ER visits account for roughly six percent of health plan spend, with costs rising faster than almost any other hospital service. Why is ER spending is spiraling out of control? And what should we do about it?

Al Lewis, founder of The Validation Institute and the gamified health literacy platform Quizzify, has built a career exposing the financial sleights-of-hand many healthcare programs use to drain employer budgets.

Lewis joins us to break down how hospitals have transformed federal mandates like the Emergency Medical Treatment and Labor Act (EMTALA) into high-margin profit centers through aggressive pricing and "up-coding" tactics. Lewis also shares strategies for individuals and employers to challenge the lack of transparency that often characterizes emergency department charges.

Find the transcript of this episode at movingtovalue.org/transcript/lewis

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Thank you to our members who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership.

Tired of muddled pitches, point solution fatigue and hours of endless meetings? You're not the only one.

Chris Fisher is on a mission to fix one of the biggest bottlenecks in the employee benefits industry — the noise. As the founder of BenefitsAlly, Fisher created the 3x3x3 Challenge, which asks vendors to explain what they do, how they’re different and who they’re for in three minutes.

This format levels the playing field for vendors while giving brokers, consultants and business leaders a faster, clearer way to evaluate new ideas.

Fisher joins us to discuss the virtues of radical brevity.

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Thank you to our members who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership.

The American healthcare system is facing market failure driven by consolidation by industry profiteers. Perhaps no one has a clearer view of how this took place — and what to do about it — than Wendell Potter.

Called ‘the ideal whistleblower’ by Time magazine, Potter was a senior executive at insurance giants like Humana and Cigna until a crisis of conscience in 2008.

As the Editor-In-Chief of the HEALTH CARE un-covered newsletter, President of the Center for Health and Democracy and bestselling author of Deadly Spin and Nation on the Take, Potter has since dedicated his career to exposing the tactics insurers use to prioritize shareholder returns over patient outcomes.

He joins us to discuss the strategies employers, clinicians, policymakers and patients can implement to reclaim a system built on actual value.

Find the transcript of this episode at movingtovalue.org/transcript/potter

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Thank you to our members who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership.

"We could probably think of dozens of brilliant ideas on this very podcast to improve healthcare," says AJ Loiacono, Co-Founder & CEO of Judi Health. "Good luck implementing any of them on our aging infrastructure."

Loiacono founded Capital Rx, transforming the pharmacy benefit manager (PBM) industry by introducing a transparent, flat-fee model. Now, that mission has evolved into something even more ambitious.

With the launch of Judi Health, Loiacono and his team are tackling the trillion dollar problem of administrative waste in healthcare. They’ve built the industry’s first unified claims processing platform, a system that puts medical, pharmacy, dental and vision claims onto a single ledger.

Modernizing healthcare's technology infrastructure, Loiacono believes, will empower solutions that improve value for patients.

Find the transcript of this episode at movingtovalue.org/transcript/loiacono

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Thank you to our members who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership.

"Now is the time to strike when the iron is hot. People need healthcare."

Join us in the halls of the Connecticut General Assembly, where lawmakers are considering a bill to authorize Association Health Plans in the state. This would let small employers pool risk and receive health insurance as one group, boosting their power to negotiate better value for employees.

Grace Brangwynne, Policy Director for Healthcare, Insurance and Housing at the Connecticut Business and Industry Association, describes the "breaking point" of double-digit premium hikes facing small employers across the state. She talks us through the guardrails built into the current Association Health Plan proposal, the tension between market innovation and state regulation and why the survival of Connecticut’s mom-and-pop shops depends on a fundamental shift in healthcare purchasing.

Find the transcript of this episode at movingtovalue.org/transcript/brangwynne

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Thank you to our members who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership.

Why do savvy business leaders track every penny of office spend but ignore the "black box" of what's often their second-largest expense?

With renowned healthcare advisor Ann Lewandowski, we dive into the systemic blind spots that make it difficult for even the most sophisticated plan sponsors to manage healthcare with the same fiduciary rigor they apply to other parts of their business.

Lewandowski breaks down how to navigate the Consolidated Appropriations Act (CAA) as a North Star for transparency, the hidden pitfalls of high-deductible plans and how to build a 21st-century healthcare system with trust, accountability and patient-centered care at the core.

Find the transcript of this episode at movingtovalue.org/transcript/lewandowski

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Thank you to our members who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership.

From the ball park to the operating room, Michael LaFauci spots solutions with an innovator's eye. The idea for his current venture, Midas Healthcare Solutions, began with a lint roller.

LaFauci discusses the "innovator’s DNA" that led him from pharmacy assistant to serial entrepreneur. He developed technology that allowed sports fans to order refreshments from their seats. He created a device to prevent fetal lacerations during C-sections. Now, his team's MidasVIEW system is increasing transparency and safety in drug diversion within health systems, integrating digital connectivity, 360-degree cameras and artificial intelligence to create a verifiable chain of custody and make medication disposal feel cool.

Beyond the technology, LaFauci touches on the grit required for innovation — the blood, sweat and tears of a years-long journey from a lint roller prototype to a commercialized pilot, as well as the courage to "fall forward" and trust his vision.

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Thank you to our members who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership.

Are we approaching the "401(k) moment" of health insurance?

We're joined by Chris Ellis, co-founder and CEO of Thatch, a platform that helps employers offer personalized healthcare experiences to employees using Individual Coverage Health Reimbursement Arrangements (ICHRAs) .

Ellis explains how his team of fintech veterans is leveraging ICHRAs to decouple benefits from the employer-chosen model, allowing employees to use tax-free stipends to purchase plans that fit their lives. By making coverage personal rather than corporate, Thatch is shifting the industry's focus from short-term ROI to long-term prevention and healthcare portability.

When individuals have the power to choose, Ellis notes, local health systems can finally compete on quality and efficiency through curated care pathways, finally creating a substrate for the high-value, cost-effective healthcare outcomes the industry has long promised.

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Thank you to our members who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership.

What does healthcare look like when a community-centered approach takes the lead? New York State Assembly Member Chantel Jackson, a licensed social worker representing New York’s 79th District, joins us to discuss increasing access to and trust in healthcare services.

With a background in New York City public schools, Assembly Member Jackson brings a unique, holistic perspective to the legislature, recognizing that health is inextricably linked to social and emotional well-being. She advocates for an "all of the above" approach to reform, addressing everything from noise pollution to neighborhood safety to food insecurity to financial literacy.

Together, we unpack the stark realities of health disparities in the Bronx and around the country, and discuss how legislators and industry leaders can create meaningful change.

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Thank you to our members who make our work possible! As a 501(c)(3) nonprofit, the Moving to Value Alliance relies on generous supporters to advance our mission of creating a value-based healthcare ecosystem with high-quality health outcomes at a reasonable cost for plan sponsors and their members. Get involved at movingtovalue.org/membership.

Healthcare is the second or third largest expense of most employers. As costs continue to rise, hidden incentives, legacy brokerage models and lack of transparency keep employers stuck in the same expensive cycle.

Donovan Pyle, CEO of Health Compass Consulting, offers a sharp diagnosis of the barriers employers face in reforming this system, as well as the strategies employers can put in play to get more value from their healthcare spending.

Drawing on insights from his new book, Fixing Healthcare: How Executives Can Save Their People, Their Business, and the Economy, Donovan maps out what it takes to flip the script: building a value-driven benefits strategy, eliminating waste and improving outcomes.

Join us for a candid, practical conversation on how employers can drive real change in healthcare.
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As a 501(c)(3) nonprofit, we rely on support from our grassroots network to advance our mission. Get involved at movingtovalue.org/membership.