Relentless Health Value Podcast Por Stacey Richter arte de portada

Relentless Health Value

Relentless Health Value

De: 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. Enfermedades Físicas Higiene y Vida Saludable Política y Gobierno
Episodios
  • EP505: The Death of the "What Is Value" Guessing Game for Clinical and Plan Decision-Makers Ready to Move On, With Ahilan Sivaganesan, MD

    EP505: The Death of the "What Is Value" Guessing Game for Clinical and Plan Decision-Makers Ready to Move On, With Ahilan Sivaganesan, MD
    Apr 2 2026
    Stacey Richter interviews neurosurgeon Dr. Ahilan Sivaganesan (Dr. Siva) about replacing vague healthcare "value" claims with quantified outcomes and unit-level costs, introducing his Operative Value Index (OVI). They discuss how hospitals often lack true internal episode costs and how common quality metrics miss patient-reported outcomes and appropriateness across the full care journey. Using time-driven activity-based costing (TDABC) and condition- or procedure-specific patient-reported outcomes, OVI creates a common mathematical language to compare surgeons, practices, or health systems, risk-adjust for confounders, and support steering/tiering and direct contracting for self-funded employers. Siva describes transparency via bubble charts that spur clinician behavior change without new incentives and argues this infrastructure is essential as bundled payments and risk-based arrangements expand, framing a "Yahoo vs Google" shift from fee-for-service volume to measurable value. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP505 ✉️ 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/ 00:00 Introduction to this episode. 00:38 The goal of this episode. 01:28 What the Operative Value Index (OVI) is. 02:04 A quick episode overview. 04:23 EP434 with Benjamin Schwartz, MD, MBA. 04:44 How this episode came about. 09:24 How Dr. Siva got involved in the research around outcomes and costs. 11:51 How the value equation doesn't add up to true quality. 14:12 What measuring quality across the entire care journey means. 15:00 EP326 with Rishi Wadhera, MD, MPP. 15:08 EP295 with Rebecca Etz, PhD. 16:07 Why appropriateness is the foundation of quality. 19:08 Why practicing clinicians need to be thinking about the true costs of delivering care. 21:20 Time-driven activity-based costing (TDABC). 23:44 The two things that must be known for value-based care to succeed. 24:06 Article by Dana Prommel Strauss. 27:09 A quick summary of the conversation thus far. 30:42 The power of transparency in Dr. Siva's bubble plots. 32:39 EP449 with Marty Makary, MD, MPH. 34:05 Why these bubble plots work not just at the procedural level but at the diagnosis level, too. 36:13 EP503 with Ryan Wells; Leo Spector, MD, MBA; and Adam Stavisky. 36:21 EP501 with Ivana Krajcinovic, PhD. 36:30 EP398 with Jacob Asher, MD. 37:28 The "big blue ocean" opportunity for forward-looking providers. 38:52 Substack post by John Lee, MD. 40:37 The incredible opportunity for entities and groups that can help provide the infrastructure needed for this value index. 41:42 Essay written by Dr. Siva. 43:19 Last thoughts by Dr. Siva on TDABC and competition on value.
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    44 m
  • EP504: A Back-to-Basics Roadmap Through the Perverse Incentives to Advanced Primary Care, With Ryan Jacobs

    EP504: A Back-to-Basics Roadmap Through the Perverse Incentives to Advanced Primary Care, With Ryan Jacobs
    Mar 26 2026
    It's been a while since we started from the beginning, so let's just take stock of the basics in this show, refresh ourselves if you're a longtime listener, or welcome if you're new around here. Today we are digging on and about what I would call the poster child for proven healthcare strategies: advanced primary care, otherwise known as APC. 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. If you look at the data, APC, well done and with the right segmentation—neither of which should be underestimated—but done well, APC should be a slam dunk. It improves patient outcomes. It reduces costs. Listen to the episode with Kenny Cole, MD (EP431) for more on what good advanced primary care looks like and the show with Beau Raymond, MD (EP455) on pulling it off in a community. Now I wanna make one thing really clear. When I say advanced primary care (APC), please note I do not mean some kind of seven-minute patient visit during which the clinician tells the patient he or she is limited to but one concern only and if they wanna talk about anything else, they gotta make another appointment and pay another co-pay. I'm also not talking about any kind of model where a doctor takes a capitated payment and then doesn't even see the patient. They just process a referral, which I saw a post about by Stacy Mays the other day. So, nothing of that ilk. We're talking about real advanced primary care, which is managing risk, not symptoms. So anyway, here is the probably multibillion-dollar question: If the evidence for APC is so robust, why isn't APC everywhere? Why aren't we tripping over high-value primary care clinics on every street corner? And if you're a clinician trying to do APC, why isn't it super easy to stand up a practice and get paid? The answer, as usual, lies in the pachinko machine that is the U.S. healthcare industry. You throw a great idea—even when with lots of evidence—into our industry, into our sector; and the results that bounce out the other side are rarely what anybody may have expected, intended, or wanted. So, on the show today first, we are exploring the pit traps, I'll call them—the blockades that keep APC from really scaling, starting with two root causes, the first one being conflicting fiduciary duties. Because look, when we talk about your average—let's just say hospital board, let's just start there—health system board's fiduciary responsibility, we aren't just talking about mission. There's a reason for the epidemic of burnout and moral injury amongst clinicians in this country. There's a reason why fewer than half (45%) of frontline clinicians trust their organization's leadership to do what's right by patients. At the board or C-suite level, it's all about heads in beds, as they say. A health system drives revenue by driving volume, profitable surgeries, infusions that are tens of thousands of dollars more than you can find at an indie practice, and, again, filling those beds. Meanwhile, the entire goal of advanced primary care is to keep patients out of the hospital and out of the ER. As my guest, Ryan Jacobs, today points out, there is a very steep uphill battle when your innovation actually threatens the revenue of some of the largest players in the nonmarket that we have here. Listen to the episode with Scott Conard, MD (EP391) talking about his, he calls it his Pelican Brief moment when he was dealing with a local health system. It is a really stunning, just stop you in your tracks perfect example of this whole conflicting fiduciary duties thing playing out in real life. So then, after that, we get to a second reason why APC is not available on every corner. Ryan Jacobs, again, my guest today, he calls this second reason the black box of complacency. In our healthcare nonmarket, innovators and those looking to improve quality or lower costs often don't lose to better competitors. They lose to the status quo. I mean, you think about this—it is often a rational move for "lazy networks" and consolidated health systems to do nothing because they get the volume anyway, especially when self-insured employers buy on discounts and not much else. Listen to the episode with Jonathan Baran (EP483) on the healthcare flywheel for a really, really deep dive into this point. All right … now let's make all this actionable. Ryan lays out a three-step roadmap for founders, clinicians, plan sponsors, anybody who is tired of waiting for the invisible hand to fix things because … yeah, exactly. There's no functioning market in most of the healthcare industry, so there is no invisible hand that's gonna level up quality or keep prices down. It does not work that way. Here's the roadmap that Ryan Jacobs lays out today: Step 1: Perform a reality-based assessment. Think about all the things that we just talked about. No magical thinking allowed. You have to follow the...
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    34 m
  • Insights to Outwit the Hot Mess of the Non-Healthcare Market

    Insights to Outwit the Hot Mess of the Non-Healthcare Market
    Mar 19 2026
    In this Inbetweenisode, Stacey shares listener feedback and reflects on making better decisions in employer-sponsored healthcare, spotlighting LinkedIn posts by Ken Wosczyna and Michelle Bernabe. Ken argues Relentless Health Value moves from theory to practical transformation by sharpening judgment, which Stacey ties to how millions of workplace decisions shape the healthcare system and how actuaries and executives can align choices with values. Stacey emphasizes that good decisions require both transparency and understanding, previewing an upcoming episode with Jerry DiMaso about using transparency files to compare what peer companies pay, and citing examples of misleading "transparency" through complex contracting and financialization (e.g., CABG pricing and PBM tactics). She also questions what "disruption" means when the status quo already harms access. Stacey highlights direct contracting, Centers of Excellence, and upcoming advanced primary care episodes. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/INBW46 ✉️ 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: trying something new with this inbetweenisode. 01:29 "Insight is common. Execution is rare.": a LinkedIn post from Ken Wosczyna. 03:02 SUMS8 with Larry Bauer, MSW, MEd. 03:08 The power of the C-suite versus the decision power of workers. 03:45 SUMS7 with Keith Passwater and JR Clark. 04:00 The power of actuaries to align with values. 04:50 Rate criticals for fixing the nonexistent healthcare market. 05:50 EP501 with Ivana Krajcinovic, PhD. 06:56 Why you can't fix what you don't understand. 07:46 EP472 with Eric Bricker, MD. 09:27 A comment from Craig Herndon. 10:44 Why avoiding disruption and problems with access can create disruption and problems with access. 12:22 A LinkedIn post from Michelle Bernabe. 12:26 EP500 with Stacey. 15:56 Looking ahead: topics future episodes will be covering. 16:07 EP503 with Ryan Wells; Leo Spector, MD, MBA; and Adam Stavisky. 17:08 A Web site/app for Relentless Health Value episodes. 18:24 EP480 with Kimberly Carleson. 19:22 Check out this episode's sponsor.
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    20 m
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