Who Is Auditing These Healthcare Bills? Also, That Cigna Lawsuit, With Dawn Cornelis, Cofounder and Director of Transparency at ClaimInformatics (Encore! EP285) In this Encore, prompted by a Cigna class-action lawsuit alleging fraudulent lab billing, Stacey Richter revisits her conversation with Dawn Cornelis, cofounder of ClaimInformatics, about the roughly 30% of healthcare claims spending that's some combination of fraud, waste, and abuse. WHAT YOU'LL LEARN ✅ The details of the Cigna lawsuit alleging a pseudonym lab entity was used to inflate a member's out-of-pocket costs ✅ The three main categories of claims problems: paid incorrectly, missed opportunities to help members, and claims that shouldn't have been submitted at all ✅ Why 5% to 10% of claims simply aren't paid correctly, according to Dawn's audit work ✅ Why some audit and recovery firms also do revenue optimization work for providers — the same providers whose claims they're supposed to be auditing ✅ Why plan sponsors need to ask who is auditing their claims data, and by whom WHY THIS MATTERS The Cigna lawsuit is a headline-grabbing example of a much bigger, quieter problem: roughly 30% of healthcare spending is fraud, waste, or abuse, and plan sponsors often don't know whether their claims are being audited by a firm with a conflicting revenue-optimization relationship with the very providers submitting those claims. Asking who's auditing the bills — and whether that auditor has skin in the other side of the game — is a basic fiduciary question too many plan sponsors haven't asked. === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 00:00 Introduction 06:57 The story in the data. 07:33 Who's submitting these claims? 08:04 The three problems with the data. 10:54 The varying factor between carrier systems to stop fraud, waste, and abuse. 11:32 Why carriers don't push for better systems to stop inappropriate dollars. 13:28 The difference between fraud, waste, and abuse. 14:46 "When it becomes the norm, that's what's very bothering." 15:10 The barriers or hurdles in the marketplace. 17:38 What we don't know about but could do better at when looking at the data. 19:10 "It's not so much the health system and what they are charging. It's about…what the contracted rate is agreed to." 20:04 "Data's fixed for itself." 22:49 Identifying and eliminating fraud. 22:54 The lack of enforcement behind preventing illegal billing. 26:01 How providers ensure they aren't inadvertently harming employers and patients through billing.

This is Part 1 of a two-part reflection on why host Stacey Richter started Relentless Health Value and what she's hoping the show accomplishes. Rather than a guest interview, Stacey turns the mic toward her own listeners — the self-described "Relentless Health Value Tribe" — explaining who they are, why she believes each of them has more influence over the healthcare system than they realize, and why the sum of thousands of individual, seemingly small decisions is what actually determines an organization's impact on patients. Part 2 (EP400) picks up the thread the following episode. WHAT YOU'LL LEARN ✅ Who actually listens to Relentless Health Value — Stacey estimates more than 40% are senior-level executives with real decision-making authority, spanning providers, payers, digital health, policy, benefits, and more ✅ Why Stacey believes individual employees, not CEOs, actually determine an organization's impact — it's the sum of thousands of daily micro-decisions, not the incentive structures set at the top, that adds up to real-world outcomes ✅ The pachinko-machine metaphor Stacey uses for healthcare: an action intended to help patients can bounce around the system's black box and pop out the other side doing the opposite of what was intended ✅ Why incremental progress and long-term disruption aren't competing strategies — and the math behind why even a 0.01% improvement matters at scale (roughly 35,000 people and $300 million in a country the size of the US) ✅ Why Stacey sees Relentless Health Value less as a media product and more as a loose-knit community — per Malcolm Gladwell's The Tipping Point — where listeners across the industry can find each other and collaborate on points of mutual interest WHY THIS MATTERS "You are not synonymous with the company you work for," Stacey tells her audience — a reminder that the industry's slow-moving, financialized incumbents don't have to be an excuse for inaction. As she puts it, "It's the sum of all those micro choices…that determine the impact that that organization has on those it serves." Individual listeners, however small their formal authority, are the ones with their hands directly on the pachinko machine — and that, she argues, is where healthcare actually gets transformed. === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify 📺 Subscribe to our YouTube channel === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 00:47 What is your role as the listener of this show? 01:27 How did Stacey realize how special our listeners are? 01:56 Who are our listeners? 03:15 Why did Stacey start the Relentless Health Value podcast? 04:10 What have the listeners of the Relentless Health Value podcast and its guests accomplished? 05:13 What is Stacey's advice to listeners that feel powerless? 06:22 "It's the sum of all those micro choices…that determine the impact that that organization has on those it serves." 09:22 "There are lots of synergies to explore." 10:51 Sign up for the weekly email newsletter.

The Minefield That Is a PBM Contract and Also Some Advice for EBCs Who Are Taking Money Under the Table, With Paul Holmes. Signing a Standard PBM Contract Could Be Costing Your Company 30% to 40% Above Market. Episode 397. Stacey Richter talks with Paul Holmes, JD, an ERISA attorney specializing in PBM contracts, about the buried treasures hidden in standard pharmacy benefit manager contracts—and why plan sponsors need independent, third-party review before they sign. WHAT YOU'LL LEARN ✅ Why signing a PBM's standard model contract can mean paying 30% to 40% over market for pharmacy benefits ✅ What the roughly 17 common costly terms buried in typical PBM contracts actually do ✅ Why an independent third party—not your existing EBC—should review every PBM contract ✅ How the Consolidated Appropriations Act (CAA) exposes plan sponsors to new ERISA fiduciary-breach lawsuit risk ✅ What red flags suggest an EBC may be taking undisclosed payments at the plan sponsor's expense ✅ Why a lawyer-provided disclosure statement without disclaimers is a reasonable ask of any EBC relationship WHY THIS MATTERS A few thousand dollars in independent legal review could save a company millions in overpaid drug spend—and now, post-CAA, protect it from real fiduciary-breach litigation exposure. Holmes's minefield map gives plan sponsors and their advisors a concrete checklist for a contract category most employers sign without truly understanding. MENTIONED IN THIS EPISODE EP379 with AJ Loiacono: Apple Podcasts | Spotify | Other Apps === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 06:06 What are Paul's usual observations when a PBM contract crosses his desk? 06:57 "If you just sign … one of their model contracts …, you're probably gonna pay 30% to 40% above market on your drug spend." 10:35 What is a PBM lawyer? And why is it important to find an ERISA PBM lawyer? 15:37 EP379 with AJ Loiacono. 16:05 Who is on the hook for the cost of the PBM contracts? 20:36 What's the problem with most ERISA lawyers today? 22:28 Lawsuit about PBM contract. 27:15 What's Paul's advice for benefits consultants? 31:11 How much might a plan sponsor be paying their consultant versus what a consultant might be making from a PBM?

The Minefield That Is a PBM Contract and Also Some Advice for EBCs Who Are Taking Money Under the Table, With Paul Holmes. Signing a Standard PBM Contract Could Be Costing Your Company 30% to 40% Above Market. Episode 397. Stacey Richter talks with Paul Holmes, JD, an ERISA attorney specializing in PBM contracts, about the buried treasures hidden in standard pharmacy benefit manager contracts—and why plan sponsors need independent, third-party review before they sign. WHAT YOU'LL LEARN ✅ Why signing a PBM's standard model contract can mean paying 30% to 40% over market for pharmacy benefits ✅ What the roughly 17 common costly terms buried in typical PBM contracts actually do ✅ Why an independent third party—not your existing EBC—should review every PBM contract ✅ How the Consolidated Appropriations Act (CAA) exposes plan sponsors to new ERISA fiduciary-breach lawsuit risk ✅ What red flags suggest an EBC may be taking undisclosed payments at the plan sponsor's expense ✅ Why a lawyer-provided disclosure statement without disclaimers is a reasonable ask of any EBC relationship WHY THIS MATTERS A few thousand dollars in independent legal review could save a company millions in overpaid drug spend—and now, post-CAA, protect it from real fiduciary-breach litigation exposure. Holmes's minefield map gives plan sponsors and their advisors a concrete checklist for a contract category most employers sign without truly understanding. MENTIONED IN THIS EPISODE EP379 with AJ Loiacono: Apple Podcasts | Spotify | Other Apps === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 06:06 What are Paul's usual observations when a PBM contract crosses his desk? 06:57 "If you just sign … one of their model contracts …, you're probably gonna pay 30% to 40% above market on your drug spend." 10:35 What is a PBM lawyer? And why is it important to find an ERISA PBM lawyer? 15:37 EP379 with AJ Loiacono. 16:05 Who is on the hook for the cost of the PBM contracts? 20:36 What's the problem with most ERISA lawyers today? 22:28 Lawsuit about PBM contract. 27:15 What's Paul's advice for benefits consultants? 31:11 How much might a plan sponsor be paying their consultant versus what a consultant might be making from a PBM?

How to Answer This Question: Will Humira® Biosimilars Reduce Drug Spend? With Anna Hyde. Biosimilar Competition Alone Won't Lower Prices—Uptake Is What Actually Moves the Needle. Episode 396. Stacey Richter talks with Anna Hyde, VP of advocacy and access at the Arthritis Foundation, about why the arrival of a dozen Humira biosimilars in 2023 won't automatically lower drug spend—and what has to happen for prices to actually come down. WHAT YOU'LL LEARN ✅ Why having competitors on the market doesn't erode a monopoly without real patient and provider uptake ✅ How manufacturer rebates keep PBMs "addicted" to the reference product even after biosimilars launch ✅ Why provider and patient confidence in biosimilar interchangeability is just as important as market dynamics ✅ What tipping point in net pricing would be needed to force PBMs to prefer biosimilars over Humira ✅ Why clear, proactive communication prevents patients from feeling blindsided by a switch to an unfamiliar delivery device ✅ What health plans should be doing right now to prepare for a thoughtful biosimilar transition WHY THIS MATTERS Competition on paper doesn't guarantee lower prices in practice—it takes real patient and provider uptake to break a rebate-driven monopoly. Hyde's advice gives health plans a communication-first roadmap for actually reaching the tipping point where biosimilar savings materialize, rather than assuming market dynamics will handle it alone. MENTIONED IN THIS EPISODE No past-episode citations in this episode's timestamped chapter list. === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 07:38 What does a successful biosimilar market depend on? 09:07 Why does uptake seem to reduce prices? 10:24 How important is the relationship with the healthcare provider? 11:35 Where are we in getting these biosimilars to market? 13:02 Are there differences between the reference product and biosimilars? 19:26 Why does the way you approach the patient matter? 22:36 Why do providers feel like they don't have a lot of agency in the biosimilar conversation? 24:50 What should health plans be thinking if they want to go down the biosimilar path? 27:36 "Our goal is to keep a feedback loop such that no patient falls through the cracks." 28:21 What is the "nocebo" effect? 31:27 What is Anna's advice to plan sponsors on communicating with providers and plan sponsors?

Game Theory Gone Wild: Co-pay Cards, Co-pay Accumulators, and Co-pay Maximizers, With Dea Belazi, PharmD, MPH, President and CEO of AscellaHealth (Encore! EP293) In this Encore, Stacey Richter revisits her conversation with Dea Belazi, PharmD, MPH, president and CEO of AscellaHealth, about the escalating game-theory battle between Pharma's co-pay cards and PBMs' co-pay accumulators and maximizers — with patients caught in the middle. WHAT YOU'LL LEARN ✅ Why drug abandonment happens, and how PBMs use it as leverage to extract rebates from Pharma ✅ How co-pay accumulators and maximizers emerged as PBMs' countermove to Pharma's co-pay discount cards ✅ Why this same leverage battle, once fought over small-molecule drugs, now plays out over six-figure specialty therapies ✅ How some PBMs' separate maximizer entities upcharge employer plan sponsors while extracting cash from Pharma ✅ What the proposed HELP Copays Act aims to address in this system WHY THIS MATTERS Co-pay accumulators and maximizers sound like obscure PBM plumbing, but they determine whether a patient can actually afford the "miracle drug" their doctor prescribed — and whether Pharma's high list prices get checked or emboldened by how much of the out-of-pocket burden shifts onto patients. Understanding this game theory is essential for any plan sponsor trying to figure out who's actually benefiting from their benefit design. MENTIONED IN THIS EPISODE EP241 with Vinay Patel: Apple Podcasts | Spotify | Other Apps (link unavailable) === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 00:00 Introduction 11:06 "The concept of co-pay accumulators wasn't just a…PBM thought, but it also came from their customers, whether it was health plans or employer groups." 15:50 "[This is] literally a math problem based on, 'Do I spend it now? Do I spend it later?'" 17:20 What reason do employers and payers have for doing this? 21:13 "This is another mechanism for payers to push down additional cost to both the patient and now the pharma company." 22:24 EP241 with Vinay Patel. 22:59 "I don't think accumulators are really forcing Pharma to be more competitive." 25:06 How co-pay maximizers are different from co-pay accumulators. 28:09 Who doesn't like co-pay accumulators and maximizers? 30:01 How patient advocacy groups are a different model. 32:10 What is the biggest challenge facing employers right now?

Consolidated Hospital Systems and Cunning Anticompetitive Contracts, With Brennan Bilberry. Four Contract Terms Every Anticompetitive Hospital System Uses to Lock In Higher Prices. Episode 395. Stacey Richter talks with Brennan Bilberry, founding partner of Fairmark Partners, about the four anticompetitive contract terms hospital systems use to consolidate market power and keep prices climbing. WHAT YOU'LL LEARN ✅ How all-or-nothing contracting forces payers to include every hospital facility in-network at monopoly-level prices ✅ Why anti-steering and anti-tiering clauses eliminate any chance of using consumerism to route patients to better care ✅ What pricing gag clauses are and why they prevent employers and patients from knowing costs in advance ✅ How dominant hospitals use admitting privileges and referral leverage to control ostensibly independent providers ✅ Why hospital system consolidation functions as a flywheel: consolidate, force anticompetitive contracts, then raise prices ✅ What legal and legislative strategies are emerging to fight back against these anticompetitive practices WHY THIS MATTERS Anticompetitive hospital contract terms are normalized in healthcare in a way that would never be tolerated in any other industry. Bilberry's antitrust litigation work gives employers, TPAs, and legislators a concrete playbook for identifying and challenging the specific contract mechanics that lock communities into ever-rising hospital prices. MENTIONED IN THIS EPISODE EP373 with Cora Opsahl: Apple Podcasts | Spotify | Other Apps EP249 with Dale Folwell: Apple Podcasts | Spotify | Other Apps EP391 with Scott Conard, MD: Apple Podcasts | Spotify | Other Apps EP389 with Mike Thompson: Apple Podcasts | Spotify | Other Apps EP390 with Gloria Sachdev, PharmD, and Chris Skisak, PhD: Apple Podcasts | Spotify | Other Apps === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 06:16 What happens after a hospital consolidates? 07:23 What does an anticompetitive system look like when a hospital consolidates? 10:35 What are some anticompetitive "tricks" that hospitals employ? 12:37 The Sutter case in northern California. 14:50 What can you do if you're forced to engage in an all-or-nothing contract with a hospital system? 18:31 The Atrium case in North Carolina. 19:36 EP373 with Cora Opsahl. 21:33 What are price gag clauses? 23:08 How are legacy gag clauses designed to prevent scrutiny in litigation? 24:04 EP249 with Dale Folwell. 26:08 How do hospital restrictions on other providers create an anticompetitive environment? 27:23 EP391 with Scott Conard, MD. 29:48 EP389 with Mike Thompson or EP390 with Gloria Sachdev and Chris Skisak.

Spoiler Alert: It Is Counterintuitive Which Hospitals Offer the Most Charity Care, With Vikas Saini, MD, and Judith Garber, MPP. Richer Hospitals Often Give Less Charity Care—Here's Why. Episode 394. Stacey Richter talks with Vikas Saini, MD, and Judith Garber, MPP, of the Lown Institute, about why the hospitals with the most money frequently offer the least charity care—and what would actually fix it. WHAT YOU'LL LEARN ✅ Why building in wealthy suburbs with little affordable housing structurally reduces the need for charity care ✅ How the shift of surgeries to ambulatory surgical centers can leave EDs unable to treat indigent patients—raising EMTALA concerns ✅ Why "non-profit and for-profit is a tax position, not a philosophy" for some hospital decision-makers ✅ What "fair share spending" means and which hospitals are actually meeting it ✅ Why pooling regional hospital charity dollars under a community board could fix uneven charity care distribution ✅ How financially strapped hospitals often give back more to their communities than well-resourced ones WHY THIS MATTERS The assumption that bigger, richer hospitals do more community good doesn't hold up under the Lown Institute's data. Understanding the specific mechanisms—site selection, ASC shifts, and tax-position thinking—gives policymakers and community advocates concrete levers to demand real accountability instead of taking halo-effect PR at face value. MENTIONED IN THIS EPISODE EP374 with Dave Chase: Apple Podcasts | Spotify | Other Apps === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 06:50 Why does America need socially responsible hospitals? 08:23 What standards are hospitals beholden to with their charitable spending? 08:47 "It's the honor system, essentially." 11:38 What is fair share spending? 13:43 Which hospitals are paying their fair share? 15:05 Why do hospitals that are financially more strapped tend to give back to their communities more? 17:25 Why is it hard for hospitals with the most privately insured patients to do the most for their community? 18:56 "These outcomes … are the outcomes of the [current system]." 21:23 "A key problem here is [that] systems have gotten so big." 22:30 What's the solution to fixing the problem with hospital charity care? 23:52 EP374 with Dave Chase. 29:21 What would be the level of acceptance with changing the system as it stands with hospitals?

How Do You Know if a Practice or a CIN Is Actually Clinically Integrated? With David Muhlestein, PhD, JD. The One-Sentence Litmus Test for Whether Your Care Is Really Integrated. Episode 393. Stacey Richter talks with David Muhlestein, PhD, JD, chief research and innovation officer at Health Management Associates, about the litmus test for genuine clinical integration—and the four-step process practices need before taking on downside risk. WHAT YOU'LL LEARN ✅ The one-sentence litmus test: did the practice change how it delivers care to drive predetermined outcomes? ✅ Why wanting to get paid more for care you're already delivering isn't the same as clinical integration ✅ David's four-step process: self-assessment, matching capacity to population needs, identifying processes, and starting small ✅ Why downside risk fundamentally changes how physicians think about their patient cohort ✅ How capitated, integrated primary care models like Iora, ChenMed, and Oak Street achieve outsized profitability ✅ Why strong, mission-driven leadership—not the payment model alone—determines whether value-based care actually improves outcomes WHY THIS MATTERS "Clinical integration" gets used loosely across the industry, but Muhlestein's litmus test cuts through the ambiguity: did practice patterns actually change? That distinction matters enormously for any CIN or ACO deciding whether it's ready to take on downside risk, or just ready to ask for more money for what it was already doing. MENTIONED IN THIS EPISODE Encore! EP176 with Robert Pearl, MD: Apple Podcasts | Spotify | Other Apps (link unavailable) EP391 with Scott Conard, MD: Apple Podcasts | Spotify | Other Apps Encore! EP326 with Rishi Wadhera, MD, MPP: Apple Podcasts | Spotify | Other Apps === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 07:57 What does it mean to be clinically integrated? 10:23 How does changing practice patterns count as becoming clinically integrated? 11:11 How do you change the delivery of care to get better outcomes? 12:05 What does it mean to see better outcomes when becoming clinically integrated? 14:46 Encore! EP176 with Dr. Robert Pearl. 17:42 "Their structure is dictating what they are going to prioritize." 19:02 "How do you care for the patients that have yet to come and see you?" 20:16 EP391 with Scott Conard, MD. 22:38 "When you're integrated, you realize you're not alone." 25:50 Why does clinically integrating require a significant mindset change? 28:55 What does this country need to do from a policy perspective for this change? 30:24 Encore! EP326 with Rishi Wadhera, MD, MPP.

The 5 Business Models for Digital Health Companies, With Nikhil Krishnan (Encore! EP355) In this Encore, Stacey Richter revisits her conversation with Nikhil Krishnan, founder of the Out-Of-Pocket newsletter, about the five business models digital health start-ups eventually settle into — and why knowing who's paying the bills matters more than any clinical mission statement. WHAT YOU'LL LEARN ✅ The five business models: cash-pay ecosystems, better middleware, serving incumbents, joint ventures, and old-school incumbents ✅ Why start-ups pitching "lower costs and improve patient care" as their whole pitch often get cast out by administrators who don't share that incentive ✅ Why so many digital health founders struggle to pinpoint who their actual paying customer is ✅ Why selling tech directly to large incumbents rarely moves the needle ✅ Why board-level focus on clinical outcomes, not just financing, separates the mission-driven companies from the rest WHY THIS MATTERS A digital health company's clinical mission means little if its business model doesn't match who's actually paying — and in healthcare, payers, providers, and health systems often have a financial stake in costs going up, not down. Knowing which of the five models a start-up occupies, and whether its customer's incentives are actually aligned with better patient outcomes, is the real test of whether it can survive and do good at the same time. === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 00:00 Introduction 06:20 What are the different models of digital health? 08:05 What are the different motives for cash-pay digital health models? 13:54 "One of healthcare's original sins is that every solution deployed has been a custom solution for the end user." 14:19 How willing will these companies be to share their data with third parties? 18:07 "I don't think selling tech to large incumbents is going to move the needle." 21:14 "These companies, most of them are actually getting extra money for the more expensive stuff." 22:58 How did joint-venture digital health business models come about? 26:37 Why do you see partnerships more on the payer/provider side? 27:29 Who are the old-school digital health companies that could be considered incumbents? 29:36 Why do so many digital health start-ups have a hard time pinpointing who will pay for their services? 32:10 "The ability to go through the idea maze is way faster now." 34:55 "The field is wide open to help teach people how healthcare works."