Relentless Health Value

In this encore episode of 'Relentlessly Seeking Value,' host Stacey Richter revisits an inspiring conversation with Marilyn Bartlett, a CPA who transformed the State of Montana's employee health plan from a $9 million deficit to a $112 million surplus within three years. Known for her fiscal discipline and patient-first approach, Marilyn shares her strategic steps, from identifying waste in the system and securing quick wins to negotiating better deals with hospitals and ensuring long-term success. She emphasizes the importance of assembling a strong team, maintaining transparency, and staying focused on the ultimate goal of creating real health value. This episode is a must-listen for anyone looking to drive meaningful change in the healthcare industry. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EncoreEP450 ✉️ 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/ 07:09 What gave Marilyn the confidence to fix Montana's state health plan? 08:35 Why Marilyn knew she would have enough power to make the changes needed in Montana's state health plan. 09:35 What Marilyn achieved in her time as the administrator of the Montana State Employee Health Plan. 11:03 What were the "quick wins" Marilyn was able to achieve when she first took over as administrator? 17:55 EP453 with Claire Brockbank, which covers RFP in detail. 18:12 How Marilyn structured her plan for the Montana State Employee Health Plan. 21:42 What's the key to setting yourself up for success when doing what Marilyn was able to achieve? 25:23 Why putting together your own team is so important. 28:20 EP397 with Paul Homes. 28:24 EP418 with Mark Cuban and Ferrin Williams, PharmD, MBA. 29:28 What happened when Marilyn left the Montana State Employee Health Plan? 31:28 Have the costs of the plan gone up since Marilyn's time working on it?

In episode 495 titled 'Wait. Flip that. A Crazy Revelation I Had About Trying to Fix US Healthcare,' host Stacey Richter speaks with Dr. Mick Connors, an emergency room pediatrician and healthcare entrepreneur, about a groundbreaking insight into the US healthcare system. They discuss the paramount need to flip the way healthcare costs and outcomes are measured: moving towards unit-level cost accounting and whole-patient or whole-community outcomes assessment. The episode delves into the fundamental pitfalls of the current healthcare structure, emphasizing the misalignment between cost aggregation and patient-level outcome measurements. They explore the challenges faced by physicians in the current system, the role of investor mindsets, and the importance of dyad leadership and mission-driven practices to improve overall healthcare value. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP495 🔗 Visit this week's sponsor Payerset: https://payerset.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= 🎤 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 06:32 How Dr. Mick Connors defines margin. 08:18 EP294 with Steve Schutzer, MD. 08:54 Why nobody wants to do cost accounting in healthcare. 09:20 EP490 with Shane Cerone and Sam Flanders, MD. 11:05 Infographic by Andrew Tsang showing streams of income. 12:27 What is the value equation? 15:55 EP404 with Suhas Gondi, MD, MBA. 15:59 EP466 with Vivian Ho, PhD. 16:01 EP482 with Preston Alexander. 16:25 EP474 with Yashaswini Singh, PhD. 17:44 How business decisions can really undermine the value proposition. 18:58 Classic article on incentivizing. 23:07 EP295 with Rebecca Etz, PhD. 24:21 Why it comes down to the 80/20 rule. 26:31 EP445 with Tom X. Lee, MD. 26:35 EP460 with Rushika Fernandopulle, MD. 26:40 Why mission return requires dyad leadership. 27:13 What does dyad leadership mean? 27:33 EP492 with Sam Flanders, MD, and Shane Cerone.

In Episode 494 of Relentless Health Value, host Stacey Richter engages in a detailed discussion with Sarah Emond, CEO of ICER, about the intricate dynamics of pharmaceutical drug pricing. They explore six primary tensions within the current system, including the fair valuation of drugs, the misalignment between drug prices and patient affordability, the disconnect between lifetime drug value and short-term insurance assessments, and the challenge of integrating societal and individual perceptions of value. Emond and Richter also discuss potential solutions, emphasizing the need for value-based pricing models free from financial conflicts of interest. They highlight the critical role of payers, PBMs, and drug manufacturers in aligning pricing with value to improve patient access and reduce overall healthcare costs. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP494 🔗 Visit our sponsor Payerset https://payerset.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/ 08:18 Why list prices are a lie. 10:59 How does the rebate model sometimes get in the way of paying for value? 12:50 Bonus clip with Sarah Emond. 13:14 EP491 with Elizabeth Mitchell. 13:20 EP490 and EP492 with Shane Cerone and Sam Flanders, MD. 14:37 The tension that is created between affordability and adherence. 15:03 When cost sharing makes sense in pharmaceutical drug pricing. 17:26 INBW42 with Stacey on moral hazard. 18:53 How GLP-1s are "wildly cost effective." 21:32 Why the sticker shock on cost-effective drugs is a failure in the system for paying for value. 22:38 ICER's report on GLP-1s. 26:59 EP385 with Dan Mendelson. 28:57 How employers and payers can have a value assessment approach and a health insurance system that allows access to cost-effective drugs. 29:48 How cost-effective prices are calculated. 31:55 One of the core value underpinnings for value assessment of drugs. 34:54 Why manufacturers and pharmacy benefit managers should work together more by referencing something like an ICER report. 36:55 EP426 with Nina Lathia, RPh, MSc, PhD. 38:21 "We can make different choices."

In this bonus episode of 'Relentlessly Seeking Value,' host Stacey Richter engages in a conversation with Sarah Emond, CEO of the Institute for Clinical and Economic Review (ICER). They discuss the complex 'arms race' of pharmaceutical pricing in the current healthcare system, emphasizing issues like inflated drug list prices, patient affordability, and cost-effectiveness. They highlight ICER's role in conducting value assessments of prescription drugs to ensure fair pricing and improve affordability and access. The episode underscores the need for multi-stakeholder dialogues to deescalate financial tensions and promote value-based healthcare choices. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP494-BonusClip 🔗 Visit our sponsor Payerset: https://payerset.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/ 06:51 EP293 ("Game Theory Gone Wild") with Dea Belazi, PharmD, MPH. 02:38 What is ICER? 02:54 What does the Institute for Clinical and Economic Review do? 05:14 The importance of still showing up, even when others don't understand or disagree. 09:12 Why it's important to think about population health and how our choices impact affordability for everyone.

In this special Thanksgiving episode of Relentless Healthcare Value, the focus is on gratitude and giving thanks to various contributors within the healthcare community. Host Stacey Richter extends her 'baskets of thank yous' to colleagues, mentors, and partners committed to transforming healthcare. These baskets recognize those who maintain respectful dialogues despite small disagreements, those who collaborate and pay it forward within the community, and those who support the concept of a 'demand curve' in healthcare markets. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/INBW43 ✉️ 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/ 01:25 First thank you: to those who do not succumb to healthcare narcissism. 01:36 INBW39 with Stacey. 02:51 INBW37 with Stacey. 03:00 EP399 and EP400 with Stacey. 05:40 Second thank you: to those willing to pay it forward. 05:53 EP489 with Dan Greenleaf. 08:12 EP452 with Cora Opsahl. 08:38 Third thank you: to those who aid the demand curve in healthcare. 09:14 EP490 with Shane Cerone and Sam Flanders, MD. 09:16 EP491 with Elizabeth Mitchell. 09:17 EP492 with Sam Flanders, MD, and Shane Cerone. 09:49 Why healthcare needs a demand curve. 13:34 Fourth thank you: to those who have contributed financial support to the Relentless Health Value podcast. 15:47 The final thank you: to the listeners.