Relentless Health Value

Insights to Outwit the Hot Mess of the Non-Healthcare Market

Mar 19, 2026
A breezy catch-up highlighting listener mailbag moments and practical decision-making in employer-sponsored healthcare. Topics include transparency data that reveals what employers actually pay, actuaries and algorithms that can embed patient affordability, and how everyday choices shape organizational direction. Also covered: direct contracting, center-of-excellence networks, and a new interactive map of show content.
Ask episode
AI Snips
Chapters
Transcript
Episode notes
ADVICE

Use Transparency Data To Expose Overpayments

  • Do increase transparency because you can't fix what you can't see.
  • Stacey highlights new transparency data (Payerset) that reveals what employers pay across self-insured plans, exposing site-of-care overpayments.
INSIGHT

Transparency Can Be A Veneer Without Context

  • Transparency alone can be illusory if you don't understand the system's layers.
  • Stacey warns of financialization, regulatory capture, and reclassification tricks (PBM/pharmacy spread, carrier stop loss gaming) that mask real cashflow shifts.
ANECDOTE

Carrier Stop Loss Can Mask Inflated Prices

  • Stacey recounts carrier stop loss use that lets systems report low negotiated rates while charging much higher billed prices.
  • Example: a negotiated infusion rate shown as $140K while billed averages approach $800K in the same geography.
Get the Snipd Podcast app to discover more snips from this episode
Get the app