Ep 38 | Rethinking Risk: How Employers Prepare for Cell and Gene Therapy

EP 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 beyond weight loss. It addresses what happens when innovation outpaces coverage strategy and how benefit decision makers are responding to one of the most disruptive drug classes in recent history. Key Topics * What GLP-1 medications are and how they work * The science behind metabolic syndrome and weight regulation * GLP-1s vs. SGLT2 inhibitors * From diabetes treatment to weight loss demand * GLP-1s as an alternative to bariatric surgery * Cardiovascular and metabolic benefits * Side effects and risk considerations * Employer and government plan coverage challenges * Budget impact and utilization explosion * Long-term implications for benefit design and market access Episode Chapters with Timestamps 00:00 – Introduction to Healthcare 101: GLP-1s 00:32 – What are GLP-1 medications? 01:01 – How GLP-1s affect appetite, digestion, and blood sugar 02:48 – Understanding metabolic syndrome 04:20 – Lifestyle factors vs. pharmaceutical intervention 05:30 – GLP-1s vs. SGLT2 inhibitors 06:45 – From bariatric surgery to pharmaceutical alternative 07:56 – Plan sponsor perspective and coverage disruption 09:13 – Who qualifies and why coverage changed 09:27 – Side effects and real world risks 10:52 – Cardiovascular approvals and expanded indications 11:59 – Type 1 vs. Type 2 diabetes management 13:46 – Final thoughts on the future of GLP-1s Michael's LinkedIn [https://www.linkedin.com/in/michael-navin-7411388/] Randy's LinkedIn [https://www.linkedin.com/in/randyvogenberg/] Sponsored by: Peek [https://peekmeds.com/]: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/ [https://peekmeds.com/]. Institute for Integrated Health [https://iih-online.com/] (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/ [https://iih-online.com/].

Ep 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 * The historical evolution of the American health insurance system * Cost, access, and quality as the core healthcare triangle * Employer-sponsored coverage and government programs * The rise of managed care and third-party intermediaries * Vertical integration and consolidation in healthcare * Who the “middlemen” are and how they influence costs * Transparency challenges in healthcare pricing * Cash pay options vs. traditional insurance pathways * How consumers and employers can become more engaged Episode Chapters with Timestamps 00:00 – Introduction to Healthcare 101 00:34 – What is the American health insurance system? 01:04 – How cost, access, and quality shape healthcare 03:55 – Why the system is so complicated 05:20 – Who are the key players in healthcare? 07:15 – The role of middlemen and consolidation 09:16 – Vertical integration explained 09:59 – What individuals can do to navigate the system 11:51 – Cash pricing vs. traditional insurance models 13:00 – Why understanding the system matters Michael's LinkedIn [https://www.linkedin.com/in/michael-navin-7411388/] Randy's LinkedIn [https://www.linkedin.com/in/randyvogenberg/] Sponsored by: Peek [https://peekmeds.com/]: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/ [https://peekmeds.com/]. Institute for Integrated Health [https://iih-online.com/] (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/ [https://iih-online.com/].

Ep 40 | Engaging the Healthcare Consumer: Transparency, Trust, and the Skills We Are Missing

In this episode of the Only Healthcare Podcast, Michael Navin and Randy Vogenberg welcome Lynn Hanessian [https://www.linkedin.com/in/lynnhanessian/], 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 healthcare engagement has become a missing skill • The shift of cost and decision-making to patients • How employers have become the most trusted healthcare messenger • Transparency gaps in pricing and plan design • Changing information behaviors and the rise of generative search • AI, technology, and their limits in improving care today • Consumer confusion around access, urgency, and cost • Public trust, misinformation, and the burden on providers • What engagement must look like for the future of care Episode Chapters with Time-Stamps 00:05 – Welcome and introduction 01:05 – Lynn Hannessian’s background and focus on engagement 03:32 – Defining engagement and identifying critical audiences 05:06 – Employers, patients, and the information gap 06:12 – Shifts in how people seek healthcare information 09:22 – Care management, stakeholders, and alignment challenges 12:13 – Transparency tools and pricing visibility 15:06 – Empowering consumers to question costs 16:07 – Building healthcare literacy and decision skills 18:02 – Trust, misinformation, and public health messaging 21:10 – AI, post-COVID acceleration, and system strain 24:58 – Access challenges in rural and underserved areas 26:37 – Expectations of consumers and providers 29:41 – Policy, JPMorgan conference insights, and what is coming 34:25 – Specialty care growth and employer readiness 36:11 – Multi-generational care complexity 37:51 – Closing thoughts and where engagement goes next Michael's LinkedIn [https://www.linkedin.com/in/michael-navin-7411388/] Randy's LinkedIn [https://www.linkedin.com/in/randyvogenberg/] Sponsored by: Peek [https://peekmeds.com/]: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/ [https://peekmeds.com/]. Institute for Integrated Health [https://iih-online.com/] (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/ [https://iih-online.com/].

Ep 39 | The Great American Healthcare Heist: Transparency, Power, and What Must Change

In this episode of the Only Healthcare Podcast, Michael Navin and Randy Vogenberg welcome healthcare attorney, policy advocate, and author Chris Deacon [https://www.linkedin.com/in/cdeaconc/] 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 incentives is critical and where real opportunities for reform may still exist. Key Topics Discussed • How healthcare incentives became misaligned across the system • Why transparency is essential to restoring affordability • The evolving role and impact of pharmacy benefit managers • FDA approval, drug marketing, and assumptions about efficacy • Vertical integration and the corporatization of medicine • Public sector healthcare insolvency and budget crowd-out • How AI is being used to optimize billing rather than reduce costs • Practical levers employers can use to regain control Episode Chapters with Time-Stamps 00:04 – Welcome and introduction to Chris Deacon 01:01 – Chris’s background in public service and healthcare oversight 03:12 – Why state healthcare plans mirror the commercial market 04:16 – The motivation behind The Great American Healthcare Heist 07:28 – Training gaps and healthcare literacy challenges 09:07 – Pharmacy benefits, PBMs, and middlemen dynamics 12:21 – FDA approval, drug marketing, and flawed assumptions 14:49 – Healthcare spending surpasses $5 trillion 16:04 – Public sector insolvency and budget crowd-out 18:54 – AI, revenue optimization, and unintended consequences 20:17 – Hospital consolidation and vertical integration 23:20 – Transparency, direct contracting, and paths forward 26:22 – Practical levers employers can pull today 29:19 – Early signs of market change 31:27 – Closing reflections and call to action Michael's LinkedIn [https://www.linkedin.com/in/michael-navin-7411388/] Randy's LinkedIn [https://www.linkedin.com/in/randyvogenberg/] Sponsored by: Peek [https://peekmeds.com/]: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/ [https://peekmeds.com/]. Institute for Integrated Health [https://iih-online.com/] (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/ [https://iih-online.com/].

Ep 38 | Rethinking Risk: How Employers Prepare for Cell and Gene Therapy

In this episode of the Only Healthcare Podcast, hosts Michael Navin and Randy Vogenberg are joined by Luke Prettol [https://www.linkedin.com/in/lukeprettol/], 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 value, and the growing complexity tied to treatment risk, provider selection, and fair pricing. The episode explores why rare disease therapies will no longer be one-off events, how proactive patient identification and centers of excellence can reduce risk, and why employers must plan several years ahead instead of reacting year to year. Key Topics Discussed • How employers define success beyond lowest cost • Why cell and gene therapies create new risk challenges • Treatment risk, provider risk, and financial risk explained • Why rare diseases are becoming more common at scale • Planning for 3–7 year benefit strategy horizons • Proactive patient identification and care navigation • Centers of excellence and site-of-care decisions • Managing pricing certainty and outcome accountability • Budget volatility, stop-loss pressure, and financial risk • Structural challenges including ERISA erosion and data gaps Episode Chapters & Timestamps 00:04 Welcome and episode overview 01:36 Luke Prettol background and role at AT&T 02:21 How employers define winning in benefits strategy 03:30 Claim size versus outcomes and long-term value 06:45 The three core risks employers must manage 08:30 Why cell and gene therapies change the risk equation 10:34 Rare disease growth and planning for 2030 13:19 Lessons from specialty drug adoption 15:24 Proactive patient identification and early intervention 19:50 Centers of excellence and treatment accuracy 22:03 Predictability, data, and risk reduction 23:26 ROI, retention, and member experience 26:22 The employer “triple pain” framework 32:35 Defining success and planning beyond today 36:06 Closing remarks Michael's LinkedIn [https://www.linkedin.com/in/michael-navin-7411388/] Randy's LinkedIn [https://www.linkedin.com/in/randyvogenberg/] Sponsored by: Peek [https://peekmeds.com/]: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/ [https://peekmeds.com/]. Institute for Integrated Health [https://iih-online.com/] (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/ [https://iih-online.com/].