In this episode of the Only Healthcare Podcast, co-host Randy Vogenberg, PhD, sits down with Winston Wong, Editor-in-Chief of the Journal of Clinical Pathways, to explore the past, present, and future of one of the most influential publications in oncology care.

Winston shares how clinical pathways have evolved over more than two decades—from simple treatment sequencing tools designed to reduce variability, to comprehensive frameworks that now integrate personalized medicine, genomic testing, value-based care, and whole-person support. As the first and only editor-in-chief since the journal’s inception in 2015, Winston offers a unique perspective on how the publication has grown, adapted, and helped shape the national conversation around oncology quality, affordability, and outcomes.

Listeners will also get a behind-the-scenes look at the journal’s mission, how article categories have expanded across clinical, operational, economic, and palliative domains, and why JCP is now pursuing National Library of Medicine indexing to strengthen its credibility and impact for clinicians, employers, and researchers.

The episode concludes with a forward-looking discussion on what the next decade may bring for pathways—and how integrated care, social determinants of health, and evolving value-based care models will define the next frontier of oncology practice.

Key Topics Discussed

• The evolution of clinical pathways: From early-stage treatment sequencing to advanced tools supporting personalized oncology, genomic testing, and multidisciplinary care.

• The growth and mission of the Journal of Clinical Pathways: How JCP expanded from its 2015 launch to a nationally recognized publication advancing value-based oncology care.

• Article categories shaping the future of oncology: Prevention and diagnosis, treatment innovation, outcomes measurement, business infrastructure, predictive cost modeling, palliative care, and prehabilitation.

• The role of employers and managed care stakeholders: Why value-based care and clinical effectiveness require alignment between clinical quality and economic impact.

• The journal’s pursuit of NLM indexing: How indexing will enhance credibility, visibility, and submissions across clinical and health economics fields.

• The next decade of clinical pathways: Integration of whole-person care, personalized medicine, social disparities, and cross-journal collaboration.

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Institute for Integrated Health (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/.

In this episode of the Only Healthcare Podcast, hosts Randy Vogenberg, PhD, and Michael Navin unpack key insights from Health Rosetta Fest 2025, held in Denver, Colorado. This year’s event brought together more than 1,200 leaders across the healthcare ecosystem — from employers and brokers to innovators and policymakers — all focused on transforming how healthcare is purchased, delivered, and managed in the United States.

Michael shares firsthand takeaways from the conference, including how employers are taking a more active role in shaping healthcare strategy, the debut of Health Rosetta’s new Navigator tool, and the growing push for price transparency, fiduciary responsibility, and care navigation innovation.

The discussion highlights the rise of employer-driven healthcare reform, featuring examples of organizations improving employee care through on-site clinics, direct contracting, and transparent PBM solutions. The hosts also explore insights from author Chris Deacon (The Great Healthcare Heist) on systemic barriers, policy challenges, and the urgent need for accountability across payers, brokers, and hospital systems.

Listeners will gain an inside look at the cultural shift occurring within healthcare — from passive purchasing to proactive change — and learn how collaboration, data transparency, and new technologies are redefining the future of care delivery.

Key Topics Discussed:

• Employer empowerment: How businesses are taking control of healthcare costs and outcomes
• Transparency and fiduciary responsibility: Lessons from The Great Healthcare Heist
• The Health Rosetta Navigator: A practical tool for plan sponsors to evaluate healthcare contracts
• Direct primary care and on-site clinics: Proven strategies for better care and lower costs
• AI and workforce evolution: Redefining healthcare roles through automation and care navigation
• Case studies: How innovative employers are transforming benefits models

Chapters
00:00 Introduction: Why Health Rosetta Fest matters
03:00 Who attended and what made this year unique
07:00 Launching the Health Rosetta Navigator tool
10:00 Transparency, policy reform, and employer responsibility
15:00 Insights from The Great Healthcare Heist
20:00 The role of AI in healthcare navigation
24:00 Case studies: Direct care and on-site employer success stories
28:00 Closing reflections and looking ahead to Rosetta Fest 2026 in Nashville

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Sponsored by:
Peek: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/.

Institute for Integrated Health (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/.

In this episode of the Only Healthcare Podcast, recorded live at the Nicholas Hall North America Conference, our panel explores how the FDA’s new Additional Conditions for Nonprescription Use (ACNU) rule could transform chronic disease management—particularly for diabetes—by empowering consumers and redefining self-care.

Hosts Randy Vogenberg, PhD, and Mary Alice Lawless are joined by Joe McGovern, Teresa DeSantis, and Bob Barron, experts in diabetes care, life sciences, and healthcare marketing. Together, they discuss how ACNU creates new opportunities for safer, more accessible, and affordable treatment options while enabling innovative digital care interventions that improve patient engagement and adherence.

Listeners will gain insight into how ACNU bridges clinical care, technology, and consumer empowerment—reshaping the future of nonprescription healthcare access..

Key Topics Discussed:

• Diabetes as a Public Health Crisis: With 38.4 million diagnosed Americans and 9 million undiagnosed, non-adherence continues to drive higher costs and poor outcomes.
• ACNU for Access and Adherence: How the FDA’s new rule opens the door for nonprescription treatment pathways—especially for chronic conditions like diabetes.
• Digital Care Innovation: Personalized tools that deliver education, reminders, and ongoing support to help patients stay on track.
• Retail and Employer Readiness: How retailers, marketers, and employers are preparing to implement ACNU to reduce costs and enhance consumer health outcomes.
• Measuring Success: Why adherence tracking and consumer empowerment will define the next era of self-care.

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Sponsored by:
Peek: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/.

Institute for Integrated Health (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/.

In this episode of the Only Healthcare Podcast, recorded live at the Nicholas Hall North America Conference, our panel explores how the FDA’s new Additional Condition for Nonprescription Use (ACNU) rule is reshaping the future of consumer healthcare.

Hosts Randy Vogenberg, PhD, and Mary Alice Lawless are joined by experts Jim Parker and Bob Sterling to unpack the first major change to U.S. drug regulation since 1951. Together, they discuss how ACNU opens new pathways for safe, affordable, and equitable access to medications—bridging the gap between prescription and over-the-counter treatments.

Listeners will gain insight into the public health potential of nonprescription statins, the role of health plans and employers, the impact on retailers and PBMs, and how this policy could reduce costs while improving patient outcomes.

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Sponsored by:
Peek: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/.

Institute for Integrated Health (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/.

In this episode of Only Healthcare, host Randy Vogenberg welcomes William Sarraille, retired senior partner from Sidley Austin's healthcare practice and nationally recognized expert in US healthcare law. As both a legal authority and rare disease patient himself, Bill exposes how the 340B drug discount program has evolved from a modest safety net initiative into an $80 billion profit machine that enriches hospitals while burdening employers and devastating patients with medical debt.

With 30 years of experience representing all stakeholders in the 340B ecosystem, Bill reveals the shocking reality: what began as Congress fixing a "boo-boo" in Medicaid drug pricing has become the single largest driver of healthcare consolidation and price inflation, with hospitals charging employers 150-400% markups while providing charity care to only 2.15% of patients on average.

Key Topics Discussed:

• The $148 Billion Profit Explosion and Market Manipulation - New peer-reviewed IQVIA research reveals 80-100% of 340B's explosive growth from $6 billion in 2010 to $148 billion today stems from hospital utilization manipulation, not drug price increases, with hospitals charging employers 150-400% markups on discounted drugs while using profits to consolidate markets and eliminate competition
• Medical Debt Crisis Despite Massive Hospital Profits - 340B hospitals average only 2.15% charity care spending despite $80 billion in annual profits, with patients never informed about assistance programs, making 340B the largest contributor to medical bankruptcies in America while only 3-5% of contract pharmacy transactions provide patient assistance despite 32% of Americans being uninsured or underinsured
• The Employer Cost-Shift Trap and Transparency Failures - How self-interested brokers mislead employers with "50% discount" offers that represent markdowns from astronomically inflated charges, while 80% of 340B entities generating the most profits operate in complete opacity with no reporting requirements, feeding more dollars into hospital consolidation machines that raise prices on all healthcare services

The episode reveals how a program designed to help indigent patients has become a massive wealth extraction mechanism that enriches tax-exempt hospitals while bankrupting the very patients it claims to serve.

🎧 Listen now: onlyhealthcarepodcast.com

Hosted by: Randy Vogenberg, PhD

Guest: William Sarraille, Retired Senior Partne

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Sponsored by:
Peek: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/.

Institute for Integrated Health (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/.

In this episode of Only Healthcare's Risk Series, hosts Michael Navin and Randy Vogenberg welcome Tom Sondergeld, managing partner of TS Consulting Group with over 30 years in healthcare benefit consulting and former senior advisor to McKinsey & Company. As a national leader in benefit design strategy and cancer survivor who has personally navigated the healthcare maze, Tom provides both professional expertise and patient perspective on the explosive growth of ultra-high-cost therapies threatening to devastate employer-sponsored health plans.

With 3,700 ultra-high-cost therapies in development and 30+ cell and gene therapies already approved by the FDA, Tom reveals how employers—especially mid-size companies with $2-4 million annual plans—face potential financial catastrophe from single claims reaching $4-7 million. Drawing from his experience managing benefits at major companies like Walgreens, he exposes the systemic failures that leave even healthcare experts lost in prior authorization labyrinths while outlining innovative solutions for survival.

Key Topics Discussed:

• The $24 Million Reality Check for Large Employers - Predictive analytics reveal that large employers with massive populations likely face 6+ employees needing ultra-high-cost therapies at $4 million each, creating $24 million exposures that are increasingly difficult to hide, while mid-size employers with $2-4 million total plans face doubling of costs from single claims hitting at the worst possible times
• The Prior Authorization Hell Even Experts Can't Navigate - Tom's personal experience being lost in prior authorization systems despite 30+ years of healthcare expertise, unable to reach decision-makers or understand requirements, highlighting how the system sidelines patients when they need advocates most, with navigation becoming a "magical" skill that third parties possess but patients and employers lack
• Breaking Down Healthcare's Wall Between Stakeholders - The artificial separation between pharmaceutical manufacturers, providers, and employers that prevents direct conversations and cost management, with successful examples like Boeing and Caterpillar achieving demonstrable savings through direct contracting, while traditional middlemen create opacity that benefits no one except intermediaries

The episode reveals that employers must abandon traditional "peanut butter" formulary approaches and embrace value-based benefit designs that connect high-cost therapies with comprehensive care programs, while building coalition

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Sponsored by:
Peek: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/.

Institute for Integrated Health (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/.

In this episode of Only Healthcare's Risk Series, hosts Michael Navin and Randy Vogenberg welcome Drew Wilkins, Managing Director at Monitor Deloitte with over 20 years of consulting experience in corporate strategy and innovation. As an expert in access and health with deep expertise in life sciences, Drew reveals how cell and gene therapies are fundamentally breaking America's employer-sponsored healthcare system—not through gradual cost increases, but through unpredictable "lightning strike" events that can cost $3-5 million per patient.

Drawing from his extensive work with biopharmaceutical companies and self-insured employers, Drew exposes the fundamental mismatch between a healthcare system designed to amortize costs over a plan year and breakthrough therapies that deliver potentially curative results in a single treatment. With the average drug development cost reaching $2.6 billion over 12 years with only a 10% success rate, he explains why these therapies command million-dollar price tags while proposing innovative risk-pooling solutions that could revolutionize healthcare financing.

Key Topics Discussed:

• The Healthcare System's Lightning Strike Problem - How America's post-WWII employer healthcare model designed to spread predictable annual costs is fundamentally incompatible with one-time curative therapies costing $3-5 million, creating unpredictable "lightning strike" financial events that smaller self-insured employers cannot absorb, while traditional stop-loss insurance becomes prohibitively expensive as thresholds approach treatment costs

• The Plan Year Trap and Long-Term Investment Dilemma - Why healthcare's annual budgeting cycle prevents employers from making rational long-term investments like GLP-1 coverage for weight loss, since cardiovascular and diabetes benefits accrue over 5-10 years but employee tenure averages 12-24 months, creating perverse incentives to defer preventative care and push costs to future employers

• Revolutionary Risk Pool Innovation for Ultra-High-Cost Therapies - Drew's novel approach to carve out cell and gene therapies from traditional employer benefits into consolidated risk pools that spread costs across multiple employers on a per-member-per-month basis, creating predictability for budgeting while maintaining coverage, similar to reinsurance but bringing risk management closer to self-insured employers

The episode reveals how rebate models designed for tr

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Sponsored by:
Peek: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/.

Institute for Integrated Health (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/.

In this episode of Only Healthcare, hosts Randy Vogenberg and Michael Navin welcome Tamara Thomas, Founder and Editor-in-Chief of Urban Health Today, for a candid discussion about the consumer perspective on America's broken healthcare system. Drawing from her extensive background in health disparities coverage and a shocking revelation from an insurance executive years ago, Tamara exposes the fundamental conflict between profit motives and patient care.

With her unique lens as both a healthcare journalist and certified health coach, Tamara joins Randy and Michael in dissecting how insurance companies have systematically extracted value from the healthcare system while leaving patients, providers, and employers bearing the financial burden. Together, they reveal practical solutions for consumers to navigate and escape the current system's stranglehold.

Key Topics Discussed:

• The Insurance Industry's True Confession - Tamara's undergraduate encounter with a student health insurance underwriter who openly admitted their goal was "to make as much money as possible and spend as little money as possible," revealing the industry's fundamental misalignment with patient needs
• Provider Shortage Crisis and Root Causes - How financial disincentives drive talented individuals away from healthcare careers, with medical school debt reaching $500,000 while reimbursements decline, forcing physicians into corporate employment or high-paying specialties instead of primary care
• Healthcare Price Transparency Failures - Real-world examples of mandated hospital pricing files being deliberately incomprehensible, while tools like Peak's transparent pricing platform can reduce costs by 80% (EEG example: $4,000 reduced to $800 through negotiation)
• The Managed Care Extraction Machine - Tamara's personal story of fighting managed Medicaid for her dying mother's basic needs, and how removing the managed care component immediately opened access to necessary equipment and services
• Diversity Crisis in Healthcare Workforce - Startling statistics showing 65% of physicians are white while representing 75% of population, with underrepresented minorities unable to pursue primary care due to debt burdens, creating care deserts in communities that need it most
• PBM Rebate Manipulation Exposed - Concrete example of pharmaceutical CEO needing to charge $1,200 monthly to net $200 profit due to 70% PBM rebate demands, demonstrating how middlemen extract maximum value while patients pay

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Sponsored by:
Peek: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/.

Institute for Integrated Health (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/.

In this episode of Only Healthcare, hosts Michael Navin and Dr. Randy Vogenberg welcome two healthcare transformation pioneers: Dave Chase, co-founder of Health Rosetta, and Steve Ditto, compliance advisor and founder of Ditto and Associates. Together, they reveal how employers can slash healthcare costs by 50% or more while improving employee benefits through strategic procurement and fiduciary compliance.

With decades of experience in healthcare technology and benefits consulting, Dave and Steve break down the systemic failures that have turned healthcare into a $5 trillion extraction machine, and more importantly, show the proven blueprint that thousands of employers are using to reclaim control and turn healthcare waste into business prosperity.

Key Topics Discussed:

• The PBM Evolution from Helper to Extractor - How pharmacy benefit managers transformed from value-adding organizations in the early days to complex revenue extraction machines with up to 50 different revenue streams, now owning their own drug companies
• The $540 Million Success Story - Real case study of Rosen Hotels (500-5,000 employees) saving cumulative millions through primary care focus, direct contracting, and PBM bypass strategies, enabling full college tuition coverage for employees and their children
• Open Source Healthcare Revolution - Health Rosetta's $4 million investment in open-sourcing procurement standards, contracting templates, and data platforms through Nautilus Health Institute to democratize healthcare transformation
• PBM Field Guide Launch - New standardized tools including RFPs, contract terms, and evaluation criteria to help employers and advisors navigate away from conflicted PBMs toward transparent alternatives

The fundamental insight: healthcare dysfunction isn't accidental—it's codified in legal agreements. But employers who embrace fiduciary responsibilities and apply basic procurement principles can achieve remarkable results, turning the 30-50% healthcare waste into a competitive advantage and employee prosperity.

Learn more about Rosetta Fest by clicking here.  Disrupting Healthcare: Join the Brightest Minds, Leaders, and Change Makers at RosettaFest 2025 on August 24-27, 2025 in Colorado Convention Center - Denver, CO. 

🎧 Listen now:

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Sponsored by:
Peek: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/.

Institute for Integrated Health (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/.

In this episode of Only Healthcare, hosts Michael Navin and Dr. Randy Vogenberg welcome guest Deborah Williams, a leading healthcare strategy and policy expert, to explore the explosive growth and complex economics of GLP-1 medications like Ozempic and Wegovy. 

With her extensive background working on Medicare Part D legislation and with major pharmaceutical companies, Deborah breaks down how these breakthrough diabetes and weight loss drugs exemplify everything wrong with America's healthcare incentive structure.

Key Topics Discussed:

• Explosive Market Growth & Cost Impact - GLP-1 scripts increased 442% between 2021-2023, creating a market three times larger than cancer spending, with list prices reaching $1,400 monthly while costing only $60 in Germany
• Coverage vs. Affordability Crisis - Only 33% of employers cover obesity indications, with 17 state employee plans dropping coverage due to budget constraints, while patients face full list prices until hitting deductibles
• PBM-Driven Pricing Distortion - Real-world example of a CEO needing to charge $930 monthly to net $200 profit due to PBM rebate demands, while a $63 diabetes alternative (Steglatro) gets excluded because it offers no rebate opportunity
• Direct-Pay Solutions & Reform - Analysis of Lilly Direct and Novo Cares programs that bypass traditional middlemen, offering vial-and-syringe options at net pricing similar to post-rebate costs but as cash-pay transactions

The fundamental problem isn't just drug pricing, it's a system where every stakeholder is incentivized to maximize revenue rather than patient health outcomes, with PBMs controlling access based on rebate potential rather than clinical effectiveness.

🎧 Listen now: onlyhealthcarepodcast.com

Chapters:

(00:00) Introduction
(02:00) GLP-1 category overview and 442% script growth explosion
(06:00) Patient engagement challenges: lifestyle vs. medication approach
(10:00) Coverage gaps: employer plans dropping obesity coverage
(16:00) PBM rebate demands forcing artificial price inflation
(23:00) Compounding alternatives and FDA policy changes
(27:00) Direct-pay programs: Lilly Direct and Novo Cares analysis
(31:00) Future outlook and policy reform recommendations

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Sponsored by:
Peek: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/.

Institute for Integrated Health (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/.