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Aug 11, 2022

Members taking specialty drugs represent about 2% of any given employer’s population but often consume as much as 30% of an employer’s total cost of care. As Pramod John, PhD, in EP353 has said, this isn’t just small companies we’re talking about here. Some of the largest employers in the US are dropping big...


Aug 4, 2022

Interoperability. Let’s just review a few key points that probably everybody listening knows but certainly bear repeating because they matter.

I don’t want to dig into the technical or regulatory details of interoperability. That is above my pay grade. But I want to talk about the really important stuff that maybe...


Jul 28, 2022

Medicare Advantage (MA), otherwise known as the “money machine,” is often the most profitable parts of many payers’ business lines. Medicare Advantage plans can make a lot of cash if they are good at what they do. Look at any of these large, consolidated carriers’ financial statements to get the magnitude of...


Jul 21, 2022

So, let’s put the last, I don’t know, 300 episodes of Relentless Health Value into perspective here. The USA wastes about $1.5 trillion a year on some combination of paying way too much for low-value care, fraud, and waste—$1.5 trillion down the drain. As my guest, Dave Chase, says in this healthcare podcast, if...


Jul 14, 2022

In this healthcare podcast, I am speaking with Cora Opsahl, who directs the 32BJ Health Fund. This is the second conversation I’m having with Cora (last one was EP372), but these two conversations are not really linear—so listen in whatever order you want to.  

Important to know about Cora’s background, in...