Productivity 26:14 - Challenges and Pushback in the Medical Community 35:05 - Conclusion --- RESOURCES Society of Women in Urology https://swiu.org/home.aspx

"If you know how a PBM gets paid, that's the best transparency you can ask for.” - Julie WassermanJulie Wasserman, VP of Sales for VerusRx, joined me this week to discuss the PBM industry in 2025. If you're a PBM, how do you gain trust with employers and build plans that work for them? We talk about what every PBM should be doing for their employers, what true transparency looks like, how to reach employees directly through software, and how GLP1s are changing the industry.If you're a PBM or work with them, or are just curious about one of the biggest industries in healthcare, make sure to tune in this week to Self-Funded with Spencer to hear from Julie on what the best practices need to look like.Chapters:00:00:00 What The PBM Industry Should Focus On In 2025 | with Julie Wasserman00:15:07 Increasing Employee Engagement00:20:16 Complexity in the PBM Industry00:25:03 Data-Driven Health Savings for Employers00:31:27 What Does True Transparency Look Like00:49:36 Global Drug Price Discrepancies00:56:38 Incentivizing Cost-Effective Healthcare Decisions in PBMs01:01:11 Financial Risks of Covering GLP1s for Weight LossKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/Key Words: VerusRx, PBM, PBMs, Rebate, Rebates, Pharmacy Rebates, Transparency, PBMIndustry, GLP1, GLP1s, Ozempic, Wegovy, pharma, Reference Based Pricing, RBP, Healthcare Costs, julie wasserman, spencer smith, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance#VerusRx #PBM #PBMs #Rebate #Rebates #PharmacyRebates #Transparency #PBMIndustry #GLP1 #GLP1s #Ozempic #Wegovy #pharma #ReferenceBasedPricing #RBP #HealthcareCosts #juliewasserman #spencersmith #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance

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Tripp Limehouse discusses the multifaceted challenges of retirement planning, emphasizing the importance of being proactive about potential risks such as longevity, inflation, and healthcare costs. He highlights the necessity of creating a comprehensive financial plan that includes guaranteed income streams and addresses long-term care needs. The conversation also features listener questions, providing personalized insights into retirement strategies. Visit Limehouse Financial to learn more. Call 800-940-6979See omnystudio.com/listener for privacy information.

Here's my new idea for an episode. Welcome to it. I want to talk about a major theme running through the last few episodes of Relentless Health Value. And this theme is, heads up, going to continue through a few upcoming shows as well. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. We have Matt McQuide coming up, talking about patient engagement, and Christine Hale, MD, MBA, talking about high-cost claimants. And we also have an encore coming up with Kenny Cole, MD, talking about a lot of things; but patient trust is one of them. But before I get to the main theme to ponder here, let me talk about what gets selected to talk about on Relentless Health Value. I will freely admit, how topics for shows get picked, it's not exactly a linear sort of affair. And furthermore, even if it were, I can't always get the stars to align to get a specific cluster of guests to all come on like one after the other. So, for sure, it might be less than obvious at times where my head is at—and sometimes, admittedly, I don't even know. This may sound incredibly scattershot (and it probably is), but in my defense, this whole healthcare thing, in case you didn't know, it's really complicated. Every time I get a chance to chat with an expert, I learn something new. I feel like it's almost impossible to sit in a vacuum and mastermind some kind of grand insight. Very, very fortunately, I don't need to sit in a cave and do all this heavy thinking all by myself. We got ourselves a tribe here of like-minded, really smart folks between the guests and you lot, all of you in the tribe of listeners who are here every week. Yeah, you rock! And I can always count on you to start teasing out the themes and the through lines and the really key actionable points. You email me. You write great posts and comments on LinkedIn and elsewhere. Even if I am a little bit behind the eight ball translating my instinct into an actual trend line, it doesn't slow this bus down. It's you who keeps it moving, which is why I can confidently say it's you all who are to blame for this new idea I came up with the other day after the podcast with Al Lewis (EP464) triggered so much amazing and really deep insight and dot connecting back and forth that hooked together the past six, I'm gonna say, or so shows. Let's just start at the beginning. Let's start with the topics that have been discussed in the past several episodes of the pod. Here I go. Emergency room visits are now costing about 6% of total plan sponsor spend on average. That was the holy crap moment from the episode with Al Lewis (EP464). Emergency room volume is up, and also prices are up. In that show with Al Lewis, I did quote John Lee, MD, who is an emergency room doctor, by the way. I quoted him because he told a story about a patient who came into the ER, winds up getting a big workup in his ER. Dr. Lee says he sees this situation a lot where the patient comes in, they've had something going on for a while, they've tried to make an appointment with their PCP or even urgent care, they could not get in. It's also really hard to coordinate and get all the blood work or the scans and have that all looked at that's needed for the workup to even happen. I've spoken with multiple ER doctors at this point, and they all say pretty much the same thing. They see the same scenario happen often enough, maybe even multiple times a day. Patient comes in with something that may or may not be emergent, and they are now in the ER because they've been worried about it for weeks or months. And the ER is like the only place where they can get to the bottom of what is going on with their body. And then the patient, you know, they spend the whole day in the ER getting what amounts to weeks' worth of outpatient workup accomplished and scans and imaging and labs. And there's no prior authing anything down. It's also incredibly expensive. Moving on from the Al Lewis show, earlier than that I had had on Rushika Fernandopulle, MD (EP460) and then also Scott Conard, MD (EP462). Both are PCPs, both talking about primary care and what makes good primary care and what makes bad primary care and how our current “healthcare marketplace,” as Dr. Conard puts it, incentivizes either no primary care and/or primary care where volume driven throughput is the name of the game—you know, like seeing 25 patients a day. These visits or episodes of care are often pretty transactional. If relationships are formed, it's because the doctor and/or the patient are rising above the system, not the other way around. And none of that is good for primary care doctors, nurses, or other clinicians. It's also not good for patients, and it's not good for plan sponsors or any of the ultimate purchasers here (taxpayers, patients themselves) because while all of this is going on, those patients getting no or not good primary care are somebody's next high-cost claimant. Okay, so those were the shows with Rushika Fernandopulle and Scott Conard. Then this past week was the show with Vivian Ho, PhD (EP466), who discusses the incentives that hospital leadership often has. And these incentives may actually sound great on paper, but IRL, they wind up actually jacking up prices and set up some weird incentives to increase the number of beds and the heads in them. There was also two shows, one of them with Betsy Seals (EP463) and then another one with Wendell Potter (EP384), about Medicare Advantage and what payers are up to. Alright, so let's dig in. What's the big theme? What's the big through line here? Let's take it from the top. Theme 1 is largely this (and Scott Conard actually said this flat out in his show): Primary care—good primary care, I mean—is an investment. Everything else is a cost. And those skyrocketing ER costs are pure evidence of this. Again, listen to that show with Al Lewis earlier (EP464) for a lot of details about this. But total plan costs … 6% are ER visits. Tim Denman from Premise Health wrote, “That is an insane number! Anything over 2% warrants concern.” But yeah, these days we have, on average across the country, 200 plan members out of 1000 every single year dipping into their local ER. That number, by the way, will rise and fall depending on the access and availability of primary care and/or good urgent cares. Here's from a Web site entitled ER Visit Statistics, Facts & Trends: “In the United States, emergency room visits often highlight gaps in healthcare accessibility. Many individuals turn to ERs for conditions that could have been managed through preventative or primary care. … This indicates that inadequate access to healthcare often leads to increased reliance on emergency departments. … “ED visits can entail significant costs, particularly when a considerable portion of these visits is classified as non-urgent. … [Non-urgent] visits—not requiring immediate medical intervention—often lead to unnecessary expenditures that could be better allocated in primary care settings.” And by the way, if you look at the total cost across the country of ER visits, it's billions and billions and billions of dollars. In 2017, ED visits (I don't have a stat right in front of me), but in 2017, ED visits were $76.3 billion in the United States. Alright, so, the Al Lewis show comes out, I see that, and then, like a bolt of lightning, François de Brantes, MBA, enters the chat. François de Brantes was on Relentless Health Value several years ago (EP220). I should have him come back on. But François de Brantes cemented with mortar the connectivity between runaway ER costs and the lack of primary care. He started out talking actually about a new study from the Milbank Memorial Fund. Only like 5% of our spend going to primary care is way lower than any other developed country in the world—all of whom, of course, have far higher life expectancies than us. So, yeah … they might be onto something. François de Brantes wrote (with some light editing), “Setting aside the impotence of policies, the real question we should ask ourselves is whether we're looking at the right numbers. The short answer is no, with all due respect to the researchers that crunched the numbers. That's probably because the lens they're using is incredibly narrow and misses everything else.” And he's talking now about, is that 5% primary care number actually accurate? François de Brantes continues, “Consider, for example, that in commercially insured plans, the total spend on … EDs is 6% or more.” And then he says, “Check out Stacey Richter's podcast on the subject, but 6% is essentially what researchers say is spent on, you know, ‘primary care.' Except … they don't count those costs, the ER costs. They don't count many other costs that are for primary care, meaning for the treatment of routine preventative and sick care, all the things that family practices used to manage but don't anymore. They don't count them because those services are rendered by clinicians other than those in primary care practice.” François concludes (and he wrote a great article) that if you add up all the dollars that are spent on things that amount to primary care but just didn't happen in a primary care office, it's conservatively around 17% of total dollars. So, yeah … it's not like anyone is saving money by not making sure that every plan member or patient across the country has a relationship with an actual primary care team—you know, a doctor or a nurse who they can get on the phone with who knows them. Listen to the show coming up with Matt McQuide. This theme will continue. But any plan not making sure that primary care happens in primary care offices is shelling out for the most expensive primary care money can buy, you know, because it's gonna happen either in the ER or elsewhere. Jeff Charles Goldsmith, PhD, put this really well. He wrote, “As others have said, [this surge in ER dollars is a] direct consequence of [a] worsening primary care shortage.” Then Dr. John Lee turned up. He, I had quoted on the Al Lewis show, but he wrote a great post on LinkedIn; and part of it was this: “Toward a systemic solution, [we gotta do some unsqueezing of the balloon]. Stacey and Al likened our system to a squeezed balloon, with pressure forcing patients into the [emergency room]. The true solution is to ‘unsqueeze' the system by improving access to care outside the [emergency room]. Addressing these upstream issues could prevent patients from ending up in the [emergency room]. … While the necessary changes are staring us in the face, unsqueezing the balloon is far more challenging than it sounds.” And speaking of ER docs weighing in, then we had Mick Connors, MD, who left a banger of a comment with a bunch of suggestions to untangle some of these challenges that are more challenging than they may sound at first glance that Dr. Lee mentions. And as I said, he's a 30-year pediatric emergency physician, so I'm inclined to take his suggestions seriously. You can find them on LinkedIn. But yeah, I can see why some communities are paying 40 bucks a month or something for patients without access to primary care to get it just like they pay fire departments or police departments. Here's a link to Primary Care for All Americans, who are trying to help local communities get their citizens primary care. And Dr. Conard talked about this a little bit in that episode (EP462). I can also see why plan sponsors have every incentive to change the incentives such that primary care teams can be all in on doing what they do. Dr. Fernandopulle (EP460) hits on this. This is truly vital, making sure that the incentives are right, because we can't forget, as Rob Andrews has said repeatedly, organizations do what you pay them to do. And unless a plan sponsor gets into the mix, it is super rare to encounter anybody paying anybody for amazing primary care in an actual primary care setting. At that point, Alex Sommers, MD, ABEM, DipABLM, arrived on the scene; and he wrote (again with light editing—sorry, I can't read), “This one is in my wheelhouse. There is a ton that could be done here. There just has to be strategy in any given market. It's a function of access, resources, and like-minded employers willing to invest in a direct relationship with providers. But not just any providers. Providers who are willing to solve a big X in this case. You certainly don't need a trauma team on standby to remove a splinter or take off a wart. A great advanced primary care relationship is one way, but another thing is just access to care off-hours with the resources to make a difference in a cost-plus model. You can't help everybody at once. But you can help a lot of people if there is a collaborative opportunity.” And then Dr. Alex Sommers continues. He says, “We already have EKG, most procedures and supplies, X-ray, ultrasounds, and MRI in our clinics. All that's missing is a CT scanner. It just takes a feasible critical mass to invest in a given geography for that type of alternative care model to alter the course here. Six percent of plan spend going to the ER. My goodness.” So, then we have Ann Lewandowski, who just gets to the heart of the matter and the rate critical for primary care to become the investment that it could be: trust. Ann Lewandowski says, “I 100% agree with all of this, basically. I think strong primary care that promotes trust before things get so bad people think they need to go to the emergency room is the way to go.” This whole human concept of trust is a gigantic requirement for clinical and probably financial success. We need primary care to be an investment, but for it to be an investment, there's got to be relationships and there has to be trust between patients and their care teams. Now, neither relationships nor trust are super measurable constructs, so it's really easy for some finance pro to do things in the name of efficiency or optimization that undermine the entire spirit of the endeavor without even realizing it. Then we have a lot of primary care that doesn't happen in primary care offices. It happens in care settings like the ER. So, let's tug this theme along to the shows that concern carriers, meaning the shows with Wendell Potter (EP384) on how shareholders influence carrier behavior and with Betsy Seals (EP463) on Medicare Advantage plans and what they're up to. Here's where the primary care/ER through line starts to connect to carriers. Here's a LinkedIn post by the indomitable Steve Schutzer, MD. Dr. Schutzer wrote about the Betsy Seals conversation, and he said, “Stacey, you made a comment during this fabulous episode with Betsy that I really believe should be amplified from North to South, coast to coast—something that unfortunately is not top of mind for many in this industry. And that was ‘focus on the value that accrues to the patient'—period, end of story. That is the north star of the [value-based care] movement, lest we forget. Financial outcome measures are important in the value equation, but the numerator must be about the patient. As always, grateful for your insights and ongoing leadership.” Oh, thank you so much. And same to you. Grateful for yours. Betsy Seals in that podcast, though, she reminded carrier listeners about this “think about the value accruing to the patient” in that episode. And in the Wendell Potter encore that came out right before the show with Betsy, yeah, what Wendell said kind of made me realize why Betsy felt it important to remind carriers to think about the value accruing to patients. Wall Street rewards profit maximization in the short term. It does not reward value accruing to the patient. However—and here's me agreeing with Dr. Steve Schutzer, because I think this is what underlies his comment—if what we're doing gets so far removed from what is of value to the patient, then yeah, we're getting so removed from the human beings we're allegedly serving, that smart people can make smart decisions in theoretical model world. But what's being done lacks a fundamental grounding in actual reality. And that's dangerous for plan members, but it's also pretty treacherous from a business and legal perspective, as I think we're seeing here. Okay, so back to our theme of broken primary care and accelerating ER costs. Are carriers getting in there and putting a stop to it? I mean, as aforementioned about 8 to 10 times, if you have a broken primary care system, you're gonna pay for primary care, alright. It's just gonna be in really expensive care settings. You gotta figure carriers are wise to this and they're the ones that are supposed to be keeping healthcare costs under control for all America. Well, relative to keeping ER costs under control, here's a link to a study Vivian Ho, PhD, sent from Health Affairs showing how much ER prices have gone up. ER prices are way higher than they used to be. So, you'd think that carriers would have a huge incentive to get members primary care and do lots and lots of things to ensure that not only would members have access to primary care, but it'd be amazing primary care with doctors and nurses that were trusted and relationships that would be built. It'd be salad days for value. Except … they're not doing a whole lot at any scale that I could find. We have Iora and ChenMed and a few others aside. These are advanced primary care groups that are deployed by carriers, and these organizations can do great things. But I also think they serve—and this came up in the Dr. Fernandopulle show (EP460)—they serve like 1% of overall patient populations. Dr. Fernandopulle talked about this in the context of why these advanced primary care disruptors may have great impact on individual patients but they have very little overall impact at a national scale. They're just not scaled, and they're not nationwide. But why not? I mean, why aren't carriers all over this stuff? Well, first of all—and again, kind of like back to the Wendell show (EP384) now—if we're thinking short term, as a carrier, like Wall Street encourages, you know, quarter by quarter, and if only the outlier, mission-driven folks (the knights) in any given carrier organization are checking what's going on actually with plans, members, and patients like Betsy advised, keep in mind it's a whole lot cheaper and it's easier to just deny care. And you can do that at scale if you get yourself an AI engine and press Go. Or you can come up with, I don't know, exciting new ways to maximize your risk adjustment and upcoding. There's an article that was written by Sergei Polevikov, ABD, MBA, MS, MA

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter In this quarterly podcast summary (QPS) episode, Peter summarizes his biggest takeaways from the last three months of guest interviews on the podcast. Peter shares key insights from his discussions on diverse topics such as aerobic efficiency and VO2 max with Olav Aleksander Bu; insulin resistance with Ralph DeFronzo; economics of the US healthcare system and cost-saving strategies with Saum Sutaria; diagnosis and treatment of autism, ADHD, and anxiety in children with Trenna Sutcliffe; and strength training with Mike Israetel. Additionally, Peter shares any personal behavioral adjustments or modifications to his patient care practices that have arisen from these fascinating discussions. If you're not a subscriber and are listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your private RSS feed or our website at the episode #338 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: Overview of topics to be discussed [2:00]; Olav Aleksander Bu Pt.2 episode: metrics to track aerobic efficiency and insights about VO2 max, and the ability of increased carbohydrate consumption to boost performance [4:30]; The best practices for performing a VO2 max test, the differences between VO2 max training and all-out efforts, and the role of energy intake in endurance performance [14:45]; Ralph DeFronzo episode: the pathophysiology of insulin resistance and type 2 diabetes—how they impact different organs, flaws in conventional diabetes treatment, and more [24:30]; Understanding type 2 diabetes beyond the traditional triumvirate of features: the “ominous octet” describes changes in other organs [31:45]; Pharmacological treatments for insulin resistance and type 2 diabetes [41:30]; The importance of early detection and intervention in insulin resistance [50:30]; Saum Sutaria episode: the economic and systemic drivers of high healthcare costs in the U.S. [54:00]; Reducing health care costs: redefining health insurance, lowering drug prices while maintaining innovation, leveraging AI for efficiency, and more [1:07:15]; Trenna Sutcliffe episode: insights on autism, ADHD, and anxiety in children—definitions and diagnosis [1:11:45]; Exploring the rising prevalence of autism spectrum disorder [1:17:15]; Trenna's views on caring for children with autism [1:21:15]; Misconceptions around vaccines and autism [1:26:00]; Mike Israetel episode: insights about strength training, minimum effective dose, troubleshooting plateaus, tips for beginners, and more [1:28:15]; Topics Peter is interested in exploring in future podcasts [1:40:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube