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The Astonishing Healthcare Podcast
Capital Rx
96 episodes
2 days ago
If you’ve ever wondered what pharmacy benefit managers (PBMs) do, why the pharmaceutical supply chain is so complicated or the pace of change in healthcare seems so slow, how vendor purchasing decisions are made, or why our nation’s electronic claim administration infrastructure must be updated, Astonishing Healthcare by Capital Rx is the podcast for you. Covering everything from niche and broad pharmacy and health benefit topics to regulatory change, disruptive technologies, and macro issues like the trend for drug prices or the total cost of care, we’ve got the information and insights you need. For show notes and additional resources from Capital Rx, visit https://www.cap-rx.com/insights.
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All content for The Astonishing Healthcare Podcast is the property of Capital Rx and is served directly from their servers with no modification, redirects, or rehosting. The podcast is not affiliated with or endorsed by Podjoint in any way.
If you’ve ever wondered what pharmacy benefit managers (PBMs) do, why the pharmaceutical supply chain is so complicated or the pace of change in healthcare seems so slow, how vendor purchasing decisions are made, or why our nation’s electronic claim administration infrastructure must be updated, Astonishing Healthcare by Capital Rx is the podcast for you. Covering everything from niche and broad pharmacy and health benefit topics to regulatory change, disruptive technologies, and macro issues like the trend for drug prices or the total cost of care, we’ve got the information and insights you need. For show notes and additional resources from Capital Rx, visit https://www.cap-rx.com/insights.
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Medicine
Business,
News,
Business News,
Health & Fitness
Episodes (20/96)
The Astonishing Healthcare Podcast
AH091 - Trends Shaping the Workplace: 2026 Forecast, with Dan Schawbel
On Episode 91 of Astonishing Healthcare, we dove into the Workplace Intelligence Forecast for 2026 - The 10 Trends Businesses Need to Focus On! Here at Judi Health, we obviously live in the health benefits world and generally focus on content revolving around the pharmaceutical supply chain (i.e., PBM), health tech, and the administration of employee benefits, more broadly... but there is A LOT more going on our there that impacts America's workforce. Our guest, Dan Schawbel, Managing Partner of Workplace Intelligence (links below), has been tracking and publishing research on workplace trends for well over 15 years, and he unpacks the forces shaping the future of work, today. Aside from rising healthcare costs, how are employers - and their benefits leaders - thinking about remote work vs. returning to the office (and the impact on working mothers), the use of AI and a widening skills gaps, and the shift from white-collar to blue-collar jobs?
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2 days ago
21 minutes 31 seconds

The Astonishing Healthcare Podcast
AH090 - The Survey Says: Inflation is a Problem, and Change is Imminent, with Business Group on Health's Jim Winkler
For Episode 90 of Astonishing Healthcare, Jim Winkler, Chief Strategy Officer at Business Group on Health, joins us in the studio for a lively discussion about the results of their 2026 Employer Health Care Strategy Survey! This annual study is packed with qualitative and quantitative information and highlights the top trends in employer-sponsored health care. Jim brings decades of experience to the table and puts helpful context around the headline data and employers' expectation for a ~9% year-over-year health care cost increase. He also shares his perspective on the evolution of the role benefits brokers and consultants play, how employers can navigate the rapidly evolving market and inflationary storm, vendor accountability, and how to position difficult decisions around making big changes.
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1 week ago
26 minutes 18 seconds

The Astonishing Healthcare Podcast
AH089 - Some [Healthcare] Data Visualization Treats, with Andrew Tsang
On Episode 89 of Astonishing Healthcare, we are talking about some "visual treats," as the title suggests! Our guest, Andrew Tsang, has been posting some very cool things on LinkedIn of late, including Sankey and other dynamic charts highlighting where the money flows in healthcare (from the premium dollars to the care plan members receive), and which stakeholders win or lose in different scenarios via a 5-Way Seesaw he developed using AI! If you're a [healthcare] data nerd, this episode is for you.
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2 weeks ago
17 minutes

The Astonishing Healthcare Podcast
AH088 - Celebrating Women Pharmacist Day 2025: A Discussion About Growth, Mentorship, Leadership, and More
On Episode 88 of Astonishing Healthcare, we're celebrating Women Pharmacist Day (#WPD2025) and sharing stories from four of our amazing team members: Allison Gallant, PharmD (Sr. Strategic Account Executive), Cindy Strassner, RPh (Customer Success Pharmacist), Lorece Shaw, PharmD (Sr. Director of Prior Authorization and Clinical Care), and Hope Nakazato, PharmD (VP of National Business Development). These women aren't just talking about improving healthcare or celebrating one day - they're actively promoting and implementing change, mentoring the next generation of pharmacists, and building systems to improve clinical workflows and member care.
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3 weeks ago
18 minutes 6 seconds

The Astonishing Healthcare Podcast
AH087 - 2025 Flu Season Update, with Libbi Green, PharmD
In this episode of Astonishing Healthcare, return guest Libbi Green, PharmD (Manager, Formulary Operations) joins Justin Venneri for a discussion about the 2025 flu season, including the latest vaccine-related updates that employer plan sponsors and plan members need to know. We discuss the effectiveness of last year's flu vaccines, factors influencing the rates, vaccination timing, and how there can be differences in state vs. federal guidelines, among other topics!
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1 month ago
14 minutes 47 seconds

The Astonishing Healthcare Podcast
AH086 - Balancing Technology and a Human Touch in Member Service, with Lisa Ellerhorst and Sonia Pettis
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1 month ago
19 minutes 2 seconds

The Astonishing Healthcare Podcast
AH085 - Addressing Barriers to Drug Access & Affordability, with Valeris' Andy Glade
This episode of the Astonishing Healthcare podcast features a unique client of ours - Andy Glade, Senior Director of Trade Operations at Valeris. We discussed how to remove financial barriers to care and streamline access to the medications people need through the use of copay cards, vouchers, and patient assistance programs (PAPs). In a rapidly evolving market, these programs play an important role in reducing prescription abandonment and increasing adherence in convenient ways, particularly for chronic conditions and when extremely expensive specialty medications are prescribed.
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1 month ago
15 minutes 17 seconds

The Astonishing Healthcare Podcast
AH084 - Solving Pharmacy Benefits: Inside the RFP Process, with Josh Golden & Nic Bolitho
In this episode of the Astonishing Healthcare podcast, host Justin Venneri is joined by Josh Golden, SVP of Strategy, and RFP Content Manager, Nic Bolitho, for a timely discussion about trends they're seeing in the market and how to run a better request for proposal (RFP) process to select a pharmacy benefit management (PBM) partner. Long story short, the "old way" of running a PBM RFP is broken, but, as Josh describes, there are some "tectonic shifts" happening as plan sponsors demand to see more options (i.e., transparent PBMs) and benefits brokers and consultants upgrade the questions and scoring used to force accountability and drive meaningful results for plans and plan members.
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1 month ago
21 minutes 16 seconds

The Astonishing Healthcare Podcast
AH083 - Your PBM vs. Your Bottom Line: Biosimilars & Rebates, with Bridget Mulvenna
Episode 83 of the Astonishing Healthcare podcast features returning guest, Bridget Mulvenna (VP, National Business Development at Capital Rx)! We discuss specialty drugs, pharmaceutical manufacturer rebates, and the shift to biosimilars. Yes, GLP-1s come up as well (how could they not?), and Bridget explains how employer plan sponsors can consider opportunities to provide access to these medications while not ignoring their inflationary potential and the economic impact on the plan - i.e., how to pivot from a rebate-driven models to a net-cost approach, facilitating more accurate cost management and budgeting.
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1 month ago
20 minutes 20 seconds

The Astonishing Healthcare Podcast
AH082 - Pharmacy Benefit Implementations: Have No Fear, Alignment & Process are Here
In this episode of the Astonishing Healthcare podcast, Tracey Rollins, CPM (Sr. Director, Client Implementations) and Kristen Morgan (Director, Health Plan Implementations) join Justin Venneri in the studio for a discussion about pharmacy benefit implementations and how switching to an aligned, transparent partner can be efficient and a pleasant experience, despite the complexities involved.
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2 months ago
16 minutes 19 seconds

The Astonishing Healthcare Podcast
AH081 - Promoting Competition & Innovation: The Push for PBM Reform, with Rep. Jake Auchincloss
This special episode of the Astonishing Healthcare podcast features Congressman Jake Auchincloss, who discusses his efforts to reform pharmacy benefit managers (PBMs) and address systemic issues in the U.S. healthcare system to bring down costs. Representing Massachusetts' 4th district and growing up in a family of medical professionals and scientists, Rep. Auchincloss draws on his experience to advocate for policies that promote competition, innovation, and improved access to affordable care. He highlights his Pharmacists Fight Back Act (H.R.9096), noting that he looks forward to reintroducing the widely supported, bipartisan bill that aims to protect independent pharmacies, employers, and plan members, and he shares optimism about the potential for meaningful PBM reform to become law.
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2 months ago
25 minutes 44 seconds

The Astonishing Healthcare Podcast
AH080 - Health Benefits 101: The Importance of "Smart" Care Navigation, with Andy Kageleiry
Episode 80 of the Astonishing Healthcare podcast focuses on care navigation! Our guest, Andy Kageleiry (VP, Judi Care), explains the role of care navigation in helping health plan members (i.e., healthcare consumers) find care and navigate the complex U.S. healthcare system. He also discusses the importance of care navigation from the perspective of a plan sponsor. While everyone in the healthcare industry talks about patient-centered care and controlling costs, patients are left to navigate fragmented systems that work against them. Andy cuts through this contradiction and explains how care navigation can help as a core piece of the health benefits puzzle.
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2 months ago
16 minutes 43 seconds

The Astonishing Healthcare Podcast
AH079 - Capital Equilibrium, a New Level-Funded Pharmacy Plan, with Mike Miele, FSA, MAAA
In this episode of the Astonishing Healthcare podcast, Mike Miele, FSA, MAAA (SVP of Insured Services), joins us in the studio again for a discussion about a new product and the growth of level-funded pharmacy plans. What are level-funded plans? How does Capital Rx's "Capital Equilibrium" work? Listen in to hear how these plans, positioned between self-funded and fully insured models, offer employers budget certainty while maintaining flexibility and transparency. Mike highlights the scenarios where a level-funded plan can truly help - e.g., a municipality with a fixed budget and the role stop-loss plays (building on Episode 55). He also notes that not all level-funded plans are equal, and plan sponsors should look for transparency around rebates and whether any savings - if a plan's performance is better than the guarantee - ultimately benefit the plan.
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2 months ago
16 minutes 9 seconds

The Astonishing Healthcare Podcast
AH078 - More on Judi Health™ and the Unified Benefits Experience, with Dr. Sunil Budhrani and Mike Tate
In this episode of the Astonishing Healthcare podcast, Capital Rx's Dr. Sunil Bhadrani (Chief Innovation & Medical Officer) and Mike Tate (Vice President, National Business Development) discuss the questions they are fielding from channel partners and prospects interested in Judi Health™ - the first unified medical and pharmacy solution. We explore advancements in unified claims processing and how it helps address healthcare's fragmented nature by integrating pharmacy and medical benefits data with preferred vendors to tackle specific needs (e.g., for women's health or chronic condition management). Sunil also shares early, updated data revealing a ~5% per-employee-per-month (PEPM) reduction in costs YTD with Judi Health compared to 2024.
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3 months ago
21 minutes 44 seconds

The Astonishing Healthcare Podcast
AH077 - Rx Retro: An Approach to Safe & Effective Deprescribing, with Lauren Carroll, PharmD
In this episode of the Astonishing Healthcare podcast, host Justin Venneri sits down with Lauren Carroll, PharmD, a Senior Clinical Programs Manager at Capital Rx, to discuss Rx Retro. This pharmacist-led program focuses on medication deprescribing to enhance patient safety, reduce adverse drug events, and improve healthcare outcomes. Lauren shares insights into how Rx Retro leverages Judi® - Capital Rx's enterprise health platform - to identify and address drug therapy concerns through a series of alerts and outreach designed to promote the safest and most effective treatments for plan members. The conversation also highlights the broader implications of deprescribing for healthcare quality and cost savings, with Lauren noting that, "We are uniquely positioned to bridge gaps that exist in the healthcare system."
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3 months ago
20 minutes 4 seconds

The Astonishing Healthcare Podcast
AH076 - PBM 'Boogeymen' & Stopping the Madness Out There, with Jeff Hogan
In this episode of the Astonishing Healthcare podcast, we discuss recent health policy news and how to bring greater transparency to health benefits programs with returning guest, Jeff Hogan, President of Upside Health Advisors. Building on our previous discussion with Jeff - How First-Movers are Taking Control of their Health Plans in 2025 - we shed more light on the “PBM boogeyman” narrative, explaining how opaque pricing structures and unhelpful provisions buried in contracts must be discovered. Jeff reviews attempts by states around the country to intervene and halt steering and other practices that negatively impact health plans and their members - from early medical reform efforts to recent PBM-focused legislation. He also notes Medicaid cuts are likely to have some "second-order effects" that impact commercial plans, and the mood in Washington, DC, overall is "dazed and confused," so we can't count on help at the federal level.
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3 months ago
26 minutes 37 seconds

The Astonishing Healthcare Podcast
AH075 - What Health Systems Need [From a PBM]: A Blend of Tech, Transparency, and Understanding, with Lindsey Butler, PharmD, and Chris England
In this episode of the Astonishing Healthcare podcast, host Justin Venneri speaks with Lindsey Butler, PharmD, Vice President & Clinical Pharmacy Consultant at Lockton, and Chris England, Vice President of National Business Development at Capital Rx. They discuss what health systems need from a pharmacy benefit management (PBM) partner, the challenges in today's market, and the opportunities for innovation and collaboration to advance care for the patients in the communities health systems serve. State-level regulatory changes are top of mind, and Lindsey explains what she's tracking and how she's approaching meeting her clients' unique requirements: How can the benefits program aid with talent acquisition and retention? Can a pharmacy program meet everyone's needs (from the C-suite to the pharmacy team)? Both guests share insights from their extensive experience, offering ideas for health systems to enhance their pharmacy programs and improve the health benefits and healthcare experience for employees and communities.
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3 months ago
24 minutes 10 seconds

The Astonishing Healthcare Podcast
AH074 - How Fast is the Way Consumers Search for Care Evolving? Almost Beyond Comprehension, with Carrie Liken
On this episode of the Astonishing Healthcare podcast, Carrie Liken (now with Snowflake) returns to the show to discuss the insanely rapidly evolving search landscape and Google's new AI Mode. Are websites dying as AI-powered search ascends in popularity? According to Carrie, it looks that way. She and host Justin Venneri discuss the transformative impact of AI on healthcare search and patient journeys. They explore how tools like Google’s new AI Mode and ChatGPT are reshaping how consumers find healthcare information, reducing reliance on traditional websites. Carrie shares insights from her "mini research studies," highlighting the challenges and decisions healthcare organizations face in adapting to the new world.
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4 months ago
27 minutes 22 seconds

The Astonishing Healthcare Podcast
AH073 - How Low Cost Alternative Programs Can & Should Work, with Jackie Lolos, PharmD, and Haleh Campbell, PharmD
The latest episode of the Astonishing Healthcare podcast dives into the functionalities and real-world impact of Rx Smart Save, a low-cost alternative program designed to reduce medication costs for both patients and plan sposnsors. Jackie Lolos, PharmD, and Haleh (Halls) Campbell, PharmD, join Justin Venneri in the studio for a discussion highlighting the innovation and care behind this clinical program.
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4 months ago
16 minutes 57 seconds

The Astonishing Healthcare Podcast
AH072 - The Benefits You Probably Didn't Know You Have, with Marsha Perry
On Episode 72 of the Astonishing Healthcare podcast, Marsha Perry, Capital Rx's Head of Benefits and Compensation, joins host Justin Venneri in the studio for a conversation about the intricacies of employee benefits, beyond pharmacy benefits! At a high level, she shares her thoughts on setting up a "well-rounded and affordable" benefits package, what should be in the benefits guide, and how to drive app usage and engagement in underutilized programs (a little humor and sharing personal stories almost always helps 😀). Additionally, Marsha offers some specific examples of "benefits people [often] forget they have," and she dives into the importance of dental benefits (a surprisingly underutilized benefit). Lastly, but not least, Marsha shares her opinions on covering GLP-1s and the importance of maintaining a solid relationship with the finance team.
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4 months ago
19 minutes 40 seconds

The Astonishing Healthcare Podcast
If you’ve ever wondered what pharmacy benefit managers (PBMs) do, why the pharmaceutical supply chain is so complicated or the pace of change in healthcare seems so slow, how vendor purchasing decisions are made, or why our nation’s electronic claim administration infrastructure must be updated, Astonishing Healthcare by Capital Rx is the podcast for you. Covering everything from niche and broad pharmacy and health benefit topics to regulatory change, disruptive technologies, and macro issues like the trend for drug prices or the total cost of care, we’ve got the information and insights you need. For show notes and additional resources from Capital Rx, visit https://www.cap-rx.com/insights.