EP470: Continuing the ER and Primary Care Through Line Over to Rural Hospitals and Healthcare, With Nikki King, DHA
Release Date: 04/03/2025
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EP481: Seriously, IRL, What Does “No Margin, No Mission” Even Mean? With Benjamin Schwartz, MD, MBA
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Take Two: EP438: Is It Mission and/or Margin? With John Lee, MD
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EP480: Payment Integrity Meets Health System Boasts, Such as Our Rates Are 2x Medicare, With Kimberly Carleson
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Pharma Rebates: A Few Nuances You May Not Have Thought Of, With Ann Lewandowski—Summer Shorts
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EP479: Part 2. What Could Go Wrong Covering High-Cost Claimants With Stop-Loss Reinsurance?
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In this second discussion with Andreas Mang and Jon Camire of Blackstone, Stacey Richter has an advanced discussion on the intricacies of stop-loss reinsurance for high-cost claimants. This show today, for sure, it’s for plan sponsors and anyone on or about plan sponsors; but also listen if you are serving high-cost claimants some other way. Because what you’ll learn here today is some insights relative to how plan sponsors go about making sure that they can pay you—like if you work for, for example, some clinical organization. There’s a, I don’t know, 101 starting point...
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EP478: Stop-Loss Coverage, Part 1: How It Goes Right, and How It Can Go Horribly Wrong, With Andreas Mang and Jon Camire
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Host Stacey Richter discusses the intricacies of stop-loss coverage with Andreas Mang and Jon Camire from Blackstone. The episode focuses on defining stop-loss insurance and exploring its critical role in protecting self-insured employers from catastrophic financial losses. The conversation delves into the nuances of individual and aggregate stop-loss policies, laser claims, and the importance of selecting an experienced consultant to navigate this complex landscape. The episode is essential listening for those managing high-cost claimants and exploring self-insurance options. This is a...
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EP477: Through Line Show: What the Tribe Thinks You Need to Know About Trust or It’s Gonna Be a Problem. Also, Why You Are Smart, With Stacey Richter
Relentless Health Value
In this episode, Stacey Richter explores the impact of trust on healthcare outcomes, drawing from listener contributions and prior episodes of Relentless Health Value. The discussion underscores how trust or the lack thereof affects patients, clinicians, and healthcare systems. Key points include the importance of building trusted relationships, the detrimental effects of antitrust behaviors, and the broader implications for healthcare delivery. Stacey also highlights a bonus show featuring Charles Green on earning and maintaining trust. The episode concludes with an uplifting message about...
info_outlineIn this episode, host Stacey Richter revisits a conversation with Nikki King, CEO of Alliance Health Centers, discussing the critical issues facing rural hospitals and healthcare systems. They delve into the impacts of Medicaid cuts, the financial struggles of rural hospitals reliant on commercial insurance, and potential solutions like freestanding emergency rooms, telehealth, and the expanded roles of nurse practitioners.
The conversation also covers the complexities of maternity care and mental health services in rural areas, emphasizing the urgent need for systemic reforms to ensure equitable access to healthcare.
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08:14 How dire is the rural hospital situation right now?
08:33 How could freestanding ERs be a potential solution for rural hospitals?
09:56 Advice from CHQPR: Rural hospitals should not be forced to eliminate inpatient care.
11:22 Why is broadband a roadblock to telehealth as a solution for rural health access?
14:52 What are other potential rural health access solutions?
15:37 The “hot potato” of nurse practitioners in the healthcare world.
16:34 “The number of residencies for physicians each year is not increasing, but the population … is increasing.”
20:28 EP312 with Douglas Eby, MD, MPH, CPE, of the Nuka System of Care.
22:00 What’s the issue with maternity care in rural America?
24:09 “As healthcare becomes more and more specialized, [the] ability to treat high-risk cases is better, but access gets worse.”
27:57 How is mental health care affected in rural communities?
28:29 “Rural communities are trying very hard to hang on to what they have.”
29:52 “When you look at the one market plan that’s available in a rural community, you probably can’t afford it.”
31:37 What’s the single biggest challenge to moving to a model that incentivizes keeping people healthy?
32:32 “The easiest low-hanging fruit … is having national Medicaid and have that put under the same hood as Medicare.”