Dysrupt Healthcare Podcast

Behind every healthcare decision is a real person and for Lester Morales, that truth is deeply personal.

In this episode, Lester reflects on the anniversary of his mother’s passing and the lessons she left behind after 41 years serving veterans as a VA nurse: serve people first, fight for what matters, and never forget your why.

From his family’s experience with medical debt, cancer, and loss to the work he does today challenging the healthcare status quo, this conversation is a reminder that rising deductibles, delayed care, confusing benefits, and healthcare costs are never just numbers on a spreadsheet.

They affect someone’s mom, dad, spouse, son, or daughter.

As employers and benefits leaders enter another renewal and open enrollment season, the challenge is simple: remember who you’re making these decisions for and do better for the people counting on you.

What if skipping surgery was actually the smartest medical decision you could make? In this episode of the Disrupt Healthcare Podcast, host Lester sits down with Dr. Steve Schutzer, orthopedic surgeon, co-founder, and Chief Medical Officer of Upswing Health, for a deep-dive conversation that challenges everything you thought you knew about musculoskeletal care.

Dr. Schutzer left the operating room to solve a bigger problem: most people experiencing an orthopedic "ouch moment" — a twisted ankle, a sore back, a knee that won't cooperate — end up in the ER spending $2,500 on X-rays for something that didn't need surgery in the first place. Upswing fixes that by connecting employees instantly to orthopedic guidance, steering them toward the right care from the very first step.

Together, Lester and Dr. Schutzer also break down the real mechanics of self-funded employer health plans, direct-to-employer contracting, HSA/HDHP strategy, 340B pharmacy programs, Tier 1 benefit design, and how healthcare advocates can eliminate out-of-pocket costs for employees — all while cutting employer spend dramatically.

If you're an employer, benefits consultant, TPA, or simply someone who wants to understand how to navigate the healthcare system smarter, this episode is for you.

🔑 Topics covered:

• Why the first provider you see after an injury determines your entire care journey
• How Upswing's digital triage platform works at the "ouch moment"
• Tier 1 direct-to-employer contracting and self-funded plan design
• HSA/HDHP strategies and how to work around their limitations
• 340B pharmacy programs and how hospitals can turn drug costs into revenue
• The future of value-based MSK care and Centers of Excellence

Healthcare is one of the largest line items for employers… but it’s also one of the biggest opportunities for alignment.

In this solo episode of the Dysrupt Healthcare Podcast, Lester dives into the evolving relationship between employers and healthcare systems, and why the future depends on moving beyond a purely transactional mindset.

Too often, employers experience healthcare as a complex and expensive billing system, while health systems are navigating increasing pressure, rising costs, and operational complexity behind the scenes. Both sides are operating within the same trillion-dollar ecosystem, yet rarely with full alignment.

Through conversations with healthcare system leaders, employers, advisors, and investors, a clear pattern begins to emerge: the challenge isn’t a lack of effort, it’s a lack of connection.

This episode explores where that misalignment happens, why it exists, and how both sides can begin to rethink their approach. It’s not about pointing fingers or assigning blame. It’s about understanding the realities on both sides and identifying the opportunity to build stronger, more collaborative relationships.

When employers and healthcare systems move from transactions to true partnerships, the impact goes far beyond cost. It creates better access, more sustainable models, and ultimately, better outcomes for the people at the center of it all.

Because at the end of the day, this isn’t just about healthcare spend… it’s about how we build a system that actually works for everyone involved.

What if employers and hospitals weren’t negotiating againsteach other… but building together?

In this episode of the Dysrupt Healthcare Podcast,Lester sits down with Doug Hetherington, founder of Health to Business, to talk about a different approach to healthcare purchasing one rooted in transparency, partnership, and long-term alignment.

This isn’t about fighting the system.
It’s about strengthening relationships inside the communities we all serve.

Doug shares:

✔ Predictable payments
✔ Stronger patient relationships
✔ Reduced collection strain
✔ Better plan stability
✔ Healthier communities

At its core, this episode is about moving from atransactional model to a community health partnership model.

Hospitals are not the enemy.
Employers are not the enemy.
Misalignment is the problem and alignment is the solution.

If you’re a hospital leader, CFO, employer, broker, oradvisor, this conversation will give you a new lens on what’s possible when we build together.

Most employers renew healthcare like this:

“Pick the option that sucks the least.”

In this episode of the Dysrupt Healthcare Podcast, Lester sits down with Doug Hetherington (reformed broker, founder of Health to Business) for a raw, MBA-level breakdown of how direct contracting is flipping the script—by building real partnerships between employers and providers and removing the financial friction that keeps people from getting care.

This conversation is not theory.
It’s the behind-the-scenes reality of how healthcare actually works… and why it keeps getting worse—unless someone chooses to do something different.

• The “blue and blue” story that explains what’s broken in the carrier-driven model

• The moment Doug realized everyone is losing… except the insurance carrier

• Why a direct contract is “just a piece of paper”… and why the intent behind it changes everything

• The stakeholder shift: employer + patient + provider win (and the “house” stops winning)

• The real reason hospitals say insurance carriers “have a gun to my head”

• The hidden cost no one talks about: administrative burden and claims touchpoints

• What happens when you remove the dollar barrier (spoiler: people don’t get “extra colonoscopies”)

• The plan design that makes employees actually choose the better option:
  $10 doctor visit. $400 facility event. “Free babies.”

• The story that will stick with you: a 20-year employee, obesity, bariatrics, and a company culture changed forever

• Why hospitals quietly say: “You’re our #1 payer by a mile.”

If you’re an employer, advisor, CFO, or HR leader—and you’ve ever wondered:

“Is there a way to make healthcare better without blowing up the plan?”

Imaging is often treated like a “small” service line item.
It’s not.

In this episode of the Dysrupt Healthcare Podcast, Lester sits down with Dr. Cristin Dickerson, practicing radiologist and founder of Green Imaging, to unpack one of the most overlooked—and easiest—wins in healthcare cost containment.

Here’s the headline:
Imaging can represent 11–13% of total healthcare spend, not the 5% most carriers report.
And the price variation can be 8–10x for the exact same exam.

In this conversation, we cover:

• Why imaging costs are rising faster than overall healthcare inflation

• How hospitals and private equity have distorted imaging pricing

• The real math behind $4,700 CT scans vs. $485 alternatives

• Why imaging is the easiest lift for employers (no doctor disruption, no plan overhaul)

• How employers can offer $0 out-of-pocket imaging and still save millions

• The access problem nobody talks about: delayed care due to deductibles

• Why “free imaging” does not increase unnecessary utilization

• How direct contracting creates a win for employers, employees, and providers

We also walk through a real case study:

• 2,500-employee company

• 3,800 imaging transactions

• $2.7M in savings

• Significant reduction in deductible exposure

• Improved access, productivity, and employee trust

This isn’t theory.
It’s arithmetic.

If you’re an employer, advisor, CFO, or HR leader wondering where to start in 2026—this is it.

As Lester puts it:

“This isn’t witchcraft. Nobody loses. And that almost never happens in healthcare.”

Learn more or request an impact assessment at greenimaging.net.

Like, share, comment, and—most importantly—do something different.

If you’re an employer, you’re one of the largest purchasers of healthcare in the U.S.—and somehow you have the least control.

This is a summary episode of our conversation with Nurse Deb (Deb Alt), President of AIMM, and it drops right after the turn of the calendar—Happy 2026—in what many are calling the worst renewal season in years.

Here’s the hard truth:
If you didn’t do anything different during renewal… why did you expect a different result?

In this recap, Lester breaks down the mindset shift employers (and advisors) must make to stop being passive victims of a system designed to be opaque—and start acting like real purchasers.

We cover:

• Why healthcare is confusing on purpose (and how it mirrors getting a grocery bill with zero itemization)

• The dangerous gap: employers scrutinize paperclips, but not their 2nd/3rd largest expense

• Why consumers research cars, flights, and concerts—but not surgeons, facilities, or cost differences

• What changes when you build a plan around advocacy (call the nurse first)

• The uncomfortable “wait, what?” reality of misaligned incentives in healthcare and advisory models

• Why raising deductibles and payroll contributions is not a strategy—and never bends the curve

If you’re an employer, ask yourself:
Do I actually see my claims? Do I get data? Do we do pre-renewal?
Or am I stuck in “thank you sir, may I have another”?

If you’re an advisor:
If your entire book is carrier-centric, this is your challenge to rethink what “advising” really means.

Watch/listen with one goal: What’s one thing I can take from this episode and do differently this year?

Like, share, and comment what topics you want next—and if you haven’t heard the full episode with Nurse Deb, go listen to it right after this.

What if the fastest way to lower healthcare costs… is to finally put the patient at the center?
In this powerful conversation, host Lester Morales sits down with Deb Alt — “Nurse Deb” — Founder and President of AIM, a team of nurses and physicians who guide patients through the two most confusing systems in America: healthcare delivery and health insurance.

This episode exposes the misaligned incentives that keep costs rising, why patients actually get worse outcomes with traditional navigation, and how a nurse-led model radically improves both quality and affordability.

Deb breaks down:

• Why patients—not doctors—should handle prior authorizations

• How top-quality care is actually cheaper in a fee-for-service system

• Real stories of redirecting patients to better outcomes for $0 out-of-pocket

• Why 64% of Americans avoid care because of cost fears

• How employers can eliminate deductibles + copays and STILL spend less

• The cultural shift required to make employees want to call the nurse

• Why the MLR (Medical Loss Ratio) rule keeps insurers from lowering claims costs

• The math behind Deb’s ability to cut claim spend 50% in year one

Whether you're an employer, CFO, advisor, or simply someone who’s felt lost inside the healthcare maze, this episode is a masterclass on how real change happens.

This isn’t concierge care. It’s the way healthcare should have worked all along.

📌 Want an analysis of your plan data or a clinical quality breakdown?
Use the link in the show notes to request the free assessment Deb mentions.

In our final episode of the year, Lester J. Morales shares the real why behind moving from Impact Healthcare to Dysrupt Healthcare. This isn’t a cosmetic change—it’s a sharpened mission informed by everything we learned this season: self-funding that actually bends the curve, PBM transparency, employer-led innovation, and data over hype.
Here’s the blueprint for the next chapter:

• Keep the straight-talk interviews with advisors, clinicians, employers, and operators.

• Add case files where costs drop and outcomes rise—“with the receipts.”

• Ship practical Monday-morning playbooks you can run in the wild.

• Elevate patient and employer voices to anchor what truly matters.

Key takeaways

• The strategic reason for the shift—and why now.

• What stays: candor, data, employer-first lens.

• What’s new: deeper case studies + step-by-step execution.

• How this community moves from insight to repeatable systems in the new season.

Follow Dysrupt Healthcare Podcast, share this finale with your team, and send the case studies you want dissected next season. We have been dysrupted—and we’re ready.

In this recap episode, host Lester Morales breaks down the powerful conversation with Rachel Strauss — widely known as the “PBM Princess” and one of the clearest, boldest voices exposing how pharmacy benefit managers (PBMs) really work.

Rachel spent much of her career inside a leading PBM that didn’t play the traditional rebate and spread-pricing games. Today, she’s on a mission to educate employers, advisors, and everyday consumers on the hidden mechanics of drug pricing — and why most people have no idea what they’re actually paying for.

In this recap, Lester dives into:

• The emotional, financial, and human cost of a broken pharmacy system

• How PBMs actually make money (and why the incentives are completely misaligned)

• Why a $10 copay tells you nothing about the true price of a drug

• The spread-pricing “black box” and how it hurts patients, employers, and local pharmacies

• The shocking reality: 1–3% of plan members drive up to 60% of total pharmacy spend

• Why employers can reduce costs by 50–70% on high-cost drugs using modern, patient-first strategies

• The false belief that “employees won’t understand change” — and how it delays real solutions

• Real-world paths to get the exact same medication for employees at zero cost

Rachel and Lester outline a simple but powerful truth: If the PBM profits when drug prices stay high, the game will never change.

This episode is a must-listen for employers, advisors, CFOs, HR leaders, and anyone who wants to understand why pharmacy costs are exploding — and what to do about it.

👉 Listen to the full conversation with Rachel Strauss in the main episode.