Encore! EP244: A Playbook for Jumbo Employers—or Providers, Consultants, Carriers, or Pharma Who Get Paid by Jumbo Employers, With Lee Lewis, Chief Strategy Officer at the Health Transformation Alliance

In this Encore episode, Stacey Richter talks with Lee Lewis, chief strategy officer at the Health Transformation Alliance, about his three-part playbook for jumbo employers — the "how," the "what," and the "who" — for cutting health care spend while improving outcomes. WHAT YOU'LL LEARN ✅ What the "administrative superstructure" is, and why it's the first chapter of any employer health benefits playbook ✅ How to connect the "what" of care delivery to the clinical conditions driving the most cost ✅ Why overseeing the pharmacy benefit manager (PBM) is critical to controlling drug spend ✅ Why centers of excellence make sense for steering employees to high-cost, high-value care ✅ How enabling and properly paying PCPs fits into an employer's cost and quality strategy WHY THIS MATTERS Large self-insured employers are uniquely positioned to disrupt health care revenue streams that don't deliver adequate outcomes for the dollars spent — and when done well, both employer and employee win: costs go down, and employees get better care with less time lost navigating the health care system. Lee Lewis's three-chapter playbook (the how, the what, and the who) gives employers, and the providers, consultants, carriers, and pharma companies who serve them, a concrete framework for making that happen. === LINKS === 🔗 Show Notes with all mentioned links: Episode Page 🔗 Healthcare Industry Acronyms and Terms ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === MENTIONED IN THIS EPISODE === 🔗 EP241 (Apple) / EP241 (Spotify) with Vinay Patel 🔗 EP240 (Apple) / EP240 (Spotify) with Olivia Ross === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 00:00 Introduction 04:00 A playbook to reduce health care spend and achieve better outcomes. 04:08 The "how," or "administrative superstructure." 05:19 What Lee typically does when working with companies. 08:57 The "what" of delivery—connecting the "what" to the "clinical." 10:52 Overseeing the pharmacy benefit manager (PBM). 12:37 EP241 with Vinay Patel. 12:50 Looking at the medical side of health. 15:46 Improving spend and improving quality simultaneously. 18:10 EP240 with Olivia Ross. 18:53 Why centers of excellence make sense. 21:54 The "who"—who is providing the care. 24:06 Enabling and empowering PCPs and improving PCP pay to compensate for that. 26:57 Lee's advice for brokers. 28:02 Lee's advice for provider organizations, hospitals, and centers of excellence. 29:07 "Hospital systems are not [a] monolith."