Take Two: EP341: The “Just Spend Everything You’re Given” Trap—Lessons in True Provider Fiscal Discipline, With Gary Campbell
Release Date: 01/22/2026
EP504: A Back-to-Basics Roadmap Through the Perverse Incentives to Advanced Primary Care, With Ryan Jacobs
Relentless Health Value
Why Advanced Primary Care Doesn’t Scale: Conflicting Incentives, Complacency, and a 3-Step Roadmap Stacey Richter interviews Ryan Jacobs (SVP Strategy and Partnerships, Marathon Health) on why evidence-backed advanced primary care (APC)—focused on managing risk, improving outcomes, and lowering costs—still isn’t widespread. They argue APC struggles to scale due to two root barriers: conflicting fiduciary duties (health systems and payers driven by volume, “heads in beds,” and market-power growth, while APC keeps patients out of hospitals) and a “black box of complacency,”...
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Insights to Outwit the Hot Mess of the Non-Healthcare Market
Relentless Health Value
In this Inbetweenisode, Stacey shares listener feedback and reflects on making better decisions in employer-sponsored healthcare, spotlighting LinkedIn posts by Ken Wosczyna and Michelle Bernabe. Ken argues Relentless Health Value moves from theory to practical transformation by sharpening judgment, which Stacey ties to how millions of workplace decisions shape the healthcare system and how actuaries and executives can align choices with values. Stacey emphasizes that good decisions require both transparency and understanding, previewing an upcoming episode with Jerry DiMaso about...
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EP503: Smart Collaboration With Direct-to-Employer Specialty Care, With Ryan Wells; Leo Spector, MD, MBA; and Adam Stavisky
Relentless Health Value
Episode 503 of Relentless Health Value features Stacey Richter with Adam Stavisky, Dr. Leo Spector (OrthoCarolina), and Ryan Wells (Health Here) discussing how self-insured employers and specialists rarely connect directly due to intermediaries and fee-for-service “rails.” They outline three common pitfalls when bridging this gap: defining and measuring quality and appropriateness (limits of claims data and missing patient-reported outcomes), achieving scale across geographies and specialties, and ensuring benefit design and incentives so members actually use direct-contracting...
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EP502: How Some Pretty Wild Medicare Fraud Sabotages ACOs and Also Independent Practices and Could Cost Plan Sponsors Such as Self-insured Employers a Lot of Zeros Downstream, With Brian Machut
Relentless Health Value
Episode 502 features Stacey’s conversation with Brian Machut (Alliant Health) on how widespread Medicare fee-for-service fraud is inflating costs and undermining ACO shared savings in MSSP and ACO REACH. ACOs uncovered major urinary catheter fraud in 2023 tied to codes A4352/A4353, totaling about $3.5B, with some beneficiaries billed for items never received (including a case shared by Dr. Tara Lagu). CMS created a “SAHS” (significant, anomalous, highly suspect) process to remove certain suspect costs, but benchmark effects can unevenly impact ACOs; catheter fraud is still...
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EP501: Speaking of Infusions, Do You Want to Pay $135 or Do You Want to Pay $13,560 for the Exact Same Drug? With Ivana Krajcinovic, PhD
Relentless Health Value
Episode 501 of Relentless Health Value features Stacey Richter interviewing Ivana Krajcinovic, outgoing Vice President of Healthcare Delivery at Unite Here Health, about extreme and persistent price variation for medical infusions as evidence of a “no market” in healthcare. They cite examples where the same chemotherapy drug (Oxaliplatin), long off patent, cost Medicare about $35 (or $185 for a series), an independent practice about $135, but a hospital in Chicago charged $13,560 and a hospital in Monterey billed $90,000 for a series—markups described as up to nearly 500x and far beyond...
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Take Two: EP398: Why Are Commercial Carrier Marketplaces Completely Boring? Maybe Because There Isn’t a Marketplace, With Jacob Asher, MD
Relentless Health Value
The Non-Market Reality of Healthcare Carrier Marketplaces with Dr. Jacob Asher. In this episode of Relentlessly Seeking Value, host Stacey Richter introduces the 'No Market' series focused on the healthcare sector's lack of competitive market dynamics, which affects cost and quality. The episode features a conversation with Dr. Jacob Asher, who has extensive experience as a Chief Medical Officer at major healthcare plans. They discuss the stagnant nature of commercial carrier marketplaces, particularly in California, and the various factors contributing to this stasis, including employer...
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EP500: This Is Episode 500, and It’s All About You, Tribe
Relentless Health Value
In the milestone Episode 500 of the 'Relentless Health Value' podcast, Stacey Richter reflects on the significant influence and community formed around the platform. Initiated by a conversation with Cora Opsahl, the episode transforms into a heartfelt ode to the listeners — healthcare entrepreneurs, executives, and change-makers, whom Stacey refers to as 'the tribe.' Featured contributions from several listeners highlight themes such as moving from theory to practical transformation, the power of collective momentum, and 'unplugging from the Matrix' of opaque healthcare practices. ...
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EP499: Self-insured Employers and Other Plan Sponsors Are Paying Millions for MSK (Musculoskeletal) Injuries That Would Have Healed Themselves, With Jay Kimmel, MD
Relentless Health Value
In this episode of Relentless Health Value, host Stacey Richter talks with Dr. Jay Kimmel, an orthopedic surgeon and co-founder of Upswing Health, about the significant costs associated with musculoskeletal (MSK) injuries and conditions for self-insured employers and other plan sponsors. They explore how a large portion of MSK-related expenses are for low-acuity injuries that often heal on their own without the need for emergency room visits or unnecessary treatments. Dr. Kimmel discusses the importance of addressing the 'white space'—the critical initial moments when a patient decides...
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EP498: The Payment Integrity Arms Race—RCM (Revenue Cycle Management) and Plan Sponsors, With Mark Noel
Relentless Health Value
In Episode 498, host Stacey Richter converses with Mark Noel of ClaimInsight about the critical aspects of payment integrity within self-insured employers and plan sponsors, focusing on the arms race with revenue cycle management (RCM). The discussion reveals three main insights: the substantial impact of small claim errors, the inherent flaws and conflicts within prepayment analysis by TPAs, and the problematic financial incentives influencing claim processing. Noel emphasizes the importance of prepayment integrity for both plan savings and protecting members, underscoring the need for...
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Take Two: EP341: The “Just Spend Everything You’re Given” Trap—Lessons in True Provider Fiscal Discipline, With Gary Campbell
Relentless Health Value
In this Take Two episode of Relentlessly Seeking Value, host Stacey Richter speaks with Gary Campbell, CEO of Johnson Health Center, an FQHC in Virginia. The discussion centers around the importance of fiscal discipline in healthcare, especially in federally qualified health centers where there's no opportunity to cost-shift inefficiencies. This episode also revisits the notable experience and practices of Nikki King, CEO of Alliance Health Centers, focusing on her innovative methods to overcome operational challenges without additional funding. The conversation highlights the importance...
info_outlineIn this Take Two episode of Relentlessly Seeking Value, host Stacey Richter speaks with Gary Campbell, CEO of Johnson Health Center, an FQHC in Virginia. The discussion centers around the importance of fiscal discipline in healthcare, especially in federally qualified health centers where there's no opportunity to cost-shift inefficiencies.
This episode also revisits the notable experience and practices of Nikki King, CEO of Alliance Health Centers, focusing on her innovative methods to overcome operational challenges without additional funding.
The conversation highlights the importance of visionary leadership, cultural alignment, and operational efficiency to deliver high-quality patient care and maintain financial health. Gary Campbell emphasizes the necessity of strategic planning, involving clinicians in decision-making, and standardizing processes to create a better work environment and optimize patient care.
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09:03 Why is there no opportunity to cost shift in an FQHC?
09:34 What happens when an FQHC is operating inefficiently?
10:00 “Have you workflowed it out? … You can overstaff yourself in a way that your cost per patient goes way up.”
10:23 Why is taking a lean approach not an excuse to cut staff?
11:27 EP490 and EP492 with Shane Cerone and Sam Flanders, MD.
11:35 EP438 with John Lee, MD.
11:38 EP455 with Beau Raymond, MD.
11:40 EP402 with Amy Scanlan, MD.
11:42 EP405 with Eric Gallagher.
12:48 “The nurses are linchpins to everything.”
13:44 LinkedIn post from Eve Cunningham, MD, MBA.
15:10 How does standardizing care lead to personalization of care?
16:34 “Our clinical teams see that we care.”
16:53 “If you don’t have a vision for where you want to be two and three years down the road, you’re struggling.”
17:09 “I want everybody to understand, What is their why?”
19:45 Lean & Meaningful by Roger E. Herman and Joyce L. Gioia.
24:44 “You have to project plan things out that you want.”
25:51 “They don’t teach leadership in most medical schools.”—Dr. Robert Pearl
26:46 Outlive by Peter Attia, MD.
27:55 “Get to know these clinicians.”
29:39 “From a core values perspective, you can make every single decision … on core values.”
30:03 “We always start with those values. … They’re embedded in everything we do.”
30:20 How does an FQHC or private practices that are patient-oriented attract talent?
35:24 EP297 with Jerry Durham.
35:54 “First and foremost, be visible.”