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.

The pharmacy benefit world is broken — and it’s costing employers millions while pushing families into medical debt.
In this eye-opening episode of the Disrupt Healthcare Podcast, Lester Morales is joined by Rachel Strauss, founder & CEO of PBM Princess Consulting and one of the most outspoken pharmacy reform advocates in the country.

After 23 years inside a major PBM, Rachel has seen every angle of how drugs are priced, discounted, rebated, repackaged, and marked up — often leaving patients confused, employers overcharged, and advisors in the dark.

Together, Lester and Rachel unpack:

• Why 5% of members drive 80–90% of pharmacy spend
• How fully insured carriers inflate drug prices in reporting
• The truth about rebates and why they almost never benefit employers
• Why employers are told “there’s nothing you can do” — even when there absolutely IS

• International sourcing (Canada, Israel, UK, NZ)
• 340B pharmacy partnerships
• Patient assistance programs
• Medication recycling (90% cost reduction)
• How Rachel saved a Texas city 60% on their top 7 drugs within 30 days

Rachel breaks down why this exploding class of drugs is the single biggest threat to employer healthcare budgets — and how to prepare before 2030 hits.

Rachel and Lester share the emotional stories behind their work — from medical bankruptcy to life-saving treatments — and why pharmacy reform isn’t just financial… it’s deeply personal.

If you are an employer, advisor, HR leader, or healthcare innovator, this conversation will completely shift how you think about pharmacy benefits and what’s possible.

🔥 What PBMs don’t want employers to know💊 Real pharmacy strategies that work — today⚠️ The GLP-1 Problem (Ozempic, Wegovy, Mounjaro)❤️ Why this matters: the human impact

In this recap of the Disrupt Healthcare Podcast, host Lester J. Morales breaks down a powerful conversation with Dean Jargo, CEO of Fair Market Health, whose personal story and financial background expose a truth most employers never hear:

👉 Healthcare isn’t a healthcare problem. It’s a finance problem.

Dean—longtime CFO and free-market advocate—shares how his wife’s cancer and emergency heart surgery forced him into the system as a consumer, not an executive. In that vulnerable moment, even a numbers expert couldn’t make sense of the bills, the stress, or the total lack of transparency. And that’s the point.

The system is designed to be confusing.
But it doesn’t have to be.

Lester recaps the key themes of the conversation, including:

• Why the real payers of healthcare (employers & employees) are separated from the sellers of healthcare (hospitals & providers)

• How misaligned incentives make premiums go up every year—while benefits get worse

• The insane friction created by deductibles, out-of-pocket costs & denied access

• Why direct contracting and fair-market pricing consistently save 35–40% on big-ticket procedures

• The emotional and financial toll on families navigating the system while dealing with serious medical events

• Why CFOs need to stop delegating benefits decisions and start treating them like the massive P&L line item they are

• Why the status quo carriers have no incentive to change—and why real reform must come from inside the industry

This episode is a must-listen for employers, CFOs, benefits advisors, HR leaders, and anyone tired of feeling powerless in the healthcare system.

If you’ve ever thought:
“There has to be a better way…”
—this recap outlines exactly what that better way looks like.

Most CFOs would never tolerate sloppy spending anywhere else in the P&L… except in the second-largest expense of the business: healthcare.

In this episode of the Disrupt Healthcare Podcast, host Lester J. Morales sits down with Dean Jargo, former CFO and founder of Fair Market Health, to unpack why the traditional fully-insured model is structurally misaligned — and how employers can use free-market, direct contracting strategies to pay less while giving employees better access to care.

Dean shares how his perspective shifted after his wife’s cancer and emergency heart surgery threw his family deep into the healthcare system. From there, he breaks down why insurance networks aren’t really negotiating “for” employers, how minimum loss ratio rules (MLR) incentivize higher claim costs, and why CFOs must get directly involved instead of delegating everything to HR and big brokerage firms.

You’ll also hear how Fair Market Health helps employers buy services like MRIs, surgeries and other procedures directly from providers at a fair price, often:

• Saving 35–45% on individual services purchased direct

• Reducing total plan spend by 10–20%

• Waiving member out-of-pocket costs while still paying providers fairly and quickly

If you’re a CFO, CEO, HR leader or advisor, this conversation will change how you think about your health plan, your broker — and your responsibility to your people.

Show Notes

• Why fully-insured carriers are structurally incentivized for higher claim costs, not lower

• What a fair market, direct-pay model looks like for hospitals, employers and employees

• How deductibles & out-of-pocket for employees show up as accounts receivable on the hospital side

• Why hospital systems obsess over revenue instead of net profit, collection costs and time value of money

• The biggest mindset blocks for hospital administrators and employer C-suit

  Timestamps

• 00:00 – 01:04 | Intro: From Impact to Disrupt Healthcare — and why the Y matters

• 01:05 – 03:21 | Meet Dean Jargo: finance background, free-market mindset, and his wife’s cancer + emergency heart surgery story

• 03:22 – 04:57 | What is Fair Market Health? Creating a truly “fair price” marketplace between buyers and sellers of healthcare

• 04:58 – 08:32 | Who really decides the price of an MRI? The illusion of “negotiated discounts” in traditional networks

• 08:33 – 12:08 | Why carriers don’t benefit from lowering costs: MLR rules, revenue growth and misaligned incentives

• 12:09 – 14:06 | Dean’s biggest surprise: how many high-quality vendors already exist to run better, partially self-funded plans

• 14:07 – 17:46 | The “cost of change” myth and why disruption is actually what employees are begging for

• 17:47 – 20:20 | Transparent pricing + waived out-of-pocket: how buying direct actually increases access to care

• 20:21 – 22:43 | Deductibles vs A/R: the moment Lester realized member cost-sharing is just hospital accounts receivable

• 22:44 – 25:04 | Hospitals chasing revenue vs. focusing on net profit, collection costs and time value of money

• 25:05 – 27:26 | The win–win–win triangle: hospital, employer and employee all benefit in a direct model

• 27:27 – 29:38 | The emotional toll: EOBs, confusing bills and stress stacked on top of serious illness

• 29:39 – 32:00 | On the provider side: revenue myopia and “we’ve always done it this way” thinking

• 32:01 – 33:05 | On the employer side: how CEOs & CFOs delegate benefits decisions into misaligned hands

• 33:06 – 35:08 | Claims analysis 101: what Dean finds when he reprices 12–24 months of claims data

• 35:09 – 36:19 | Access advantage: why direct-pay patients move to the top of the schedule

• 36:20 – 37:36 | Dean’s message to CFOs: get engaged — your health plan is probably your highest-ROI project

• 37:37 – 38:22 | Lester’s example: $3.5M in Rx savings vs $25–30M in extra sales

• 38:23 – 39:23 | Where to find Dean and final call to action for financial leaders

• 39:24 – 40:23 | Closing: why we must disrupt healthcare before it breaks

In this quick recap of the Dysrupt Healthcare Podcast, host Lester J. Morales distills key takeaways from his interview with Heath Potter, Chief Growth Officer at Six Degrees Health—a leader in reference-based pricing (RBP) and transparent reimbursement.

Lester challenges the industry’s fear of RBP, calls out incentive conflicts that keep employers in the dark, and explains (in plain English) how bottom-up “Medicare-plus” pricing gets to a fair price—without the games behind “big network discounts.” He also shares real-world wins, access myths vs. facts, and why collaboration (not litigation) is the sustainable path.

You’ll learn:

• Why many advisors still resist RBP—and how to sanity-check that bias

• Top-down (billed charges minus “discount”) vs. bottom-up (Medicare-plus) pricing

• How modern RBP uses data + negotiation to reach fair provider payments

• Access & member experience: what’s changed from RBP 1.0 to today

• Case stories: open access, community contracts, and keeping dollars local

• How to request a no-obligation impact/savings analysis to compare models

If you’re a self-funded employer, HR/benefits leader, or advisor, this recap gives you the essentials in minutes—so you can decide whether to dive into the full episode.

00:00 – “This podcast has been disrupted.”
00:07 – What these recap episodes are (and why)
00:40 – Guest context: Heath Potter, Six Degrees Health (RBP leader)
01:03 – Love it? Hate it? Why advisors feel strongly about RBP
02:24 – Gut-check your bias: incentives, overrides, and “follow the money”
03:27 – Hundreds of RBP implementations: wins vs. rare rough patches
05:23 – The core value of RBP: transparency and bottom-up pricing
06:38 – “Discount off what?” Charge master, billed charges, and the game
06:55 – RBP in one line: get to the price (Medicare-plus)
07:05 – Why Six Degrees’ data-driven, collaborative model works
09:17 – Many hospitals already use RBP-ish logic internally
10:10 – Imagine a fair-price roundtable… and the reality today
10:39 – Six Degrees’ posture: start fair, show data, negotiate
10:51 – Real examples: open access, family stories, local community wins
11:37 – When carriers and hospitals fight… the member/employer loses
11:58 – Strategy: collaborate with good actors; limit exposure to bad ones
12:21 – Employers: if your advisor won’t teach RBP, reconsider
12:45 – If we don’t solve it, government will—lead the change
13:09 – CTA: request an impact analysis to compare savings
13:46 – Listen to the full episode with Heath Potter; share/like/feedback
14:00 – Thanks for listening to the Dysrupt recap

Guest: Heath Potter, Chief Growth Officer — Six Degrees Health
Host: Lester J. Morales — Dysrupt Healthcare Podcast

reference based pricing, RBP, Medicare plus pricing, Six Degrees Health, Heath Potter, Lester J Morales, self funded employers, healthcare transparency, cost containment, medical claims, employer health plans, open access, negotiation not litigation, benefits advisors, Dysrupt Healthcare Podcast

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