Encore! EP413: The Intersection of Healthcare Waste, Value-Based Care, and the Potential Rising Power of PCPs, With Will Shrank, MD

In this encore episode, Stacey Richter's conversation is with Will Shrank, MD. Dr. Shrank led the evaluation group at CMMI (Center for Medicare and Medicaid Innovation), spent time in the private sector at CVS Health and UPMC as chief medical officer of the health plan in Pittsburgh, and then as chief medical officer for Humana. Now he is a venture partner at Andreessen Horowitz and does some consulting for CMMI. The conversation starts with waste in healthcare — Dr. Shrank was on a team who did a study about waste in the US healthcare system, estimating upwards of a trillion dollars of waste a year, categorized into administrative and clinical failures. Dr. Shrank emphasizes the need for aligning incentives with higher quality care, paying for patient outcomes, and highlights the potential rising power of PCPs. WHAT YOU'LL LEARN ✅ The six categories of "healthcare waste" Dr. Shrank's study identified, and how much money — upwards of a trillion dollars a year — that waste actually represents ✅ Why we've "built a backbone of extraordinary waste on a fee-for-service chassis," and how that waste splits between administrative and clinical failures ✅ Why aligning incentives with higher quality care and paying for patient outcomes matters more than simply tightening administrative processes ✅ Dr. Shrank's warning to providers, and why there might be a generational shift among younger providers looking to work with different care models ✅ How Dr. Shrank's background — CMMI, CVS Health, UPMC, Humana, and now Andreessen Horowitz — shapes how he thinks about fixing healthcare waste WHY THIS MATTERS "We've built a backbone of extraordinary waste on a fee-for-service chassis." Dr. Shrank's study puts a number on what many in healthcare already sense: upwards of a trillion dollars a year in waste, split between administrative and clinical failures. His prescription is aligning incentives with quality and outcomes — not just trimming around the edges of a fee-for-service system built to reward volume. MENTIONED IN THIS EPISODE EP363 with David Scheinker, PhD: Apple Podcasts | Spotify | Other Apps EP409 with Larry Bauer, MSW, MEd: Apple Podcasts | Spotify | Other Apps EP359 with Dan O'Neill: Apple Podcasts | Spotify | Other Apps Summer Shorts 2 with Scott Conard, MD: Apple Podcasts | Spotify | Other Apps === 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 === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 00:00 Introduction 06:54 Can we cut healthcare waste while improving patient care? 07:33 What does "healthcare waste" consist of? 07:46 What are the six categories of "healthcare waste"? 10:37 How much money does Dr. Shrank estimate is wasted each year in healthcare? 13:09 Where is that healthcare waste going, and why does it happen? 20:07 Uncaring by Robert Pearl, MD. 21:18 "We've built a backbone of extraordinary waste on a fee-for-service chassis." 26:02 Dr. Shrank's warning to providers out there. 31:41 Why there might be a generational shift among younger providers looking to work with different models.