INBW44: The Relentless Health Value Themes That We Covered Throughout 2025—A Recap, Part 1

As Stacey Richter reflects on a year of Relentless Health Value episodes, three themes kept surfacing in nearly every conversation: the foundational role of trusted relationships, the cost of underinvesting in primary care, and the dominance of perverse financial incentives and profiteering. This is Part 1 of a two-part year-end Inbetweenisode hosted by Stacey Richter, drawing on episodes featuring Dr. Kenny Cole, Ann Lewandowski, Jonathan Baran, Nikki King, Yashaswini Singh, Dr. Ben Schwartz, Dr. Mick Connors, Mark Cuban, and more. WHAT YOU'LL LEARN ✅ Why trust is the foundational element required for both clinical and financial outcomes — and how a pervasive lack of trust is showing up across the system, from the patient-clinician relationship to the employer-TPA-PBM relationship ✅ How "trust and verify" or defensive plan sponsorship protects self-insured employers whose partners may not be as transparent as assumed — and why simplicity in benefit design is directly linked to trust ✅ Why ER spend reaching approximately 6% of average total plan costs is evidence of broken primary care — and how investing in unconflicted, independent advanced primary care reverses the cost flywheel ✅ How hospital systems can undermine primary care by acquiring practices and using them as referral funnels for expensive downstream services, gutting their ability to deliver real primary care ✅ Where the line is between fair profit and profiteering — and how private equity, carrier float, intercompany eliminations, upcoding, and consolidated market power all function to extract value from the system rather than create it ✅ Why Kevin Lyons' observation that "profit defends profit" matters: healthcare entities use growing revenues to fund lobbying and political contributions to the very legislators negotiating contracts with them WHY THIS MATTERS Healthcare costs keep rising in part because the incentives at nearly every layer of the system reward spending more, not less. Stacey's 2025 recap makes the case that trust, primary care investment, and confronting financial misalignment aren't separate problems — they're the same problem showing up in different settings. As she put it, 2025 surfaced some of the most egregious behavior she's seen in 25-plus years, which is exactly why understanding these dynamics — and demanding accountability — matters more than ever. === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ 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. 02:06 Theme 1: the critical need for trusted relationships and simplicity. 02:28 The two categories of trust that are needed. 02:43 Clip of Kenny Cole, MD, from EP473. 03:43 Clip of Ann Lewandowski from EP476. 06:07 Why simplicity and trust have to go together. 08:30 Theme 2: primary care as an investment, not a cost. 08:41 Clip of Jonathan Baran from EP483 (Part 1). 09:01 Clip of Nikki King, DHA, from EP470. 09:34 How broken primary care affects self-insured employers. 10:12 Why there are perverse financial incentives to gut primary care. 15:19 Theme 3: the dominance of perverse financial incentives and profiteering. 15:46 Clip of Benjamin Schwartz, MD, MBA, from EP481. 16:18 The actual definition of margin. 16:55 Clip of Mick Connors, MD, from EP495. 18:25 Clip of Yashaswini Singh, PhD, from EP474.