Relentless Health Value
Stacey Richter
Welcome to Relentless Health Value, the podcast for those working in the belly of the beast to fix our fundamentally broken healthcare system. If you are a self-insured employer, plan sponsor, benefits consultant, clinician, a C-suite executive or anyone in the business of healthcare tired of the "transformational theater" and marketing fluff, you have found your tribe.
The U.S. healthcare system isn't a rational market; it's a game of Pachinko where perverse incentives reign, and as we always say, where there's mystery, there's margin.
Hosted by Stacey Richter, we relentlessly hunt down the administrative "inches" of waste and expose the hidden fees draining the $5.6 trillion healthcare sector. We transform wonky healthcare theory into ruthlessly practical, actionable insights.
Whether it's demanding radical transparency, navigating complex PBM contracts, or buying actual healthcare instead of illusory discounts, our mandate is simple: If it results in a net positive for patients, we do it. Join the Relentless Health Value Tribe to equip yourself with the fiduciary armor needed to outwit the status quo, demand accountability, and drive real change.
The U.S. healthcare system isn't a rational market; it's a game of Pachinko where perverse incentives reign, and as we always say, where there's mystery, there's margin.
Hosted by Stacey Richter, we relentlessly hunt down the administrative "inches" of waste and expose the hidden fees draining the $5.6 trillion healthcare sector. We transform wonky healthcare theory into ruthlessly practical, actionable insights.
Whether it's demanding radical transparency, navigating complex PBM contracts, or buying actual healthcare instead of illusory discounts, our mandate is simple: If it results in a net positive for patients, we do it. Join the Relentless Health Value Tribe to equip yourself with the fiduciary armor needed to outwit the status quo, demand accountability, and drive real change.
Episodes
Mentioned books
Oct 21, 2026 • 9min
The One Question to Test if a TPA Is Actually Independent, With Kimberly Carleson
Kimberly Carleson, CEO of US Beacon and a healthcare executive and patient advocate, explores how plan sponsors can test a TPA’s true independence. They discuss independent claims audits, access to billed, allowed, and paid data, network conflicts, restrictive contract language, and why labels like “transparent” and “independent” require serious due diligence.
7 snips
Oct 14, 2026 • 37min
Level Funding Is Self-funding: 5 Avoidable Contract Risks, With Frank Pennachio
Frank Pennachio, a longtime health insurance professional and self-funding advisor, examines why level-funded plans are gaining traction amid soaring premiums. He explains the risks hidden in administrative and stop-loss contracts, from ERISA exposure and uncovered claims to disappearing surplus dollars. They also explore claims-data ownership, vendor fees, legal review, and how employers can evaluate competing models without mistaking predictable payments for safety.
10 snips
Oct 7, 2026 • 37min
Why Avoidable ER Visits Aren't the Real Cost Problem: Revisiting Our Interview With HHS Nominee Chris Klomp
Chris Klomp, a healthcare executive and policy leader, revisits his work advancing coordinated, value-based care. He explores why avoidable ER visits are only a small piece of the cost puzzle, how emergency departments reveal complex unmet needs, and the role of real-time data, shared care plans, risk analytics, and community collaboration. Social determinants and whole-person strategies take center stage.
16 snips
Sep 30, 2026 • 38min
Slaying the Three-Headed Monster of Health Plan Networks, With Evan Anderson
Evan Anderson, a healthcare strategist at Handle Health, unpacks the “three-headed monster” lurking in traditional health plan networks. They explore discount illusions, opaque contracts, payment-integrity gaps, outdated systems, and wild site-of-care price variation. The conversation also covers claims-based network evaluation, direct contracting, centers of excellence, smarter tiering, bundled care plans, and the broker’s evolving role.
6 snips
Sep 23, 2026 • 38min
A Wildly Underappreciated Point: Overpaying for Infusions Means Overpaying for Stop-Loss Coverage, With Jake Velie and Keith Hartman, RPh
Jake Velie, a healthcare executive and consultant with health plan expertise, joins pharmacist Keith Hartman to unpack the hidden costs of infusion care. They explore opaque J- and Q-codes, site-of-care decisions, and how overpaying can drive stop-loss premiums, lasering, and lost access to self-funding. They also discuss clinical oversight, member incentives, and proactive intervention.
16 snips
Sep 16, 2026 • 39min
How Stark Law, Stipends, and Noncompetes Drive Hospital Consolidation, With Eric Bricker, MD
Eric Bricker, MD, is an internal medicine physician, healthcare finance educator, and founder of AHealthcareZ. He traces how site-unneutral payments, Stark Law, hospital stipends, and noncompetes fuel consolidation, rising costs, and physician burnout. The conversation explores employer leverage, site-neutral reform, direct contracting, subscription care, and the future of value-based payment.
16 snips
Sep 9, 2026 • 39min
Private Equity in Primary Care: What the Data Actually Shows, With Yashaswini Singh, PhD. Episode 528.
Yashaswini Singh, a Brown University health economist, studies private equity and healthcare ownership. She explores whether new capital can strengthen primary care or fuel higher prices and conflicted referrals. The conversation examines team-based care, clinician judgment, opaque ownership, physician turnover, continuity, and whether independent, hospital, insurer-affiliated, or private-equity models offer the best path forward.
16 snips
Aug 26, 2026 • 20min
Mark Cuban and Cora Opsahl: The Truth About Pass-Through PBM Contracts and Generic Compliance Ratios
Cora Opsahl, a jumbo plan sponsor negotiator who reads PBM fine print, and Mark Cuban, entrepreneur building a transparent drug-pricing alternative, dig into pharmacy plumbing. They trace how wholesalers and PBM rules inflate prices. They unpack generic compliance ratios, pass-through vs billed math, pharmacy margins, RFP pitfalls, audits, and data access.
6 snips
Aug 19, 2026 • 17min
PMPM vs FFS—The Perverse Incentives Plan Sponsors Sometimes Miss, With Cristin Dickerson, MD
Cristin Dickerson, physician and founding partner of Green Imaging, explains physician-led direct contracting for imaging. She and Stacey debate PMPM subscriptions versus fee-for-service. They unpack who bears risk, the float from upfront premiums, and practical ways plan sponsors can buy defined pods of care. They also cover contract flexibility, accountability, and three factors for choosing a payment model.
14 snips
Aug 12, 2026 • 17min
Beating Provider Network Pricing Games by Thinking About Buying Healthcare Like a Manufacturer Supply Chain, With John Quinn
John Quinn, CEO of Wellnicity, builds health plan management for self-funded employers and champions buying care like a manufacturing supply chain. He describes breaking care into predictable sub-assemblies or pods and using targeted direct contracts. Conversation covers how to define pod boundaries, price them realistically, and pair broad networks with focused, digitized contracts.
