The Cost Crisis of Weight Loss Drugs

Send us a textPrimary care is the foundation of a strong healthcare system, but it faces mounting challenges, from workforce shortages to reimbursement struggles. Is advanced primary care the solution and what would that model look like?In this episode of CareTalk, David E. Williams and John Driscoll sit down with Dr. Kate Goodrich, Chief Medical Officer of Humana, to explore the critical role of primary care and how it must evolve to meet the growing demands of patients, providers, and the healthcare system as a whole.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.TOPICS(0:21) Intro(0:34) Sponsorship(2:05) The Advantages of Primary Care(3:51) Understanding Primary Care(5:06) Why Is Primary Care Struggling(6:55) The Current State of Primary Care(7:57) How Primary Care Is Changing(10:18) The Promise of Care Coordination in Primary Care(12:51) What Does Advanced Primary Care Look Like(15:20) Measuring Success in Primary Care(18:32) What Is Direct Primary Care(19:51) The State of Medicare Managed Care(23:43) Why Are Primary Care Physicians Unhappy🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. 🎙️⚕️ABOUT KATE GOODRICHKate Goodrich, MD, MHS, is the Chief Medical Officer at Humana, where she leads clinical initiatives across the insurance and CenterWell businesses, focusing on physician engagement, healthcare research, health equity, and Humana's Bold Goal programs. Previously, she served as Humana’s SVP for Clinical Analytics and Trend, overseeing analytics and rapid learning strategies to improve outcomes while reducing costs. Before joining Humana, Dr. Goodrich was the CMS Chief Medical Officer and Director of the Center for Clinical Standards and Quality, managing 18 quality and value-based purchasing programs, nationwide quality improvement efforts, and Medicare coverage decisions. A practicing hospitalist and professor of medicine, she continues her clinical work at George Washington University Medical Center, where she previously directed the Hospital Medicine division.🎙️⚕️ABOUT HUMANAHumana Inc., headquartered in Louisville, Kentucky, is a leading health and well-being company dedicated to helping people live healthy and happy lives since 1961. The company offers personalized healthcare services through its insurance products and CenterWell healthcare services, aiming to simplify the healthcare experience for millions of members across the United States. Humana's commitment extends beyond individual care, as it actively invests in local communities to support and enhance public health initiatives. With a focus on innovation and compassionate care, Humana strives to address global health challenges and make a positive impact on the lives it touches.GET IN TOUCHBecome a CareTalk sponsorGuest appearance requestsSupport the showCareTalk: Healthcare. Unfiltered. is produced by Grippi Media.

Send us a textWe’re living in an era where health data is more accessible than ever.From lab results to wearable devices like the Apple Watch, there is an overwhelming amount of health information available. However, the real challenge lies in unlocking the potential of this data to drive transformative health improvements for both patients and providers.In this episode of HealthBiz Briefs, guest Richard Kedziora, Co-Founder and COO of Estenda, discusses how they are leveraging health data to uncover patterns and trends that lead to better treatments and improved patient outcomes.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. 🎙️⚕️ABOUT RICHARD KEDZIORARichard "RJ" Kedziora, co-founder of Estenda Solutions, leverages over 25 years of experience in technology to create digital health solutions that improve patient outcomes, reduce costs, and enhance patient and provider satisfaction. A results-driven professional, he specializes in leadership, process improvement, software development, and governance, with his work earning multiple awards, including a HIMSS Davies Award, and several patents. RJ holds an MBA from West Chester University and a BS in Computer Science from Duquesne University, where he received the Excellence in Computer Science Award. A frequent podcast guest and speaker at healthcare and technology conferences, he has co-authored articles in peer-reviewed journals.🎙️⚕️ABOUT ESTENDA Estenda is an ISO 13485-certified healthcare software development and consulting company that has been advancing the science and technology of digital health since 2003. We collaborate with innovative organizations—commercial, research, clinical, or medical—to invent, design, develop, implement, and research solutions that enhance the health and well-being of individuals. Our services include custom software development, data analytics, AI/ML expertise, and strategic consulting. With a deep commitment to innovation and exceeding expectations, Estenda has successfully delivered numerous digital health projects, applying our extensive experience in healthcare, clinical, and medical systems. GET IN TOUCHBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsSupport the showCareTalk: Healthcare. Unfiltered. is produced by Grippi Media.

Send us a textGLP-1 medications like Novo Nordisk's Wegovy and Ozempic are taking the market by storm.With demand soaring, many patients are realizing these medications are either not being covered or simply too expensive.Is this all due to provider greed or is the issue more complicated?In this episode of CareTalk, David E. Williams and John Driscoll discuss how the growing demand for weight-loss drugs is creating a conundrum for providers, forcing them to decide between avoiding the costs associated with at-risk patients or investing upfront for long-term savings.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.TOPICS(0:38) Sponsorship(2:06) Obesity in America(2:40) The State of Insurance Coverage for GLP-1s(3:27) Background on Obesity Drugs(4:45) Formation of GLP-1 Use(7:20) The Cost Conundrum of Weight-Loss Drugs(10:16) How Insurance Impacts Weight-Loss Drug Coverage(11:30) Understanding Adverse Selection(14:30) How Insurers Prevent Coverage(15:04) Decisions on Weight-Loss Drug Coverage(16:07) What Makes GLP-1s Unique for Cost Coverage(18:00) Will Weight-Loss Drugs Become Cheaper?(21:22) Medicare's Role in Weight-Loss Drugs(22:17) Examining Side Effects of Weight-Loss Drugs🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. GET IN TOUCHBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsSupport the showCareTalk: Healthcare. Unfiltered. is produced by Grippi Media.

Send us a textEver tried to schedule a doctor’s appointment, only to be stuck on hold for what feels like forever?You’re not alone. A lot of Americans feel the same frustration.Could there be a better way to take control of scheduling?In this episode of HealthBiz Briefs, Relatient CEO Jeff Gartland explains why self-scheduling is still a novel concept in medicine and how its implementation can improve patient access while increasing appointment volumes for providers.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. 🎙️⚕️ABOUT JEFF GARTLANDJeff Gartland, a pioneer in healthcare information technology systems, brings decades of expertise in growth strategies, innovation, and go-to-market initiatives. As the new CEO of Relatient, he is poised to advance the company’s industry-leading patient engagement and access platform. Previously, Gartland served as President of Anthem’s Advanced Analytics & Services division, where he built scalable technology solutions for the healthcare ecosystem, and held senior leadership roles at Ciox Health and McKesson’s RelayHealth, driving innovation in revenue cycle and clinical interoperability. Relatient, which recently merged with Radix Health, offers an all-in-one platform for patient engagement and scheduling that improves patient experiences and provider utilization.🎙️⚕️ABOUT RELATIENTRelatient, Inc., the 2020 KLAS Category Leader in Patient Outreach, is a SaaS-based patient engagement company focused on improving communication between patients and providers through a mobile-first approach. In 2020, Relatient’s digital platform facilitated over 200 million patient messages for U.S. medical practices and health systems, integrating seamlessly with more than 85 practice management systems and electronic health databases. Its suite of solutions—including patient messaging, self-scheduling, digital registration, and billing—enhances operational efficiency, reduces no-shows, accelerates payments, drives new appointments and reviews, and boosts patient satisfaction, all while supporting health and care quality initiatives.GET IN TOUCHBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsSupport the showCareTalk: Healthcare. Unfiltered. is produced by Grippi Media.

Send us a textWhat if you could get personalized medical solutions tailored exactly to your needs, diagnosis, and even genetics?Personalized medicine may have sounded like a pipe dream a few years ago, but it’s fast becoming a major sector of the industry.In this episode of CareTalk, David Williams and John Driscoll sit down with Bradley Bostic, Founder and CEO of hc1 and managing director at Health Cloud Capital, to explore how diagnostics and AI are transforming personalized healthcare through data-driven innovation.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.TOPICS(0:16) Intro(0:32) Sponsorship(2:11) Congratulations to Marty Makary(2:51) How Important Is Lab Testing for Healthcare?(4:38) Going Beyond Basic Lab Data(7:49) How Tests Lead Into Personalized Medicine(10:41) Looking at Data More Effectively(15:00) Will Changes in the Healthcare System Affect Lab Data?🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. 🎙️⚕️ ABOUT BRADLEY BOSTICFor 25 years, Brad Bostic has led and invested in high-growth tech companies. Driven to improve patient care, he founded hc1 to enable precise diagnoses and treatments through optimized lab testing. Under his leadership, hc1 grew from a startup to a global leader, analyzing lab data for over 260 million patients using AI. Recognized for his transformational leadership, Brad has significantly enhanced enterprise value and was named "2020 Dynamic Business Leader of the Year" by the Indiana Chamber of Commerce and a “Top Entrepreneur” by Becker’s Healthcare.🎙️⚕️ ABOUT HC1Founded in 2011, hc1 leverages lab data to generate actionable insights that enhance patient care, streamline lab operations, and reduce costs. Today, hc1 processes data for over 90 million patients, managing 30 billion clinical transactions monthly on its secure AWS-powered platform. Their solutions, including hc1 Performance Analytics™ and PrecisionDx Advisor™, enable labs to optimize testing and treatment decisions. With its 2024 acquisition of Accumen, hc1 now offers comprehensive solutions to transform labs into strategic assets for health systems, driving precision diagnostics and improved outcomes.🎙️⚕️ ABOUT HEALTH CLOUD CAPITALHealth Cloud Capital is a private equity firm specializing in high-growth health tech companies that leverage Artificial Intelligence (AI) and Machine Learning (ML) to uncover hidden risk signals in datasets. Their mission is to revolutionize healthcare by enhancing efficiency, precision, and effectiveness to improve patient outcomes. With a focus on Health Tech Data, Health Cloud Capital has achieved returns exceeding 2X to date. Their partners bring valuable insights from investing in and managing multiple growth-stage companies across healthcare, technology, and cloud computing, providing a competitive edge. The firm has a proven track record of delivering significant returns for investors and ensures that portfolio companies utilize robust, secure, and HITRUST-cSupport the showCareTalk: Healthcare. Unfiltered. is produced by Grippi Media.

Send us a textMany patients want to have a say in their medical care, especially when it comes to end-of-life decisions.Despite this, only a third of U.S. adults have completed any form of advance care directive.Even for those who do plan ahead, traditional paper-based advance directives often face challenges like misinterpretation or even being ignored altogether.Could video-recorded directives be the answer?In this episode of HealthBiz Briefs, MIDEO CEO Dr. Ferdinando Mirarchi sheds light on the limitations of standard advance care directives and explains why video-based solutions might deliver better results, offering greater clarity and ensuring patients’ wishes are honored.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. 🎙️⚕️ ABOUT FERDINANDO MIRARCHIFerdinando Mirarchi, D.O, is the CEO and Chief Medical Officer of USACS MIDEO, LLC, and recently appointed Chairman of the National Palliative Care Committee for USACS. As the Principal Investigator of the TRIAD Research Series (The Realistic Interpretation of Advance Directives), Dr. Mirarchi has uncovered a global patient safety risk stemming from confusion around living wills, DNR, and POLST orders. His research, featured in outlets like The New York Times and The Washington Post, led to the creation of MIDEO (My Informed Decision on VidEO), an innovative, evidence-based video advance directive designed to enhance patient safety by clarifying medical orders and making them instantly accessible.🎙️⚕️ ABOUT MIDEO MIDEO is a video-based advance care planning platform that ensures patient healthcare wishes are clearly communicated when patients cannot express them themselves. By translating patient directives into medical and legal terms, MIDEO makes them easily accessible to medical professionals through a QR code. This innovative approach enhances patient care and reduces costs by providing clarity on critical and end-of-life healthcare preferences. MIDEO offers services tailored for patients, families, health plans, and clinicians, emphasizing the importance of understanding and honoring individual healthcare choices.GET IN TOUCHBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsSupport the showCareTalk: Healthcare. Unfiltered. is produced by Grippi Media.

Send us a textWord-of-mouth recommendations are great for picking a restaurant or movie, but are they the best way to find a doctor?What if there was a better way to use data to find the right doctor every time?In this episode of CareTalk, David Williams talks with Nick Reber, Founder and CEO of Garner Health, about how they’re leveraging detailed data, including physician history and patient outcomes, to match patients with high-quality doctors.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.TOPICS:(0:15) Sponsorship(1:45) Why Nick Reber Started Garner Health(4:50) Using Data to Find the Best Doctors(7:13) How Hedge Funds Relate to Healthcare(9:25) Measuring Patient Outcomes and Costs(11:20) Building Patient Trust(14:32) Dealing with Fragmented Data(16:29) Deciphering Complex Data to Determine Outcomes(20:24) Garner Health's Relation to Value-Based Care(23:18) Advice for Someone Starting a Healthcare Company🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. 🎙️⚕️ ABOUT NICK REBERNick Reber is the Founder and CEO of Garner Health, a company committed to transforming healthcare through data-driven insights and innovative financial incentives. Before establishing Garner, Nick was a key member of the leadership team at Oscar Health, where he played a significant role in analytics and the development of provider networks. His efforts contributed to Oscar's rapid growth, guiding the company to exceed $2 billion in annual revenue. Prior to his work at Oscar Health, Nick was a Partner at Bridgewater Associates, one of the world's largest hedge funds, where he served as Co-Head of Research Analytics, leading strategic analysis and research initiatives.🎙️⚕️ ABOUT GARNER HEALTHGarner Health's mission is to transform the healthcare system from the ground up. By leveraging a unique approach to data science and pioneering financial incentives, Garner Health helps patients find the highest-quality care and empowers physicians to elevate their medical practices. Their goal is to realign the economics of healthcare, so providers are rewarded for delivering top-tier medical care instead of performing a higher volume of invasive procedures. Garner Health is dedicated to making high-quality, affordable healthcare a reality for everyone.GET IN TOUCHBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsSupport the showCareTalk: Healthcare. Unfiltered. is produced by Grippi Media.

Send us a textCancer moves fast. Patients and their medical teams need to move faster.A study by Q-Centrix revealed that many hospitals face an unacceptable year-long data backlog in oncology.When crucial data about diagnosis, staging, and treatments gets held up, it can cost patients valuable time, resources, and treatment opportunities.In the latest episode of HealthBiz Briefs, guest Karen Schmidt, VP Oncology Market Lead at Q-Centrix, discusses why accurate and timely data is critical in cancer treatment and how improved data practices can lead to better outcomes and potentially life-saving care.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. 🎙️⚕️ ABOUT KAREN SCHMIDTKaren Schmidt is the VP Oncology Market Lead at Q-Centrix, bringing over 17 years of experience in cancer registry to her leadership role. A cancer survivor herself, Karen combines professional expertise with a personal commitment to improving cancer care. She leads her team in advancing the Cancer Registry Profession, enhancing the quality of cancer data, and turning data into actionable insights. Her focus is on delivering top-notch support to cancer programs nationwide, with the ultimate goal of elevating patient care and outcomes through superior data management and innovative solutions.🎙️⚕️ ABOUT Q-CENTRIXQ-Centrix is a leader in healthcare data management, offering the industry's first Enterprise Clinical Data Management (eCDM™) approach. This solution combines AI-driven technology with the largest team of clinical data experts and insights from over 1,200 healthcare partners. Q-Centrix addresses various clinical data needs—including oncology, cardiovascular, trauma, and research—enhancing quality measurement and improvement. Their eCDM™ methodology provides comprehensive data capture and integrity, transforming complex clinical information into actionable insights that improve patient outcomes, operational efficiency, and strategic growth for healthcare systems nationwide.GET IN TOUCHBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsSupport the showCareTalk: Healthcare. Unfiltered. is produced by Grippi Media.

Send us a textWith the election decided and over, Americans are looking at Republicans to make good on their campaign promises.One important promise to voters was to make America healthy again.But what does this agenda entail?And what impacts can we expect to see in healthcare?In this episode of CareTalk, David E. Williams and John Driscoll discuss the framework of Make America Healthy Again, covering what they have right, what they have wrong, and how it is set to change healthcare.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.TOPICS(0:32) Sponsorship(1:59) Positives of Make America Healthy Again(3:31) Examining Chronic Disease Rates(4:54) Framework of Chronic Diseases(5:56) Health Policies on Pollution(7:02) The Gun Safety Epidemic(8:08) Government Regulations and Health Track Record(9:16) Contradictions in Make America Healthy Again(12:04) Hope for Change in American Healthcare🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. GET IN TOUCHBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsSupport the showCareTalk: Healthcare. Unfiltered. is produced by Grippi Media.

Send us a textThere’s no shortage of data in healthcare.However, when it comes to deeper insights into patients’ futures and provider costs, the industry is sorely lacking.Is it possible to unlock this data and create both better patient outcomes and more profits for providers?In this episode of HealthBiz Briefs, guest Brad Bostic, chairman and CEO of hc1, dives into the role of diagnostic testing labs and the ability to turn them into strategic assets by identifying risks before they become dangerous and costly problems.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.🎙️⚕️ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. 🎙️⚕️ ABOUT BRAD BOSTICFor 25 years, Brad Bostic has led and invested in high-growth tech companies. Driven to improve patient care, he founded hc1 to enable precise diagnoses and treatments through optimized lab testing. Under his leadership, hc1 grew from a startup to a global leader, analyzing lab data for over 260 million patients using AI. Recognized for his transformational leadership, Brad has significantly enhanced enterprise value and was named "2020 Dynamic Business Leader of the Year" by the Indiana Chamber of Commerce and a “Top Entrepreneur” by Becker’s Healthcare.🎙️⚕️ ABOUT HC1Founded in 2011, hc1 leverages lab data to generate actionable insights that enhance patient care, streamline lab operations, and reduce costs. Today, hc1 processes data for over 90 million patients, managing 30 billion clinical transactions monthly on its secure AWS-powered platform. Their solutions, including hc1 Performance Analytics™ and PrecisionDx Advisor™, enable labs to optimize testing and treatment decisions. With its 2024 acquisition of Accumen, hc1 now offers comprehensive solutions to transform labs into strategic assets for health systems, driving precision diagnostics and improved outcomes.GET IN TOUCHBecome a CareTalk sponsorGuest appearance requestsVisit us on the webSubscribe to the CareTalk NewsSupport the showCareTalk: Healthcare. Unfiltered. is produced by Grippi Media.