Shows
Only Healthcare PodcastEP 42 | GLP-1s Explained: Breakthrough Therapy, Budget Disruptor, or Both?GLP-1 medications have moved from diabetes treatment to a cultural phenomenon in record time. But beyond the headlines and celebrity endorsements lies a far more complex story. In Episode 42, Dr. Randy Vogenberg breaks down what GLP-1s actually are, how they function in the body, and why they are reshaping conversations around obesity, metabolic syndrome, cardiovascular risk, and employer health plan budgets. From Ozempic and Wegovy to emerging alternatives, this episode explores the clinical promise, the side effects, and the financial shockwaves hitting plan sponsors across the country. For pharmaceutical leaders, HR executives, consultants, and policy stakeholders, this conversation goes...
2026-02-2600 min
ONLY HEALTHCAREEP 42 | GLP-1s Explained: Breakthrough Therapy, Budget Disruptor, or Both?GLP-1 medications have moved from diabetes treatment to a cultural phenomenon in record time. But beyond the headlines and celebrity endorsements lies a far more complex story.In Episode 42, Dr. Randy Vogenberg breaks down what GLP-1s actually are, how they function in the body, and why they are reshaping conversations around obesity, metabolic syndrome, cardiovascular risk, and employer health plan budgets. From Ozempic and Wegovy to emerging alternatives, this episode explores the clinical promise, the side effects, and the financial shockwaves hitting plan sponsors across the country.For pharmaceutical leaders, HR executives, consultants, and...
2026-02-2614 min
Only Healthcare PodcastEp 41 | Healthcare 101: Who Really Controls Cost, Access, and Coverage?In this inaugural Healthcare 101 segment, Dr. Randy Vogenberg breaks down the fundamentals of the American health insurance system. From the evolution of employer-sponsored coverage to the rise of managed care and vertical integration, this episode explores why healthcare feels so complex and where the money actually flows. Listeners will gain clarity on the role of middlemen, cost shifting, site of care decisions, and what individuals can do to better navigate the system. Whether you are an employer, industry leader, or consumer, this episode offers foundational insights to help you make more informed healthcare decisions. Key Topics Episode Chapters with Timestamps 00:00 – In...
2026-02-1900 min
ONLY HEALTHCAREEp 41 | Healthcare 101: Who Really Controls Cost, Access, and Coverage?In this inaugural Healthcare 101 segment, Dr. Randy Vogenberg breaks down the fundamentals of the American health insurance system. From the evolution of employer-sponsored coverage to the rise of managed care and vertical integration, this episode explores why healthcare feels so complex and where the money actually flows.Listeners will gain clarity on the role of middlemen, cost shifting, site of care decisions, and what individuals can do to better navigate the system. Whether you are an employer, industry leader, or consumer, this episode offers foundational insights to help you make more informed healthcare decisions.
2026-02-1914 minOnly Healthcare PodcastEp 40 | Engaging the Healthcare Consumer: Transparency, Trust, and the Skills We Are MissingIn this episode of the Only Healthcare Podcast, Michael Navin and Randy Vogenberg welcome Lynn Hanessian, founder of Engager, for a wide-ranging discussion on why healthcare engagement has become a critical challenge for employers, providers, and consumers. Drawing on her background in economics, healthcare communications, and strategy, Lynn explains how rising costs, shifting information sources, and complex benefit designs are placing new demands on patients who are not equipped to navigate them. The conversation explores transparency, trust, technology, AI, employer responsibility, and the growing need to teach consumers how to engage with healthcare decisions in real time. Key Topics Discussed• Why...
2026-02-1200 min
ONLY HEALTHCAREEp 40 | Engaging the Healthcare Consumer: Transparency, Trust, and the Skills We Are MissingIn this episode of the Only Healthcare Podcast, Michael Navin and Randy Vogenberg welcome Lynn Hanessian, founder of Engager, for a wide-ranging discussion on why healthcare engagement has become a critical challenge for employers, providers, and consumers. Drawing on her background in economics, healthcare communications, and strategy, Lynn explains how rising costs, shifting information sources, and complex benefit designs are placing new demands on patients who are not equipped to navigate them.The conversation explores transparency, trust, technology, AI, employer responsibility, and the growing need to teach consumers how to engage with healthcare decisions in real time.
2026-02-1238 minOnly Healthcare PodcastEp 39 | The Great American Healthcare Heist: Transparency, Power, and What Must ChangeIn this episode of the Only Healthcare Podcast, Michael Navin and Randy Vogenberg welcome healthcare attorney, policy advocate, and author Chris Deacon for an in-depth conversation on how structural incentives, middlemen, and lack of transparency have reshaped the U.S. healthcare system. Drawing from her experience overseeing New Jersey’s state health benefits program and her book The Great American Healthcare Heist, Chris explains how employers and public sector plans are increasingly squeezed by rising costs, opaque pharmacy benefit structures, hospital consolidation, and technology deployed to optimize revenue rather than reduce spend. The episode explores why understanding contracts, data, and incen...
2026-02-0500 min
ONLY HEALTHCAREEp 39 | The Great American Healthcare Heist: Transparency, Power, and What Must ChangeIn this episode of the Only Healthcare Podcast, Michael Navin and Randy Vogenberg welcome healthcare attorney, policy advocate, and author Chris Deacon for an in-depth conversation on how structural incentives, middlemen, and lack of transparency have reshaped the U.S. healthcare system.Drawing from her experience overseeing New Jersey’s state health benefits program and her book The Great American Healthcare Heist, Chris explains how employers and public sector plans are increasingly squeezed by rising costs, opaque pharmacy benefit structures, hospital consolidation, and technology deployed to optimize revenue rather than reduce spend. The episode explores why understanding co...
2026-02-0532 minOnly Healthcare PodcastEp 38 | Rethinking Risk: How Employers Prepare for Cell and Gene TherapyIn this episode of the Only Healthcare Podcast, hosts Michael Navin and Randy Vogenberg are joined by Luke Prettol, benefits strategy leader at AT&T, for a deep dive into how employers are preparing for the growing impact of cell and gene therapies. The conversation focuses less on headline costs and more on the real risk employers face as utilization increases, therapies evolve, and benefit design struggles to keep pace. Luke explains how AT&T defines success in benefits strategy, prioritizing patient outcomes while staying ahead of market trend. He walks through how large employers think about claim size, long-term v...
2026-01-2900 min
ONLY HEALTHCAREEp 38 | Rethinking Risk: How Employers Prepare for Cell and Gene TherapyIn this episode of the Only Healthcare Podcast, hosts Michael Navin and Randy Vogenberg are joined by Luke Prettol, benefits strategy leader at AT&T, for a deep dive into how employers are preparing for the growing impact of cell and gene therapies. The conversation focuses less on headline costs and more on the real risk employers face as utilization increases, therapies evolve, and benefit design struggles to keep pace.Luke explains how AT&T defines success in benefits strategy, prioritizing patient outcomes while staying ahead of market trend. He walks through how large employers think about...
2026-01-2937 min
Only Healthcare PodcastEp 37 | Why Employers Are Reinvesting in Primary Care and What It Means for Cost, Care, and EngagementEmployers are no longer waiting for healthcare costs to stabilize. In this episode, Randy Vogenberg and Michael Navin are joined by Murray Harbour to break down why advanced primary care, direct contracting, and value-based benefit design are moving from pilot ideas to core employer strategies. The conversation examines how employers are shifting away from traditional networks, why prevention and engagement continue to struggle at scale, and what is finally changing in 2025 and beyond. From GLP-1 program missteps to bundled care models and local primary care solutions, this episode offers real-world examples of how employers can regain control of cost while...
2026-01-2200 min
ONLY HEALTHCAREEp 37 | Why Employers Are Reinvesting in Primary Care and What It Means for Cost, Care, and EngagementEmployers are no longer waiting for healthcare costs to stabilize. In this episode, Randy Vogenberg and Michael Navin are joined by Murray Harbour to break down why advanced primary care, direct contracting, and value-based benefit design are moving from pilot ideas to core employer strategies.The conversation examines how employers are shifting away from traditional networks, why prevention and engagement continue to struggle at scale, and what is finally changing in 2025 and beyond. From GLP-1 program missteps to bundled care models and local primary care solutions, this episode offers real-world examples of how employers can regain control...
2026-01-2230 min
Only Healthcare PodcastEp 36 | Drug Pricing at the Center: IRA, MFN, and Employer Direct Purchasing in 2026In this episode of the Only Healthcare Podcast, hosts Michael Navin and Dr. Randy Vogenberg welcome back Jayson Slotnick for a fast-moving year-in-review of 2025 and a grounded outlook for 2026. The conversation breaks down what changed through the Inflation Reduction Act implementation, why Most Favored Nation pricing keeps resurfacing, and how these policy forces could ripple across Medicare, Medicaid, and employer-sponsored coverage. Jayson also explores how direct purchasing, transparent pricing models, and the shifting PBM landscape may affect affordability, access, and benefit design. From Part D redesign and underused smoothing to biosimilars, 340B dynamics, and the role of the FDA in d...
2026-01-1500 min
ONLY HEALTHCAREEp 36 | Drug Pricing at the Center: IRA, MFN, and Employer Direct Purchasing in 2026In this episode of the Only Healthcare Podcast, hosts Michael Navin and Dr. Randy Vogenberg welcome back Jayson Slotnick for a fast-moving year-in-review of 2025 and a grounded outlook for 2026. The conversation breaks down what changed through the Inflation Reduction Act implementation, why Most Favored Nation pricing keeps resurfacing, and how these policy forces could ripple across Medicare, Medicaid, and employer-sponsored coverage. Jayson also explores how direct purchasing, transparent pricing models, and the shifting PBM landscape may affect affordability, access, and benefit design. From Part D redesign and underused smoothing to biosimilars, 340B dynamics, and the role of t...
2026-01-1540 min
ONLY HEALTHCAREEp 35 | Healthcare at a Breaking Point: Costs, Policy Gridlock, and What 2026 HoldsIn this episode of the Only Healthcare Podcast, hosts Michael Navin and Randy Vogenberg welcome back healthcare policy veteran Deborah Williams for a candid conversation on why 2025 became such a difficult year for employers, patients, and policymakers alike.Coming off the tensions of the government shutdown and escalating healthcare costs, the discussion breaks down what is actually driving premium increases, prescription drug spending, hospital consolidation, and benefit design changes. Deborah draws on decades of Washington experience to explain why many policy ideas keep resurfacing, why they continue to fall short, and what risks lie ahead as the...
2026-01-0825 minOnly Healthcare PodcastEp 35 | Healthcare at a Breaking Point: Costs, Policy Gridlock, and What 2026 HoldsIn this episode of the Only Healthcare Podcast, hosts Michael Navin and Randy Vogenberg welcome back healthcare policy veteran Deborah Williams for a candid conversation on why 2025 became such a difficult year for employers, patients, and policymakers alike. Coming off the tensions of the government shutdown and escalating healthcare costs, the discussion breaks down what is actually driving premium increases, prescription drug spending, hospital consolidation, and benefit design changes. Deborah draws on decades of Washington experience to explain why many policy ideas keep resurfacing, why they continue to fall short, and what risks lie ahead as the system moves into 2026...
2026-01-0800 min
ONLY HEALTHCAREEp 34 | ACNU Explained: How FDA’s New Nonprescription Pathway Could Expand Access and Improve AdherenceRecorded live at the Nicholas Hall North American Conference, this special episode of the Only Healthcare Podcast dives into the FDA’s new Additional Conditions for Nonprescription Use (ACNU) pathway and what it means for access, compliance, and the future of consumer healthcare.Host Randy Vogenberg is joined by industry veterans Bob Stirling and Bob Barron, with questions moderated by Mary Alice Lawless. Together, they break down how ACNU differs from telepharmacy and direct to consumer models, why scale matters, and how built-in safeguards could enable safer no...
2026-01-0612 min
Only Healthcare PodcastEp 34 | ACNU Explained: How FDA’s New Nonprescription Pathway Could Expand Access and Improve AdherenceRecorded live at the Nicholas Hall North American Conference, this special episode of the Only Healthcare Podcast dives into the FDA’s new Additional Conditions for Nonprescription Use (ACNU) pathway and what it means for access, compliance, and the future of consumer healthcare. Host Randy Vogenberg is joined by industry veterans Bob Stirling and Bob Barron, with questions moderated by Mary Alice Lawless. Together, they break down how ACNU differs from telepharmacy and direct to consumer models, why scale matters, and how built-in safeguards could enable safer nonprescription access to certain therapies, including acne treatments. The conversation explores compliance challenges, payer dyna...
2026-01-0600 min
ONLY HEALTHCAREEp 33 | Year in Review: The Healthcare Shifts That Defined 2025 and What’s Ahead in 2026In this year-end episode of the Only Healthcare Podcast, hosts Randy Vogenberg and Michael Navin reflect on the defining healthcare shifts of 2025 and share what they are watching as the industry moves into 2026 and beyond.The conversation looks back at the rise of consumer-driven healthcare, expanding price transparency requirements, and the growing pressure on affordability across both medical and pharmacy benefits. Randy and Michael discuss the continued disruption driven by GLP-1 utilization and pricing, emerging direct-to-consumer strategies from manufacturers, and why real change is finally starting to take hold after years of talk.
2025-12-2916 minOnly Healthcare PodcastEp 33 | Year in Review: The Healthcare Shifts That Defined 2025 and What’s Ahead in 2026In this year-end episode of the Only Healthcare Podcast, hosts Randy Vogenberg and Michael Navin reflect on the defining healthcare shifts of 2025 and share what they are watching as the industry moves into 2026 and beyond. The conversation looks back at the rise of consumer-driven healthcare, expanding price transparency requirements, and the growing pressure on affordability across both medical and pharmacy benefits. Randy and Michael discuss the continued disruption driven by GLP-1 utilization and pricing, emerging direct-to-consumer strategies from manufacturers, and why real change is finally starting to take hold after years of talk. They also examine the growing role of liti...
2025-12-2900 min
ONLY HEALTHCAREEp 32 | Exploring AI Patient Care and Clinical Decision Making with Carole TremontiIn this episode of the Only Healthcare Podcast, host Randy Vogenberg, PhD, is joined by Carole Tremonti of ConcertAI to recap insights from the Clinical Pathways Congress in Boston and discuss the Predictable Cost of Care initiative. Carole shares how the congress reflected stronger engagement, broader perspectives, and deeper integration across clinical pathways, oncology operations, and the business of cancer care.The discussion highlights how pathways have evolved over the past five years through improved data capture and workflow automation, enabling population-level learning alongside more personalized treatment decisions. Carole also explains where AI can add near-term value...
2025-12-2238 min
ONLY HEALTHCAREEp 31 | The Next Chapter of Oncology Pathways: AI, Transparency, and What’s NextIn this episode of the Only Healthcare Podcast, host Randy Vogenberg, PhD, sits down with consultant and longtime oncology pathways leader Gordon Kuntz to explore the evolution of the Clinical Pathways Congress and a new initiative focused on predictable cost of care in oncology. Gordon reflects on how oncology pathways have matured over the last two decades, why Congress has shifted from a primarily clinical lens to include business and operational strategy, and how artificial intelligence is beginning to move from theory into real-world oncology practice.The conversation then turns to a multi-year effort to develop a...
2025-12-1534 min
ONLY HEALTHCAREEp 30 | ACNU Live Panels Follow-Up: Deep Dive Virtual Panel On FDA’s New ACNU RuleIn this episode of the Only Healthcare Podcast, co-host Randy Vogenberg, PhD moves beyond the Nicholas Hall North America Conference to break down the FDA’s new Additional Conditions for Nonprescription. Guests Mary Alice Lawless, Ted Lawless, and Chelsea Ryan explain how ACNU grew from long-standing FDA concern over chronic undertreatment in conditions like hypertension, high cholesterol, asthma, and migraine, leading to the rule’s launch in May 2025.Mary Alice outlines the public health need behind ACNU, showing how nonadherence drives avoidable hospitalizations, higher costs, and an estimated 125,000 preventable deaths each year. She explains why the FDA sees...
2025-12-0839 min
ONLY HEALTHCAREEp 29 | The Future of the Journal of Clinical Pathways with Winston WongIn this episode of the Only Healthcare Podcast, co-host Randy Vogenberg, PhD, sits down with Winston Wong, Editor-in-Chief of the Journal of Clinical Pathways, to explore the past, present, and future of one of the most influential publications in oncology care.Winston shares how clinical pathways have evolved over more than two decades—from simple treatment sequencing tools designed to reduce variability, to comprehensive frameworks that now integrate personalized medicine, genomic testing, value-based care, and whole-person support. As the first and only editor-in-chief since the journal’s inception in 2015, Winston offers a unique perspective on how the publ...
2025-11-2419 min
ONLY HEALTHCAREEp 28 | Insights from Health Rosetta Fest 2025In this episode of the Only Healthcare Podcast, hosts Randy Vogenberg, PhD, and Michael Navin unpack key insights from Health Rosetta Fest 2025, held in Denver, Colorado. This year’s event brought together more than 1,200 leaders across the healthcare ecosystem — from employers and brokers to innovators and policymakers — all focused on transforming how healthcare is purchased, delivered, and managed in the United States.Michael shares firsthand takeaways from the conference, including how employers are taking a more active role in shaping healthcare strategy, the debut of Health Rosetta’s new Navi...
2025-11-1718 min
ONLY HEALTHCAREEp 27 | Nicholas Hall Panel Discussion 2: Nonprescription Access to Drug TreatmentIn this episode of the Only Healthcare Podcast, recorded live at the Nicholas Hall North America Conference, our panel explores how the FDA’s new Additional Conditions for Nonprescription Use (ACNU) rule could transform chronic disease management—particularly for diabetes—by empowering consumers and redefining self-care.Hosts Randy Vogenberg, PhD, and Mary Alice Lawless are joined by Joe McGovern, Teresa DeSantis, and Bob Barron, experts in diabetes care, life sciences, and healthcare marketing. Together, they discuss how ACNU creates new opportunities for safer, more accessible, and af...
2025-11-1131 min
ONLY HEALTHCAREEP 26 | OHPLive! Non prescription access to drug treatmentIn this episode of the Only Healthcare Podcast, recorded live at the Nicholas Hall North America Conference, our panel explores how the FDA’s new Additional Condition for Nonprescription Use (ACNU) rule is reshaping the future of consumer healthcare.Hosts Randy Vogenberg, PhD, and Mary Alice Lawless are joined by experts Jim Parker and Bob Sterling to unpack the first major change to U.S. drug regulation since 1951. Together, they discuss how ACNU opens new pathways for safe, affordable, and equitable access to medications—bridging the...
2025-11-1042 min
ONLY HEALTHCAREBreaking Down the $80 Billion 340B Drug Program with William Sarraille | Only Healthcare Podcast #25In this episode of Only Healthcare, host Randy Vogenberg welcomes William Sarraille, retired senior partner from Sidley Austin's healthcare practice and nationally recognized expert in US healthcare law. As both a legal authority and rare disease patient himself, Bill exposes how the 340B drug discount program has evolved from a modest safety net initiative into an $80 billion profit machine that enriches hospitals while burdening employers and devastating patients with medical debt.With 30 years of experience representing all stakeholders in the 340B ecosystem, Bill reveals the shocking reality: what began as Congress fixing a "boo-boo"...
2025-09-2540 min
ONLY HEALTHCAREHow Cell and Gene Therapies Can Bankrupt Unprepared Employers with Tom Sondergeld | Only Healthcare Podcast #24In this episode of Only Healthcare's Risk Series, hosts Michael Navin and Randy Vogenberg welcome Tom Sondergeld, managing partner of TS Consulting Group with over 30 years in healthcare benefit consulting and former senior advisor to McKinsey & Company. As a national leader in benefit design strategy and cancer survivor who has personally navigated the healthcare maze, Tom provides both professional expertise and patient perspective on the explosive growth of ultra-high-cost therapies threatening to devastate employer-sponsored health plans.With 3,700 ultra-high-cost therapies in development and 30+ cell and gene therapies already approved by the FDA, Tom reveals how...
2025-09-1841 min
ONLY HEALTHCAREHealthcare’s Lightning Strike Cost Problem with Drew Wilkins | Only Healthcare Podcast #23In this episode of Only Healthcare's Risk Series, hosts Michael Navin and Randy Vogenberg welcome Drew Wilkins, Managing Director at Monitor Deloitte with over 20 years of consulting experience in corporate strategy and innovation. As an expert in access and health with deep expertise in life sciences, Drew reveals how cell and gene therapies are fundamentally breaking America's employer-sponsored healthcare system—not through gradual cost increases, but through unpredictable "lightning strike" events that can cost $3-5 million per patient.Drawing from his extensive work with biopharmaceutical companies and self-insured employers, Drew exposes th...
2025-09-1139 min
ONLY HEALTHCAREThe Hidden Agenda of Healthcare Insurance with Tamara Thomas | Only Healthcare Podcast #22In this episode of Only Healthcare, hosts Randy Vogenberg and Michael Navin welcome Tamara Thomas, Founder and Editor-in-Chief of Urban Health Today, for a candid discussion about the consumer perspective on America's broken healthcare system. Drawing from her extensive background in health disparities coverage and a shocking revelation from an insurance executive years ago, Tamara exposes the fundamental conflict between profit motives and patient care.With her unique lens as both a healthcare journalist and certified health coach, Tamara joins Randy and Michael in dissecting how insurance companies have systematically extracted...
2025-08-2153 min
ONLY HEALTHCAREBreaking the Healthcare Monopoly with Dave Chase and Steve Ditto | Only Healthcare Podcast #21In this episode of Only Healthcare, hosts Michael Navin and Dr. Randy Vogenberg welcome two healthcare transformation pioneers: Dave Chase, co-founder of Health Rosetta, and Steve Ditto, compliance advisor and founder of Ditto and Associates. Together, they reveal how employers can slash healthcare costs by 50% or more while improving employee benefits through strategic procurement and fiduciary compliance.With decades of experience in healthcare technology and benefits consulting, Dave and Steve break down the systemic failures that have turned healthcare into a $5 trillion extraction machine, and more...
2025-08-0156 min
ONLY HEALTHCAREGLP-1s: The Billion Dollar Dilemma in US Healthcare with Deborah Williams | Only Healthcare Podcast #20In this episode of Only Healthcare, hosts Michael Navin and Dr. Randy Vogenberg welcome guest Deborah Williams, a leading healthcare strategy and policy expert, to explore the explosive growth and complex economics of GLP-1 medications like Ozempic and Wegovy. With her extensive background working on Medicare Part D legislation and with major pharmaceutical companies, Deborah breaks down how these breakthrough diabetes and weight loss drugs exemplify everything wrong with America's healthcare incentive structure.Key Topics Discussed:Explosive Market Growth & Cost Impact - GLP-1 scripts i...
2025-07-2434 min
ONLY HEALTHCAREWhy Are Prescription Drugs So Expensive with Michael Navin & Dr. Randy Vogenberg | Only Healthcare Podcast #19In this episode of Only Healthcare, hosts Michael Navin and Dr. Randy Vogenberg dive deep into one of America's most pressing healthcare questions: Why are prescription drugs so expensive? Michael, a leading expert in biotech market access and commercialization strategies, unpacks the complex web of pricing decisions, negotiations, and middleman systems that drive up drug costs for patients and employers alike.Key Topics Discussed:Drug Pricing Fundamentals - How pharmaceutical companies set initial prices based on market research, differentiation analysis, and anticipated rebate demands f...
2025-07-1024 min
ONLY HEALTHCAREWhy the US Spends the Most on Healthcare But Gets the Worst Outcomes with Dr. Randy Vogenberg & Michael Navin | Only Healthcare Podcast #18In this episode of Only Healthcare, we tackle the fundamental question: Why does the US spend more on healthcare than any other country yet rank last in outcomes? Key Topics:The cost-outcome paradox – How $12,000 per capita spending leads to worst-in-class life expectancy and preventable death rates among developed nationsSystem misalignment – Why emergency care dominates over preventative care, driving up costs while reducing effectivenessAdministrative waste – The $600 billion to $2 trillion in wasteful spending caused by middlemen, lack of transparency, and disconnected carePatient empowerment strategies – Practical steps individua...
2025-06-1925 min
ONLY HEALTHCARESecrets to Solutions: How Real-Time Pricing Data Can Heal Healthcare“Trillions of dollars are working against transparency.”In this explosive episode of the Only Healthcare Podcast, hosts Michael Navin and Randy Vogenberg, PhD, sit down with Mark Galvin, CEO of Talon Health, to expose the powerful forces fighting to keep healthcare costs opaque—and why that’s costing you more than you realize. Whether you're an employer, patient, policymaker, or provider, this episode is your wake-up call. Mark, a seasoned tech disruptor, unveils how Talon Health is dismantling the infrastructure that hides healthcare pricing from consumers...
2025-05-2045 minONLY HEALTHCAREBiosimilar Breakdown: Can Lower Drug Prices Survive the PBM Squeeze?Featured Guest: Stan Mehr — Editor of Biosimilars Review & Report, healthcare journalist, and market strategist with decades of expertise in biosimilars, pharma reform, and drug pricing dynamics. https://biosimilarsrr.com/about/In this critical episode, we explore the evolving biosimilars landscape, pricing transparency, and the tangled web of pharmacy benefit managers (PBMs) with biosimilars expert Stan Mehr. From inflated rebates to private-label manipulation, Stan sheds light on how PBMs and policy changes under the Inflation Reduction Act are reshaping access to lower-cost drugs.If you're an employer, payer, or pharma manufacturer navigating the biosimilar sp...
2025-04-1835 minONLY HEALTHCAREConfronting the Affordability Crisis: Unmasking the True Cost of HealthcareJoin us as we examine the heart of the healthcare affordability crisis. In this episode, Michael Navin and Randy Vogenberg, PhD discuss the hidden costs exacerbating healthcare access and decision-making. Listen in as they set the stage for a compelling conversation about healthcare's lack of price transparency and how this obscurity fuels an ongoing affordability crisis.Key Discussion Points:Examining how opaque pricing impacts patient decisions and the healthcare system.Insights into technological advancements that could revolutionize how patients and plan sponsors view and manage healthcare expenses.Discuss the pivotal role of pr...
2025-03-2020 minONLY HEALTHCAREClear Costs, Clearer Choices: Unpacking Trump’s Transparency Drive in HealthcareJoin Michael Navin in this insightful brief episode of the "Ask The Expert" series on The Only Healthcare Podcast. In this episode, Michael dives into President Trump's recent executive order to enforce drug price transparency across the United States. Issued on February 25, 2025, this mandate directs federal agencies to ensure that hospitals and insurers disclose actual healthcare costs, building on a 2019 initiative. Episode Highlights: Understanding the Executive Order: A detailed explanation of the new directive and its expectations from healthcare providers and insurers. Impact on PBMs and Carriers...
2025-03-0312 minONLY HEALTHCAREPolicy and Power: Dismantling Middleman Dominance in HealthcareJoin hosts Michael Navin and Randy Vogenberg, PhD as they discuss more on the pivotal healthcare policy changes under the Trump administration. This episode delves into the fresh legislative adjustments affecting PBMs, the impacts of new Medicare reports, and advancements in gene therapy and R&D. It also discusses the broader implications of these policies on healthcare costs, accessibility, and the expansion of IVF coverage. Tune in for a critical analysis of what these changes mean for public and industry stakeholders and how they align with the "Make America Healthy Again" agenda. Episode Highlights:
2025-02-2719 minONLY HEALTHCARERethinking Risk: Innovating Benefit Design for Whole-Person CareWelcome to another insightful episode of "The Only Healthcare Podcast," where we unpack the demand for change in risk management for employers within commercial insurance and benefit design. In this episode, our host, Dr. Randy Vogenberg, is joined by Rajiv Sood, the founder of Sood Health Advisors. With over 30 years of experience spanning healthcare, clinical settings, insurance, and InsureTech, Rajiv brings a wealth of knowledge and a unique perspective on managing financial risks in healthcare. In this episode, you will learn: Innovative Risk Management: Explore how innovative financial strategies can mitigate risks fo...
2025-02-1432 minONLY HEALTHCARENavigating the Future of Healthcare PolicyWelcome back to "The Only Healthcare Podcast." This episode delves deep into the evolving landscape of healthcare policy in 2025. Hosted by Randy Vogenberg, PhD we are joined by special guest Jayson Slotnik, a seasoned health policy expert from Health Policy Strategies, LLC.Jayson Slotnik is a prominent figure in health policy consultation, with over 15 years of experience at Health Policy Strategies, LLC. He works with government agencies, manufacturers, patient advocacy groups, and healthcare providers to navigate and influence significant policy changes. His expertise includes advocating for better patient access and developing commercial strategies. Jayson's approach combines his...
2025-01-2837 minONLY HEALTHCARETransforming Healthcare: Innovations in Clinical Pathways with Dr. Randy VogenbergJoin us on the "Only Healthcare Podcast" as we dive into the transformative discussions from the recent Clinical Pathways Congress in Boston with Dr. Randy Vogenberg. Discover the latest trends in clinical practice, payment models, and policy shaping healthcare's future.What You’ll Learn:Insights on Clinical Practice Changes: Understand the new dynamics in clinical pathways affecting patient care and how healthcare providers are adapting to these changes.Impact of Benefit Design on Care: Explore how benefit design influences patient access to treatments, particularly in oncology, and what it means fo...
2025-01-0910 minONLY HEALTHCAREWhat Can Be Done to Bridge the Gap Between Employer-Manufacturer CollaborationIn this episode of The Only Healthcare Podcast, co-hosts Michael Navin and Dr. Randy Vogenberg, PhD, welcome esteemed guest Tonya Vyhlidal, a senior consultant with over 25 years of experience in building comprehensive health and wellness programs. Together, they dive deep into the components of employer and biopharmaceutical manufacturer collaboration and the benefits it holds for all stakeholders involved. Key Highlights: The Current Landscape: Understanding why collaboration between employers and manufacturers remains fragmented and what obstacles exist that hinder these essential partnerships. The Role of Stakeholders: How employers, benefit consultants (EBCs), and...
2024-11-2131 minONLY HEALTHCAREUnlocking Access and Collaboration: The Benefits of Employer-Pharma RelationshipsIn this enlightening episode of The Only Healthcare Podcast, hosts Michael Navin and Dr. Randy Vogenberg, PhD, dive deep into the crucial need for employer-manufacturer collaboration in the commercial healthcare market exploring:Data Transparency: Why both employers and manufacturers must share data to create more informed, efficient, and impactful benefit plans.Equitable Access: The challenges and opportunities in balancing network limitations, production costs, and patient affordability.Whole Person Care: Understanding how patient-centered care improves clinical outcomes, reduces costs, and mitigates risks.Dr. Vogenberg and Michael discuss how recent trends, including increased...
2024-11-0718 minONLY HEALTHCAREHow Employer-Pharmaceutical Collaboration Can Transform Healthcare PlansIn Episode 7 of the Only Healthcare Podcast, co-hosts Michael Navin and Dr. Randy Vogenberg, PhD, are joined by Zak Kornblum, a pharmacy consultant with expertise in navigating the complexities of employer-PBM relationships. Together, they discuss the critical need for employer-pharmaceutical collaboration to drive transparency, improve data access, and enhance patient outcomes.Key discussion points include:The challenges employers face when relying solely on PBMs for data and transparency.How direct collaboration with pharmaceutical manufacturers can offer better insight into drug pricing and improve access to advanced therapies.The importance of educating employers on understanding...
2024-10-2426 min
ONLY HEALTHCARENavigating State-Level Legislation & The Future of Patient-Centered CareIn this episode of the Only Healthcare Podcast, we sit down with Dr. Randy Vogenberg, PhD, to discuss the rising influence of state-level healthcare legislation and how employers must adapt to ensure their healthcare plans align with changing regulations. With over 270 pieces of healthcare legislation in 45 states, employers must understand how these changes may impact fully-funded and self-funded plans under ERISA.Dr. Vogenberg also dives into the evolving landscape of patient-centered care, focusing on oncology as a key example. From managing multiple chronic conditions during cancer treatment to the growth of concierge services and integrated...
2024-10-1611 min
ONLY HEALTHCAREAsk The Expert with Michael Navin: Unpacking the Latest Prescription LawsuitsHosted by industry expert, Michael Navin. Listen in to the latest series of Ask The Expert hosted by Michael Navin. In this brief episode, Michael delves into the growing concern surrounding prescription lawsuits and the risks employers face in managing employee health benefits. As lawsuits in the healthcare space come to light, it’s essential for employers to understand their fiduciary responsibility and the implications of working with Pharmacy Benefit Managers (PBMs) and third-party administrators. Michael walks listeners through the complexities of self-funding, PBM accountability, and how businesses can make more informed decisions to sa...
2024-09-2703 minONLY HEALTHCAREGLP-1 Drugs: Rapid Growth and Market EvolutionIn this episode of the Only Healthcare podcast, Dr. Randy Vogenberg and Michael Navin dive deep into the GLP-1 drug category, exploring the rapid growth and market evolution surrounding these diabetes and obesity management medications. This conversation sheds light on the opportunities and challenges faced by employers, manufacturers, and patients in managing these high-demand and high-cost treatments.Key Topics Covered:The Explosive Growth of GLP-1 Drugs:These drugs have become game-changers for patients with metabolic conditions, but they also bring unique challenges in managing costs and access for employers and health...
2024-09-1521 min
ONLY HEALTHCAREAsk the Expert with Dr. Randy Vogenberg: How Government Policies Influence Commercial Insurance ImplicationsStay informed on critical moves in healthcare with our new series, "Ask the Expert." In this brief episode of "Ask the Expert," Dr. Randy Vogenberg delves into the complex relationship between government healthcare policies and their impact on commercial insurance stakeholders. This brief but insightful episode focuses on a significant lawsuit by Vertex Pharmaceuticals against the Office of Inspector General (OIG). The case centers on whether Vertex can provide a patient assistance program for its gene therapy patients, explicitly addressing the associated fertility assistance needs.Dr. Vogenberg discusses the broader implications of this legal battle, e...
2024-08-2205 minONLY HEALTHCAREHow Employer Decisions Impact Coverage & ReimbursementIn this episode of Only Healthcare, we dive into the complexities of the commercial insurance landscape, particularly focusing on how employer decisions shape health benefits coverage and reimbursement processes. The conversation does not touch on entitlement programs but rather hones in on the intricacies of commercial health insurance and its impact on both employers and employees.Key Topics Discussed:1. Coverage:Definition and Legal Framework: We explore the legal right to receive reimbursement or payment for healthcare costs under a contract with an insurance company, a group health plan, or government programs like Medicare.Difference Between...
2024-08-1222 min
ONLY HEALTHCAREExploring Healthcare Stakeholder InteractionsWelcome to the inaugural episode of "Only Healthcare," where hosts Michael Navin and Dr. Randy Vogenberg discuss the intricacies of therapies and their impact on the US healthcare system. In this episode, Michael and Randy explore the complexities of drug distribution and the pivotal role that transparency plays in today's healthcare landscape. They discuss the journey of pharmaceuticals from manufacturers to patients, employer lawsuits, ERISA, and more. Key Discussion Points: The Distribution Process: How drugs are developed, distributed, and paid for in the US. Transparency in Healthcare: The dema...
2024-07-1018 min
Relentless Health ValueEP265: The What, the How, and the Questionable Why of Digital Therapeutic Formularies, With Randy Vogenberg, PhDThere is a lot going on with digital health tools these days. Which ones are the good ones and which ones are nothing burgers packaged up in beautiful marketing? That's a good question, and it would be nice to have a go-to source for such information. Some parties — mainly PBMs [pharmacy benefit managers] and to some extent payers and providers — recognize that this actually would be nice, and they see that creating digital formularies could be an opportunity to grow revenue for their shareholders by meeting a market need potentially and offering additional services to the marketplace. But...
2020-03-1929 min