- Artificial Intelligence (AI)
- Physician Leadership
- Value-Based Care
- Healthcare Administration
- Health Policy
- Oncology
- Cancer
- Practice Management
"No cancer patient ever got healthier because their claim was denied and delayed," Mark Cuban says, and his answer is a contract that starts by trusting the doctor. On this episode of the BackTable Podcast, Dr. Ruchika Talwar, value-based care leader, talks with Mark Cuban, entrepreneur and founder of Mark Cuban Cost Plus Drug Company, about who actually sets the price of care in the United States. They trace how a cold email about drug shortages led to Cost Plus Drugs and then Cost Plus Wellness, an open source library of direct contracts between self-insured employers and providers, and why he believes the contract, not the published price, is where the real problems hide. He also explains why independent practices should know their profitability by payer and call the self-insured employers among their patients. By his estimate, 67% of people with job-based coverage get it through a self-insured employer, which makes employers, not insurers, the real payers in American healthcare.
Timestamps
Resources
- Mark Cuban Cost Plus Drug Company
- KFF. 2025 Employer Health Benefits Survey https://www.kff.org/health-costs/2025-employer-health-benefits-survey/
- Gag Clause Prohibition Compliance Attestation. Centers for Medicare & Medicaid Services https://www.cms.gov/marketplace/about/oversight/other-insurance-protections/gag-clause-prohibition-compliance-attestation
- New generic drug company named after Mark Cuban first founded by a part-time radiologist. Health Imaging https://healthimaging.com/topics/healthcare-management/medical-practice-management/mark-cuban-generic-drug-company
More about this episode
The conversation then turns practical for physicians. Mark Cuban lays out how hospitals, clinics, and independent practices can offer self-insured employers direct contracts or carve-outs, why a promise to trust the doctor can earn employers a better rate, and how he runs contracts that stretch past a thousand pages through several AI models in turn. He and Dr. Talwar also cover what employers can learn from Form 5500 filings, the national changes he would make, from ending gag clauses to standardized public contracts, and why both see misaligned incentives as the root of the problem.