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Relentless Health Value

Relentless Health Value

Von: Stacey Richter
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 American Healthcare Entrepreneurs and Execs you might want to know. Talking. Relentless Health Value is a weekly interview podcast hosted by Stacey Richter, a healthcare entrepreneur celebrating fifteen years in the business side of healthcare. This show is for leaders in pharma, devices, payers, providers, patient advocacy and healthcare business. It's for health industry innovators, entrepreneurs or wantrepreneurs or intrapreneurs. Relentless Healthcare Value is the show for you if you want to connect with others trying to manage the triple play: to provide healthcare value while being personally and professionally fulfilled.©BD Bridges LLC, All Rights Reserved. Hygiene & gesundes Leben Politik & Regierungen
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  • Take Two: EP398: Why Are Commercial Carrier Marketplaces Completely Boring? Maybe Because There Isn't a Marketplace, With Jacob Asher, MD

    Take Two: EP398: Why Are Commercial Carrier Marketplaces Completely Boring? Maybe Because There Isn't a Marketplace, With Jacob Asher, MD
    Feb 19 2026
    We have been doing a little series called "The Inches Are All Around Us," digging out waste in the $5.6 trillion healthcare sector where half an inch of waste can equal billions of dollars. I'm going to right now introduce another series that is complementary but has a slightly different focus. And we will toggle kind of back and forth between these two series coming up here for a bit. 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. I'm gonna call this other series our "No Market" series, as in, in general, there is no healthcare market; and that is material because anyone who is relying on a market and the invisible hand or any principle of capitalism, frankly, to constrain costs or raise quality … yeah, bad strategy. Or what did Julia Roberts tell the shopkeeper ladies in Pretty Woman? How'd she put it? "Big mistake. Big. Huge." Do not rely on a market to keep vendors in line when there is no market. Whatever you accomplish, you gotta do it yourself. But the results are there for those who pick up the baton. There's just so many success stories, so many examples of how someone cut 15% of costs and actually raised quality for their health plan members. There's so many examples of that. So, yeah, it's just one of these areas where if you don't actively not get taken advantage of, you will actively get taken advantage of. Don't kill the messenger. So, I'm doing a Take Two of the show with Jacob Asher, MD, about why the carrier market—now he's talking specifically about California, but this is not limited to California—just why the carrier market is so boring, why it never changes. It's completely stagnant. And I'm doing this—resurfacing the show from three years ago—because it is both a great follow-on and also a great prelude for episodes past and future, and also, three years later, it's still completely boring. Nothing has changed. Giant spoiler alert. But the reason the carrier market is so boring sort of fundamentally is, again, because there is no market here. What I mean is no one is competing on the strength and quality and affordability of their provider network. And while there is an obvious fetish for discounts, as has been discussed deeply in many shows but most thoroughly maybe in that episode with Jonathan Baran (EP483) about flywheels, discounts do not automatically equal lower prices. In fact, discounts plus gamed shared savings goings-on often equate to perversely higher prices paid, irrespective of what the contract says. In short, no market. Now look (and this is exciting), there are some new TPAs (third-party administrators) inching into the market, but if I'm just talking in general, this no market business is devastatingly material. Elizabeth Mitchell talked at length about this in the episode that I reprised recently (EP436). It's called "Let's Talk About TPA and Health Plan Inertia Instead of Jumbo Employer Inertia." So again, that was with Elizabeth Mitchell from the PBGH (Purchaser Business Group on Health). It was a really popular show. So, if you haven't listened to that, go back and do so. So, yeah, while the commercial payer/commercial carrier marketplace is completely boring because there is, in fact, no market to spice it up with any action whatsoever, the reasons it's boring and there's no market are, frankly, not boring. So, let me walk you through this conversation that follows with Jacob Asher, MD. First, we establish that the relative number of each carrier's commercial members in California specifically doesn't seem to change year over year. And this has been true for years, and it's still pretty much true. When you rank order carriers by member count, the song remains the same. It is Groundhog Day. Then Dr. Asher and I dissect what anybody's actually doing to cut into Kaiser's market share or try to grab share from the two big Blues plans, if anything, these three being the biggest plans going. Why did I ask Dr. Jacob Asher to participate in this particular conversation? It was because he was a full-time health plan chief medical officer for, first, Anthem, then Blue Cross, then Cigna, then UHC (UnitedHealthcare). Now he's retired and kind of reflecting back on unsolved and unaddressed issues within healthcare, such as, why is the commercial marketplace as boring as it appears to be? After I had this conversation with Dr. Asher, I did a little reconnaissance, a little reconnoitering, meaning, I called up Wendell Potter—who everybody probably already knows, but if not, listen to episode 384—and I also called up Lauren Vela from episode 406. And I learned a few things from the two of them that really helped me frame my thoughts on some of the issues that surfaced in the conversation that I had had at that point with Dr. Asher. So, why doesn't the relative market share of the biggest payers change year over year over year in the ...
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    35 Min.
  • EP500: This Is Episode 500, and It's All About You, Tribe

    EP500: This Is Episode 500, and It's All About You, Tribe
    Feb 12 2026

    In the milestone Episode 500 of the 'Relentless Health Value' podcast, Stacey Richter reflects on the significant influence and community formed around the platform. Initiated by a conversation with Cora Opsahl, the episode transforms into a heartfelt ode to the listeners — healthcare entrepreneurs, executives, and change-makers, whom Stacey refers to as 'the tribe.'

    Featured contributions from several listeners highlight themes such as moving from theory to practical transformation, the power of collective momentum, and 'unplugging from the Matrix' of opaque healthcare practices.

    Notable testimonials underline how the podcast has guided real-world decisions, fostered community connections, and provided actionable insights that have tangibly influenced the healthcare sector. The episode concludes with gratitude for the tribe's effort toward transforming the healthcare system and a forward-looking encouragement to remain relentless in their mission.

    === LINKS ===
    🔗 Show Notes with all mentioned links:
    https://cc-lnk.com/EP500

    ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter:
    https://relentlesshealthvalue.com/join-the-relentless-tribe

    🫙 Support the podcast with a small donation to the Tip Jar:
    https://relentlesshealthvalue.com/join-the-relentless-tribe

    🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1

    🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b

    📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue

    === CONNECT WITH THE RHV TEAM ===
    ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/
    ✭ Threads https://www.threads.net/@relentlesshealthvalue/
    ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social
    ✭ X https://twitter.com/relentleshealth/

    00:00 Introduction and episode 500 announcement.
    00:22 The origin of episode 500.
    01:49 The LinkedIn post and its impact.
    02:43 Celebrating the Relentless Health Tribe.
    07:55 Clip from Michelle Bernabe and how EP373 gave her a framework to model off of and understand that the failures in healthcare weren't personal failures.
    10:08 Theme 1: Moving From Theory to Practical Transformation.
    10:38 Clip from Ken Wosczyna and the episodes that have led to consistently good decisions in his work.
    11:27 The Tipping Point by Malcolm Gladwell.
    12:55 Examples of tribe members changing and improving their corner of healthcare after being inspired by RHV episodes.
    13:54 Clip from Mark Weber.
    14:54 Clip from Alex Sommers, MD, and how EP391 and EP462 changed his work
    16:13 Clip from John Lee, MD, and how RHV helped him realize that "gaming the system" can also be used for good.
    18:42 Theme 2: The Power of the Tribe and Collective Momentum.
    19:28 Clip from Justin Leader.
    21:45 Why being a "good villager" is so important to the overall outcome of healthcare.
    23:22 Clip from Cristin Dickerson, MD, and how she draws inspiration from various RHV episodes.
    25:21 Clip from Andrew Gordon.
    27:39 Theme 3: Unplugging From the Matrix of Healthcare Opacity.
    28:32 Clip from Andrew Tsang.
    29:29 RHV episodes that cover better value out of health benefits.
    32:15 Clip from Sergei Polevikov.
    34:11 What tech needs to do in order for healthcare to succeed and improve.
    35:06 Clip from Bryce Platt, PharmD.
    36:01 More RHV episodes on unplugging from pricing opacity.
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    38 Min.
  • EP499: Self-insured Employers and Other Plan Sponsors Are Paying Millions for MSK (Musculoskeletal) Injuries That Would Have Healed Themselves, With Jay Kimmel, MD

    EP499: Self-insured Employers and Other Plan Sponsors Are Paying Millions for MSK (Musculoskeletal) Injuries That Would Have Healed Themselves, With Jay Kimmel, MD
    Feb 5 2026

    In this episode of Relentless Health Value, host Stacey Richter talks with Dr. Jay Kimmel, an orthopedic surgeon and co-founder of Upswing Health, about the significant costs associated with musculoskeletal (MSK) injuries and conditions for self-insured employers and other plan sponsors.

    They explore how a large portion of MSK-related expenses are for low-acuity injuries that often heal on their own without the need for emergency room visits or unnecessary treatments. Dr. Kimmel discusses the importance of addressing the 'white space'—the critical initial moments when a patient decides whether or not to seek emergency care.

    He emphasizes the value of immediate access to knowledgeable professionals to help guide these decisions and prevent avoidable high-cost care. They also touch on historical practices where physicians would consult each other informally, suggesting that modern solutions like Upswing Health can replicate those beneficial spontaneous interactions to improve patient care and reduce costs.

    === LINKS ===
    🔗 Show Notes with all mentioned links:
    https://cc-lnk.com/EP499

    🔗 Visit Upswing Health:
    https://upswinghealth.com

    ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter:
    https://relentlesshealthvalue.com/join-the-relentless-tribe

    🫙 Support the podcast with a small donation to the Tip Jar:
    https://relentlesshealthvalue.com/join-the-relentless-tribe

    🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1

    🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b

    📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue


    === CONNECT WITH THE RHV TEAM ===
    ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/
    ✭ Threads https://www.threads.net/@relentlesshealthvalue/
    ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social
    ✭ X https://twitter.com/relentleshealth/

    07:49 EP472 with Eric Bricker, MD, on high-cost claimants.

    08:01 What is the "white space" in MSK spend?

    10:43 Statistics on Connecticut's spending on plan members with low-acuity MSK injuries.

    13:30 How back pain also easily transitions from a low-acuity issue to a high-acuity problem.

    15:11 How plan sponsors can detect their white space downstream spend.

    16:58 EP464 with Al Lewis.

    17:02 EP470 with Nikki King, DHA.

    18:15 Why where patients start their journey often dictates where they wind up and how costly that medical pathway is.

    20:48 Where PCPs fit into this MSK spend issue.

    25:26 EP468 with Matt McQuide.

    25:34 EP471 with Christine Hale, MD, MBA.

    25:39 Why access is key.
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    28 Min.
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