- 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. None. Not one.” Mark Cuban's verdict will ring true for any urologist who has fought a denied or delayed claim, and his alternative is a contract that starts by trusting the doctor. On this episode of BackTable Urology, Dr. Ruchika Talwar, urologic oncologist and 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. 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.
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The conversation then turns practical for physicians. Mark Cuban lays out how hospitals, clinics, and independent practices can find the self-insured employers among their own patients and offer 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.