Pre-authorization Abuse and Time-Value Profits

Mark criticizes pre-auth delays as profit centers for payers and a major source of clinician frustration.

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Episode notes

Merry Christmas! Today we are re-releasing one of our favorite episode of the year. We'll be back next week with a brand new interview to kickoff 2026.

Mark Cuban is a business mogul, the “Shark” every entrepreneur wants to make a deal with, the former owner of the Dallas Mavericks, and, most recently, an online pharmacy CEO. In 2022, Mark co-founded Cost Plus Drugs with the goal of lowering prescription drug prices. The direct-to-consumer company makes generic drugs affordable by cutting pharmacy benefit managers out of the distribution chain. But, once Mark starts talking about tackling the pharmaceutical market, you get the sense he has his sights set on an even bigger goal: reforming the healthcare system at large.

Offcall co-founder Graham Walker recently got the chance to interview Mark on How I Doctor, a podcast that explores the lives and careers of physicians who are practicing medicine differently. Mark, of course, is not a physician. But, as Graham notes, “I'm talking to him because I think he actually gives a damn about healthcare, and more importantly, he's doing something about it.”

Mark pulls no punches in this episode, and frames American healthcare as a David- and Goliath-style fight between good and bad actors.

Physicians are on the good team: “I happen to be a fan of people who save lives and make other people feel better, you know? Call me crazy.”

Who’s on the bad team? Anyone trying to game the system and extract money from it for their own benefit — insurance companies, hospitals, private equity firms, and others. “In healthcare, that $4.9 trillion wherever anybody can arbitrage whatever they can out of the system, that's exactly what they are going to do.”

With clarity of conviction and a hard-charging spirit, Mark shares his vision for how to fix healthcare.

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For a full transcript of this episode click HERE

https://www.offcall.com/learn/podcast/mark-cuban-interview-how-shark-tank-star-and-cost-plus-drugs-ceo-would-fix-healthcare

Find all episodes of How I Doctor at offcall.com/podcast or subscribe on your favorite podcast player at https://episodes.fm/1767429315.

In this episode, Graham and Mark discuss:

04:26 Expanding Medical School Enrollment

09:33 Insurance Plan Designs

16:27 Insurance Company Tactics

20:45 Negotiation Loopholes and Legal Tangles

28:04 Healthcare Spending