The most played episodes among Podcast App listeners.

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   Number 1: Private Equity in Primary Care: What the Data Actually Shows, With Yashaswini Singh, PhD. Episode 528.

   Private Equity in Primary Care: Just Another Inflationary Business Model? What Does the Data Actually Show, With Yashaswini Singh, PhD (EP528) Private equity has been buying up primary care practices for years, promising the capital that chronically underfunded clinicians badly need. But does the money actually make care better? Yashaswini Singh, PhD, MPA, the Thomas J. and Alice M. Tisch Assistant Professor of Health Services, Policy, and Practice at Brown University, has spent years studying that question — and her newest research, published in Health Affairs and JAMA Health Forum, finds PE-affiliated primary care physicians negotiate prices 8% to 10% higher than independent doctors, while patient outcomes barely budge. WHAT YOU'LL LEARN ✅ Why negotiated prices for PE-affiliated primary care physicians run 8% to 10% higher than independent doctors — and why hospital-affiliated physicians still command the highest prices of all ✅ How a national study of roughly 200 PE-acquired primary care practices found a 20% increase in preventive services, including the Medicare Annual Wellness Visit, with no evidence of low-value care ✅ Why "cognitive atrophy" — deskilling from rigid, box-checking visits — isn't inevitable under PE ownership, but why the "best case scenario" often isn't what's actually happening ✅ How opaque common ownership — the same investors owning primary care, GI, orthopedic, and oncology practices — can create hidden referral incentives current data can't detect ✅ Why site-of-care payment arbitrage — a hospital-owned MRI can cost double or triple an independent one — drives referral-machine incentives regardless of who owns the practice ✅ Why PE's promise to reduce fragmentation through consolidation has instead produced physician turnover that undermines the patient-doctor relationship WHY THIS MATTERS Primary care clinicians are chronically underpaid, and private equity promises the capital to fix that. But Dr. Singh's research shows a real tradeoff: costs rise 8% to 10% while quality barely moves. Whether professional capital builds sustainable, whole-person care or becomes, as Stacey puts it, corporate arbitrage in a different Halloween costume depends on realigning payment incentives around outcomes rather than throughput — something no ownership model, PE included, is yet built to do. MENTIONED IN THIS EPISODE EP519 with Lisa Rosenbaum, MD: Apple Podcasts | Spotify | Other Apps LinkedIn Post by Yashaswini Singh, PhD EP474 with Yashaswini Singh, PhD: Apple Podcasts | Spotify | Other Apps Study: "Private Equity Acquisitions in Primary Care" (Health Affairs) Study: "Private Equity Acquisition in Primary Care and Avoidable Hospitalizations" (JAMA Health Forum) LinkedIn Comment by Andrea DeSantis, DO, FAAFP EP521 with Andrew Tsang: Apple Podcasts | Spotify | Other Apps EP523 with Suhas Gondi, MD, MBA: Apple Podcasts | Spotify | Other Apps === LINKS === 🔗 Show Notes with all mentioned links: Show Notes ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 🎤 Follow us on Apple Podcasts 🎤 Follow us on Spotify 📺 Subscribe to our YouTube channel === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 00:00 Introduction to this episode. 04:16 The three categories covered in today's episode. 05:36 The conversation with Dr. Singh. 07:02 Findings these private equity studies have found about primary care. 12:00 Does private equity make cognitive atrophy inevitable? 14:49 In PE-backed, single-specialty primary care, is it easier for PCPs to have full-spectrum clinical scope? 17:14 Why perverse financial incentives cause problems but aren't necessarily an inevitability. 22:17 Fragmentation and private equity in primary care. 25:46 Indie primary care versus PE-backed primary care versus hospital system–backed primary care. 32:22 What Dr. Singh is thinking about and looking to solve for next. 34:30 Inspiring physician-led work and a reason for hope.

   September 09, 2026·39min
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   Number 2: Beating Provider Network Pricing Games by Thinking About Buying Healthcare Like a Manufacturer Supply Chain, With John Quinn

   John Quinn, founder and CEO of Wellnecity, joins Stacey Richter in episode 524 for an outtake from their conversation last fall on rethinking how self-insured employers build their provider networks. Rather than treating the network as one big, undifferentiated system, Quinn argues employers should think like a manufacturing supply chain: break healthcare into defined "subassemblies," or pods of care — pediatric care, a cancer journey, a kidney stone episode — and direct-contract for those pods whenever the price beats the fee-for-service average. If the boundaries of the pod are clear and the price comes in lower, Quinn says, the plan and the member both win, quality being equal. WHAT YOU'LL LEARN ✅ Why Stacey Richter says the provider-network debate could fill "a 20-hour show," and why networks still have real upsides — administrative infrastructure, claims coordination, guaranteed provider payment, and broad access — even as critics like Mark Cuban ask on LinkedIn, "Why do we need networks? It is just a way for insurers to play pricing games." ✅ A real example of network rigidity: a self-insured employer identified 40 physicians who cost the plan upwards of $15 million in a single plan year while patient harm was occurring, and their ASO couldn't figure out how to remove those doctors from network under the existing contract structure ✅ How John Quinn defines a "subassembly" or "pod of care" — a bounded, definable episode like pediatric care or a cancer journey — and why purchasing that pod for less than the fee-for-service average is a win for the plan and member, assuming quality stays neutral ✅ Quinn's kidney stone example: a physician who says he can now treat a kidney stone in a 48-hour to five-day episode for roughly $2,000 to $3,000, versus the typical six weeks of pain, overuse of pain medication, and a price north of $10,000 ✅ Why Quinn frames network optimization as a manufacturing supply-chain problem — the same way an automobile gets built from subassemblies sourced from specialized providers around the globe — because it's a mental model CFOs and senior leadership at self-insured employers already trust ✅ Quinn's bottom line: "We have the tech and we've got the tools to do this at this point. We just have to get ourselves out of" the fee-for-service hangover WHY THIS MATTERS Provider networks have real tradeoffs: broad access and guaranteed payment on one side, opaque pricing and rigid contracts on the other. John Quinn's pitch to self-insured employers isn't to blow up the network model, but to layer bounded, directly contracted "pods of care" on top of it wherever a clear price beats the fee-for-service average. Framing that as supply-chain sourcing, rather than a wholesale network overhaul, gives risk-averse finance and HR leaders a model they already understand — and, Quinn argues, the technology to act on it already exists. MENTIONED IN THIS EPISODE LinkedIn Post by Mark Cuban Article: Medical Economics, "An Idea Whose Time Has Gone: Healthcare Provider Networks," by Jim Jusko, JD EP457 with Cynthia Fisher: Apple Podcasts | Spotify | Other Apps EP433 with Justin Leader: Apple Podcasts | Spotify | Other Apps EP501 with Ivana Krajcinovic, PhD: Apple Podcasts | Spotify | Other Apps EP503 with Ryan Wells; Leo Spector, MD, MBA; and Adam Stavisky: Apple Podcasts | Spotify | Other Apps EP485 with Cristin Dickerson, MD: Apple Podcasts | Spotify | Other Apps EP486 with Stan Schwartz, MD: Apple Podcasts | Spotify | Other Apps EP493 with John Quinn: Apple Podcasts | Spotify | Other Apps EP495 with Mick Connors, MD: Apple Podcasts | Spotify | Other Apps EP505 with Ahilan Sivaganesan, MD: 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 00:00 Introduction to this episode. 00:50 LinkedIn post by Mark Cuban. 01:16 EP457 with Cynthia Fisher. 01:20 EP433 with Justin Leader. 01:29 Medical Economics article by Jim Jusko, JD. 03:01 EP501 with Ivana Krajcinovic, PhD. 04:22 A breakdown of what's to come in today's conversation. 06:11 EP503 with Ryan Wells; Leo Spector, MD, MBA; and Adam Stavisky. 06:34 EP485 with Cristin Dickerson, MD. 06:49 EP486 with Stan Schwartz, MD. 07:07 EP493 with John Quinn. 07:57 The conversation with John Quinn. 10:06 Is calculating value realistic? 11:38 Looking at value calculation through an assembly lens. 14:54 The takeaway. 15:17 EP495 with Mick Connors, MD. 15:20 EP505 with Ahilan Sivaganesan, MD.

   August 12, 2026·18min
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   Number 3: The Sleeping Giants of Healthcare—Why Self-insured Employers and Clinicians Keep Missing Each Other, With Suhas Gondi, MD, MBA. EP523

   Why Self-Insured Employers and Clinicians Keep Missing Each Other, With Suhas Gondi, MD. The Sleeping Giants of Healthcare: Why Employers and Clinicians Keep Missing Each Other. Episode 523. Dr. Suhas Gondi, MD, MBA, chief medical officer at Health Strategy and an attending physician at Massachusetts General Hospital, co-wrote a New England Journal of Medicine article — "A Sleeping Giant of Health Care Affordability—Self-Insured Employers" — because most clinicians, he found, have little idea a self-insured employer, not an insurance carrier, is the one actually paying for their patients' care. Talking with Stacey Richter, Dr. Gondi argues that self-insured employers and clinicians are both "sleeping giants," each holding real power over cost and access, who rarely communicate directly — leaving patients caught in the gap. WHAT YOU'LL LEARN ✅ Why Dr. Suhas Gondi and his NEJM co-author, Zirui Song, MD, PhD, wrote for clinicians who, they found, have little sense that a self-insured employer — not the carrier name on the card — actually pays for a patient's care ✅ How a GLP-1 prescription can get denied at the pharmacy counter even after a clinician verifies coverage, because the employer has quietly moved GLP-1 coverage exclusively through a single third-party prescribing and coaching vendor ✅ Why GLP-1 spending alone can push a self-insured employer's pharmacy costs up 9% to 20% in a year, and why the roughly eight-year payback period employers are counting on assumes patients stay adherent far longer than most actually do ✅ How oncology site-of-care steering — an employer declining to pay a roughly 40% premium for infusion at a hospital-owned center instead of a physician's office — can look to the patient and oncologist like a denied cancer drug ✅ Why Dr. Gondi says EHRs like Epic are built to optimize revenue for hospital-system customers, not to surface a lower-cost site of care for patients or plan sponsors ✅ Dr. Gondi's advice for closing the gap: clinicians and employers should communicate directly, especially before a coverage change lands on patients, rather than assuming direct contracting is the only fix WHY THIS MATTERS Roughly half to 60% of the US population has commercial insurance, and nearly three-quarters of large employers self-insure that coverage — yet most clinicians have no visibility into the plan-level decisions those employers make, and most employers have no channel to explain those decisions to the doctors whose patients are affected. Both sides, Dr. Gondi says, usually believe they're doing the right thing — covering the GLP-1, covering the cancer drug — and the patient still gets lost in between. Closing that gap doesn't require full direct contracting, he argues, just employers and local provider groups actually talking to each other before a coverage change lands on a patient, not after. MENTIONED IN THIS EPISODE Study: New England Journal of Medicine article, "A Sleeping Giant of Health Care Affordability—Self-Insured Employers," by Suhas Gondi, MD, MBA, and Zirui Song, MD, PhD EP406 with Lauren Vela: Apple Podcasts | Spotify | Other Apps EP519 with Lisa Rosenbaum, MD: Apple Podcasts | Spotify | Other Apps EP509 with Patrick Nelli: Apple Podcasts | Spotify | Other Apps EP494 with Sarah Emond: Apple Podcasts | Spotify | Other Apps EP501 with Ivana Krajcinovic, PhD: Apple Podcasts | Spotify | Other Apps EP468 with Matt McQuide: Apple Podcasts | Spotify | Other Apps Article: Acquired's episode on how Epic quietly powers American healthcare === 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 to this episode. 00:35 A big thank you. 06:22 The conversation with Dr. Suhas Gondi. 07:08 Why Dr. Suhas Gondi and his coauthor wrote their article. 09:24 Why the affordability of care and the decisions self-employers are making about coverage matter to clinicians. 12:12 What the term "sleeping giants" implies and how that reflects the reality of healthcare. 14:31 A case study. 21:24 How the patient can still get lost even when both the employer and clinician think they're doing the right thing. 22:52 An example from the oncology space. 28:47 Dr. Suhas Gondi's advice to clinicians. 30:55 The communication gap between clinicians and employers. 33:30 Why the presence of middlemen should not prevent communication between clinicians and employers.

   August 05, 2026·36min
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   Number 4: How GoodRx Actually Makes Money: PBMs, Cash Prices, and Pharmacy Contracts, With Ge Bai, PhD, CPA (EP522)

   Ask Me Anything: How Does GoodRx Actually Make Money, and Who Really Pays for the Discount? Episode 522. A listener asked Stacey Richter a deceptively simple question: how exactly does GoodRx make money? To answer it, this AMA episode revisits a 2021 conversation with Ge Bai, PhD, CPA, professor of accounting at the Johns Hopkins Carey Business School and of health policy and management at the Johns Hopkins Bloomberg School of Public Health, recently nominated to serve as Assistant Secretary at the Department of Health and Human Services (HHS). Ge Bai lays out exactly how GoodRx turns pharmacy-PBM contract dysfunction into a business, and Stacey updates listeners on what's changed—and what hasn't—in the years since. WHAT YOU'LL LEARN ✅ Why GoodRx is purely a pricing platform with no pharmacy of its own—unlike Amazon, which operates its own pharmacy ✅ How PBM contracts requiring pharmacies to offer insurers their "best price" force cash list prices artificially high, the exact dysfunction GoodRx monetizes ✅ How GoodRx's network of contracted PBMs—including Express Scripts and OptumRx—collects a per-dispense fee every time a patient uses a GoodRx card ✅ Why pharmacies lose out twice: they never collect their high list price, and they still owe a fee to the PBM that "referred" the cash-pay patient to them ✅ What's changed since 2021: a wave of new cash-pay competitors like Mark Cuban Cost Plus Drugs, GLP-1-driven cash-pay behavior, and proposed legislation targeting "Most Favored Nation" (lesser-of) clauses in PBM contracts ✅ Ge Bai's recent nomination to Assistant Secretary at HHS, building on research she has used to testify before Congress and shape healthcare policy WHY THIS MATTERS GoodRx's entire business model runs on a single structural quirk: PBM contracts require pharmacies to keep their list price higher than any insurer's negotiated rate, which pushes cash prices artificially high for anyone without a coupon. As Stacey Richter puts it, this dysfunction "is sadly pretty much the same" today as when Ge Bai first explained it in 2021, even as new cash-pay entrants and proposed "Most Favored Nation" contract restrictions start to reshape the landscape. MENTIONED IN THIS EPISODE EP520 with Stacey: Apple Podcasts | Spotify | Other Apps EP517 with Stacey: Apple Podcasts | Spotify | Other Apps EP516 with Ophelia Johnson: Apple Podcasts | Spotify | Other Apps EP439 with Luke Slindee, PharmD: Apple Podcasts | Spotify | Other Apps === LINKS === 🔗 Show Notes with all mentioned links: [Show Notes link — episode not yet live, add once published] ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: 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 00:00 Introduction to this episode. 06:22 The conversation with Ge Bai. 06:28 The difference between GoodRx and Amazon Pharmacy? 06:53 The one thing GoodRx makes money from. 07:55 How is GoodRx getting paid? 08:18 Are there middlemen in GoodRx's financial model? 09:25 How PBMs play into the GoodRx model. 10:29 Where the pharmacy fits into the deals created by GoodRx. 11:59 What's changed since this conversation with Ge Bai.

   July 29, 2026·14min
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   Number 5: How Revenue Cycle Management (RCM) Became an Over $200 Billion Healthcare Hot Potato, With Andrew Tsang. EP521

   RCM: Why Revenue Cycle Management Is Healthcare's $200B Hot Potato, With Andrew Tsang (EP521) How Revenue Cycle Management (RCM) Became an Over $200 Billion Healthcare Hot Potato. Episode 521. Revenue cycle management (RCM) sounds like the least sexy phrase in healthcare — a back-office spreadsheet problem. It isn't. Andrew Tsang, an independent healthcare analyst and writer of the Substack Health Is Other People, with 15+ years across providers, payers, consulting, and policy, joins Stacey Richter to unpack how RCM has grown into a $200-plus-billion industry that eats roughly a third of every healthcare dollar spent — not on care, but on the fight over who pays for it. Together they trace RCM's front end, middle, and back end, and the "hot potato" that lands on whoever has the least leverage to fight back. WHAT YOU'LL LEARN ✅ How revenue cycle management (RCM) grew into a $200-plus-billion industry — Andrew Tsang puts RCM-related market cap at roughly $217 billion, and estimates roughly a third of every healthcare dollar goes to the fight over payment, not to care ✅ The three phases of RCM (front-end eligibility and prior authorization, middle clinical coding, and back-end claims adjudication and appeals) and why the "hot potato" of financial responsibility lands on whoever has the least administrative leverage — patients, independent practices, or self-funded employers ✅ Why a routine screening colonoscopy can flip to a diagnostic procedure — and an unexpected bill — the moment a polyp is found, even though the ACA mandates the screening itself be free ✅ How the prior authorization burden (physicians average roughly 39 prior auths a week) forces independent practices to compete on administrative capacity rather than clinical outcomes, accelerating consolidation into larger health systems ✅ Why self-funded employers face their own version of the hot potato through stop-loss "lasering," where a stop-loss carrier can exclude a specific high-cost employee from coverage after a catastrophic claim ✅ Why direct contracting — agreeing on price upfront — is Andrew Tsang's proposed way to opt out of the RCM hot potato game entirely WHY THIS MATTERS Revenue cycle management isn't a niche back-office function — it's a $200-plus-billion economy built on claim-by-claim fights over who pays. As Stacey Richter puts it, this isn't a story about villains; it's a story about an industry built around claim-by-claim fistfights. Whoever has the least administrative leverage in any given moment — patient, independent practice, or self-funded employer — is the one who winds up eating the cost. MENTIONED IN THIS EPISODE LinkedIn Post by Andrew Tsang, featuring his Revenue Cycle Market Landscape interactive chart EP497 with Zack Kanter: Apple Podcasts | Spotify | Other Apps EP363 with David Scheinker, PhD: Apple Podcasts | Spotify | Other Apps LinkedIn Post by Sheri Mancini, MD, FACS EP494 with Sarah Emond: 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 00:00 Introduction to this episode. 02:13 What revenue cycle management is. 03:22 How RCM is an endless game of hot potato. 07:10 The conversation with Andrew Tsang. 08:24 Is it actually a cycle? 08:54 How big the RCM industry actually is. 09:49 Defining revenue cycle management. 12:13 Why patients may spend more time doing revenue cycle tasks than with their doctor. 17:12 Who pays and why? 19:56 An example of RCM working within something like a colonoscopy. 22:55 The worst part about this whole revenue cycle. 24:49 How RCM affects independent doctors. 29:51 How RCM affects self-funded employers and stop-loss carriers.

   July 22, 2026·37min
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