Direct Contracting as a Solution for Self‑Insured Employers

Stacey Richter is joined by Mark Cuban, CEO and founder of Mark Cuban Cost Plus Drugs, and Cora Opsahl, Health Fund Director of the 32BJ Health Fund, to discuss pressing issues in American healthcare.

The conversation centers on the inefficiencies and complexities created by high deductible health plans and the layers of vendors self-insured employers hire to manage healthcare claims. Mark Cuban and Cora Opsahl advocate for direct contracting and increased transparency as solutions to reduce costs and improve outcomes.

They also explore the potential of simplifying the system back to a more straightforward model where healthcare prices are transparent, and patients and providers can establish trust. This episode emphasizes the importance of leadership and a proactive approach in managing healthcare costs.

If you are listening to this prior to October 9, 2025, go to the 32BJ Changing the Playbook on Hospital Prices event, where Mark Cuban will be keynoting. Cora Opsahl will also be speaking, and I will be there listening. https://32bjhealthinsights.org/2025-events/

=== LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP488 🔗 Healthcare Industry Acronyms and Terms https://relentlesshealthvalue.com/healthcare-acronymns

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06:25 What was the original rationale behind high deductibles?

07:38 How high deductibles are creating a class of functionally uninsured people.

09:29 EP482 with Preston Alexander.

10:20 "We're using health insurance as a proxy for healthcare." —Mark

12:30 How providers are now in the debt collecting business rather than the healthcare business.

12:55 EP486 with Stan Schwartz, MD.

15:16 "We have a fundamental reasonability problem." —Cora

16:07 EP425 with Marshall Allen.

18:25 Direct contracting versus self-funded employers.

19:27 EP436 with Elizabeth Mitchell.

19:30 EP480 with Kimberly Carleson.

19:33 EP372 with Cora Opsahl.

23:53 Why the current system doesn't allow the accountability that is needed.

24:39 EP452 with Cora Opsahl.

26:34 How direct contracting gives strength back to independent practices that high deductible plans take away.

27:46 Who pays, what's the price, and where does the power lie?

31:24 EP419 with Andreas Mang.

34:45 How it comes down to power and leverage when controlling healthcare costs.

38:13 EP483 (Part 1 and Part 2) with Jonathan Baran.

38:35 Why putting together a network and just buying healthcare—not discounts—is not as difficult as it seems.

40:10 Why we need to stop talking about disruption and start talking about change.

40:56 EP453 with Claire Brockbank.

41:02 EP484 with Dave Chase.

43:07 EP485 with Cristin Dickerson, MD.

44:32 EP487 (Part 1) with Kevin Lyons.

46:34 EP466 with Vivian Ho, PhD.

47:40 Why it's the incentives that are different between American hospitals and hospitals in a single-payer program.

50:25 The main takeaways from the conversation.

51:08 Why you can't fix the problems in healthcare without transparency.