What Most Reps Don’t Know (But Every Hospital Buyer Does)
What if the person you're selling to has no real power to say yes?
In this high-impact episode, Lisa and Cindy dive deep with Jeffrey DelVerne to uncover the truth behind how healthcare systems really make purchasing decisions and why many reps are pitching the wrong people.
Jeffrey breaks down the vertical integration of massive healthcare players like UnitedHealth and Optum, revealing how they’ve quietly become the largest employers of physicians in the U.S. With payer influence growing, reps need more than product knowledge—they need business acumen.
This episode is a crash course in selling smarter, not harder. Whether you’re trying to break into hospital systems, navigate insurance challenges, or understand the healthcare ecosystem, this is the blueprint for winning in 2025 and beyond.
Episode Chapter Markers
00:00 Introduction
01:07 Jeffrey DelVerne's Background in Healthcare Economics
03:10 Understanding Healthcare Economics and Market Access
04:48 Strategies for Medical Device Sales Reps
05:21 Navigating Hospital and Insurance Dynamics
08:21 Challenges with DRG and CPT Codes
12:41 Impact of Vertical Integration in Healthcare
18:25 Current Affairs in Healthcare and Insurance
Must-Hear Insights and Key Moments
The Rise of Vertical Integration – Learn how health insurance giants now control physician groups, pharmacies, and care delivery—and what that means for sales reps.
Why Sales Structures Are Outdated – Most sales orgs are built for a world that no longer exists. Jeffrey explains how collaboration is the new superpower.
How to Navigate the Optum Maze – Understand how Optum’s acquisition of practices affects local sales decisions, and how to connect the dots with your internal payer teams.
The 85/15 Rule Explained – Jeffrey breaks down the Medical Loss Ratio and how insurers profit by funneling expenses through assets they own.
Real Talk: Patients vs. Payers – Lisa opens up about the emotional toll of seeing families fight for care, while Jeffrey brings clarity on how denials get resolved.
Empowered Through Education – Cindy emphasizes the competitive edge that comes from curiosity and continuous learning in sales.
Monthly Roundtables: A Game Changer – Discover how a simple 30-minute cross-functional check-in can unlock access and accelerate deal flow.
Legacy & Leadership – The conversation ends with a powerful reminder about impact, legacy, and helping others rise.
Words of Wisdom: Standout Quotes from This Episode
First thing to think about is, you know, is it a high risk or low risk.” - Jeffrey DelVerne
“If they own the doctors, the pharmacies, and the care centers… who do you think your real customer is?” - Jeffrey DelVerne
There’s something grounding about knowing what’s really happening behind the scenes.” - Cynthia Ficara
“Everyone wants healthcare to be better. You’re here because you care—so know the system.” - Jeffrey DelVerne
“Keep your ears to the ground—your next lead might be in the grocery store line.” - Anneliese Rhodes
“We built sales teams for a healthcare system that doesn’t exist anymore.” - Jeffrey DelVerne
“It’s not about being smarter than anyone—it’s about being more curious.” - Jeffrey DelVerne
About Jeffrey
Jeff DelVerne began his healthcare career on the commercial side of the medical device industry before transitioning into market access, where he became increasingly focused on the underlying unit economics of U.S. healthcare. That curiosity led him to closely study the “Big Six” payers Cigna, Humana, CVS Health, Elevance, UnitedHealthcare, and Centene who collectively influence nearly $1.4 trillion of the over $5 trillion spent annually on healthcare in the U.S. Jeff’s core thesis is that payers control 90 cents of every dollar in healthcare. As a result, he believes that building products and services that solve payer problems isn’t just good strategy, it’s essential. He now helps health technology companies navigate this landscape by aligning product design and reimbursement strategy with payer priorities.
Currently, Jeff serves as Director of Payer Relations at Beta Bionics, where he’s helping transform how diabetes technology is accessed and reimbursed. He has led the shift of the iLet® bionic pancreas from a durable medical equipment (DME) model to a pharmacy benefit model, improving affordability and access for patients while aligning more closely with how modern payers operate.
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Blog Transcript:
Note: We use AI transcription so there may be some inaccuracies
Anneliese Rhodes: Welcome everyone to another episode of Secrets in Medical Device Sales, brought to you by the Girls of Grit Today. We have a awesome Spotlight series guest for you guys. I am super stoked, Cindy because I know nothing about this and I feel like most people don't know anything about it, so I cannot wait to have him tell us everything about healthcare economics.
Cynthia Ficara: Oh my gosh. It is so out of our comfort zone, and that's what makes this so exciting and we really hope that listening today, you're going to feel that you walk away with a couple more tips and an inside view of what goes on behind the scenes that as medical device sales reps, any role you are in medical device.
This is not something we think about on a daily basis, so, right. Yeah, absolutely.
Anneliese Rhodes: So welcome Jeffrey DelVerne. We are so happy you are here and we. Want you to give everybody a little bit of your background, tell 'em kind of a little bit about what, who you are, what you've been doing, and you guys today, Jeffrey is gonna drop some serious knowledge bombs for y'all to be able to walk into any hospital and feel more comfortable and more confident about what you know about what goes on inside the hospital and in terms of economics and rebate reimbursements, rebates, CPT codes, DRG codes, everything you can think of.
Jeffrey: that was a heck of a introduction. Now I feel like there's quite a bit of pressure for me to, , perform. No, I appreciate, you guys having me on. My background, ironically, is in medical device sales. I did that until 2019, and then someone was like. Hey, just the way that you think and I group accounts, you should get into market access.
And at that point I said, what is it? And he said, it's a big boy job. And I said, I'll take it. And so I got into calling on health plans in, early 2019. I had some success and then kind of worked into like national plans. I ended up with Centene, which is the largest managed Medicaid health plan in the country, and then Aetna, who I'm sure everybody has heard of.
And then, company called Anthem, which I'm sure everybody's heard of as well. And so kind of working through that, I decided no one had ever sold cent to our company, and so I said. I'm gonna start buying their shares, attending their shareholder meetings, reading their financial reports to figure out what makes them tick.
And so at that point, what I realized is they're trying to roll up as many managed Medicaids to get better pricing so that they could make more money. And so at that point, I went to them and said, you have 11 contracts with us. I will consolidate that into one if you give me all 35 of your states, and I'll give you a better deal than you have on the 11.
And was able to close that transaction probably within six months of having them as my customer. And so what that taught me was I needed to know more about the largest health insurers in our country. And so I started to. Study what I call the big six payers. my goal is to report that out. I have a substack, if you follow me on LinkedIn, you can, join that for free.
Basically it just talks about those big six payers. What are their pain points? How do you solve their problems? And as I've told you, before, when we've met, the biggest thing is they control 90 cents of every dollar in healthcare and. The more you can understand their pain points, the more you can think about your customers, your hospitals, and how they're being impacted it, the more you're able to sell and be successful.
And so, for me, I always tell everybody is as many meetings as you can generate, are good. All face time within your customers is good. And I think if you have a little bit different way that you're thinking about attacking some of your health systems. Whether it be a good question or a good inquiry or something you read about them, to be able to get more FaceTime deeper and really move, as I said to you kind of from the waiting room where you're just throwing random messages about your product into their boardroom and have a discussion about how they do things and why they do things, you really will be able to build a moat between you and your competition.
Here’s What Reps Must Know About DRGs, Payers & Readmissions
Cynthia Ficara: I love that. I love that. I mean, I mean, it's awesome that says it right there to go from the, get outta the waiting room, get into the board room and the amount of knowledge that you have, you know, everything that you said, knowledge is power and I love that. You know, through our platform here is this podcast.
we try to give a lot of knowledge where it's needed. I feel that when you just talked about like having your big six payers and understanding. Almost to them. Like we do a medical device. we talk about our customers being doctors and their pain points and solving their problems, but what if you even knew more behind the scenes?
That's their problem too, because a doctor's problem may be held up by one of these payers. So I think, I think that's a really good kind of place to start. Yeah. So could you begin to tell us, as. Medical device personnel. We all have different roles out here in the field. What is something that we can think about to learn?
Like if we are going to bring a device into the hospital, can you start with what we need to know about that device, what avenue we need to take and, just start from there. As a medical device rep bringing a device into the hospital.
Jeffrey: I think the first thing to think about is, you know, is it a high risk or low risk?
Is it a more of an inpatient setting versus an outpatient setting? And then what is the dollar amount, right? So as the dollar gets probably above $10,000, it's gonna fall more under a DRG or a lump bundle payment. you gotta also think about those as. Hospitals are gonna think and more scrutinize those expenses related to the larger line items.
And so those larger inpatient line items, procedures that are bundled under A DRG are gonna get the most scrutiny. So what does that mean? As a rep, you'll probably get. More meetings because they wanna find meaningful ways to reduce those costs. Again, think about it, hospitals, 56% of 'em in the US are nonprofit, right?
And they are Return on invested capital is not good. It's about 6%. Think about insurance. About 12%. So double at all of the stakeholders, whether it be a pharma, manufacturer, pharmacy, they have the worst return on investible, on invested capital. So the margins in that business are very tight. You wanna start to understand, is this an inpatient or an outpatient?
How much is it? Is it paid for by a DRG? CPT code and then start to figure out where you fit within that ecosystem. That will tell you who you need to meet with and in which setting is it, in the hospital or in maybe an outpatient surgery center.
Anneliese Rhodes: I love it. So I, I have, oh, I had a, hang on, I gotta, I'm sorry, Cindy, but I'm sitting here and I'm thinking, okay, well I know my device costs.
More than $10,000, right? So when I'm going to go to the VAT committee, which is the hos, the board that approves your products to get into the hospital, B to be used, they ask you for all of that, right? DRG codes, CPT codes, all of that kind of stuff. But they also ask you, questions like, why your device over the competitors?
Are you going to be replacing a competitor? Or what about your device stands out? And a number of times you always find yourself, at least I do. Better patient outcomes, you know, reduced or times. you're providing some data to the hospital, to the board. Is that something that payers care about? I mean, is that something that they're looking at saying?
Well, we're gonna give this great DRG code because, you know, like minimally invasive versus open, even though open's a gold standard, minimally invasive, gets the patient outta the hospital quicker, they recover quicker, all of these things. Is that something that the payer, those six big guys or gals, do they care about that?
Jeffrey: They are typically like capping the DRG payment to that hospital? So they're saying. No matter what, we're gonna bundle that and you're only getting $40,000. So if you do it for 42,000 and you lose 2000, that's on you. And if you are able to do it for 30, that's a 10 win for you. And so that's really where the hospital making decisions around what type of hardware and what.
Devices they're gonna use becomes really, really important. I think where you start to really have impacts is on those DRG bundles. Is the payer gonna get them whole if there is a readmission, or are they eating that right? So that really starts to get at the core of it where you say, all right, well we did it for 30, we used some cheap goods.
We we're at a 10 net win. But then we have. A follow up er visit, that costs 12. So now we're in the hole too. Interesting. Right? We have to eat. So you have to really think about what is important. Well, how do their agreements structured? Is it a DRG bundled code that's capped? Does it include some of these follow up expenses or is it, are you able to bill insurance additionally for those ER visits?
typically they're probably not gonna allow you to do that. Right.
Cynthia Ficara: and that's the tricky part too, the readmission rate. And sometimes in medical device, there's, different things that you sell where your company may, or maybe it's just research based from physicians, they have done studies where they look at.
Readmission rates in hospitals. So would you say this is something that, let's say you work for a company, you can look into your clinical research articles you are able to present knowing, our device claims to do X, Y, Z and take it further. We're also looking at readmission rates.
Blah, blah, blah. Because then if they're armed with their number, then this is maybe something they can bring forward when it's like Lisa's talking about bringing it to a VAC committee to be able to say, okay, if it falls under this specific DRG, this is the clinical, I guess research that proves it does what it says it does, we wanna prevent any further expending by readmission rates and et cetera.
Jeffrey: you're absolutely right. I don't think they're gonna let you, if you're a hospital, right? Like keep out on the goods, cause a readmission and then they end up paying for, the DRG that they thought was kind of a, bundle. And then because you use cheap goods, you get to, as the insurance company, pay for the readmission.
Right. So they're typically not gonna, yeah. Allow that to happen. They're looking at it and saying, alright, we're willing to pay for this. Here's what we're willing to pay. if the hospital messes up, I'm sure it's like a 30 day readmission. Mm-hmm. that's on you. Yep. And so I think we you're of the hospital or health system, that's what you're weighing, right?
You're saying Maybe we could go a little bit cheaper on this. Good. And it's not gonna cause higher hospitalizations on the backend, or is it? Something where we maybe need to use a little bit better brand. That is proven to your point, that is gonna eliminate some downside risk for us as a hospital down the road.
Yeah.
Unlocking Hidden Gatekeepers in Hospital Sales
Cynthia Ficara: you don't mind me, rewinding just a little bit, you mentioned earlier on about is your device inpatient or outpatient, then looking at whether it's D-R-G-C-P-T, whatever, and then you said, you know, take it a step further and you know who to go to from there. So my question to you is, are there different call points or people within the hospital, would one be admission?
Would one be, I don't know. Insurance side, like when you said that, where you go, what would entail the difference and who would that be?
Jeffrey: Yeah, so if you think about like what's happening in healthcare more generally, like a lot of private equity is buying up the outpatient surgery centers. so, okay.
Mm-hmm. In those instances, right, you're gonna want to go to the CFO or anyone, maybe like in a controller. Within that private equity or whoever is running that asset, right? So if it's say, tenant health system, that's a hospital that owns a bunch of surgery centers, you're gonna wanna go to the CFO or controller finance folks within tenant, because not only do they own the hospital, but they own some of the outpatient.
Assets. So you always wanna know, is it more vertically integrated? Is it standalone, private equity owned or physician owned? And then that should determine like your call point. I think if you ask some of your surgeons and say, they're gonna know, right? Because they're gonna have a, had this conversation and say, right, you know, I've been wanting to use this, but they want me to use that.
And I think that's a great segue to say, We've been making some innovation on this and we think, if we're able to bring some of our HEOR healthcare economics team and talk to some of your finance folks, you may find that there's some financial upside for you and. Given the size and expense of this surgery, it might be worth 20 minutes of your time to just, sit down, grab coffee or, grab a lunch and talk through it, because there could be huge revenue savings for you on the back end.
Whatever that conversation looks like is up to you. I think it's more, I always think of everything in hooks And that's why I stalk, for all the big six payers is like, what are they doing? So if you're a rep, you a big tenant and your tenant owns a bunch of systems, you know, I would, put together a mail brew@mailbrew.com that has tenant, and then say, Optum Health also owns a bunch of assets in your a them to your mail brew.
And then every morning at 6:00 AM you're gonna get all their news feeds of. Tenant and Optum Health, right? So I love that you're gonna be able to read and say, all right, here's what they're dealing with. Here's their pain points, here's how I can attack them to generate meetings, to maybe dig a little deeper, maybe generate a meeting.
You know, I always think about those hooks and you say, and this is gonna be a terrible way to say it, but it, probably a good way as salespeople is, you need to create an audience? Then you need to find the right person that can tell that person they're stupid, you know? And it's like, it's usually not you.
You know, unfortunately, they're usually, you're not the right person. You isn't the person that wants to tell that person they're stupid. But usually you're not. But your job is to, get a meeting with that person that figure out, right, who is someone. That they're gonna respect and they're gonna take advice or guidance or clinical data or HEOR data and that's who you bring to the meeting.
we always wanted as salespeople like, I'm gonna go in there and I'm gonna, you know, and the problem is that's usually not the right person to call him stupid. And I know that's a terrible, but that's like in sales, how I think is book. This is so great. And I'm a rambler with sales. I'm very passionate about it.
So that's kind of like why I got to reading all their clippings. If I was you, I would think very similarly in your territory.
Anneliese Rhodes: I. I love this. This is such good stuff. Like you are seriously dropping some great stuff. I mean, just the mail brew and the ideas of looking up. I mean, I'm already thinking, I'm like, gosh, I really need to learn a little bit more about this hospital system and that hospital system because I do have these, we have 'em in Florida and it's really important because I've been trying to get into the.
VAC committee with a specific hospital, but it's a larger system. Right. It would behoove me to now learn a little bit about the system and learn about how they're operating, what their costs are. Are they private? Are they public? Like, all the things that are important. And as you were talking, I was thinking back Cindy, I can't remember if we talked about this on an episode or not, but I think I told you, I was talking with one of my physicians, this goes back now, about six months, and that physician had said to me.
We are no longer taking United Healthcare patients. Yeah. And I was like, what? And I'm thinking, why? Why not? this is the reason why, we're finding out that they're not paying for these procedures as much. they aren't paying for 'em unless they're pre-qualified,
So we are basically gonna have to drop them because all of our patients aren't getting ready. And I'm thinking, I don't know anything about this, and this is a problem because this is gonna affect my bottom line because what we do together is not gonna happen anymore if I can't figure out how to get to the bottom of this.
So you just saying, Jeffrey, that we need to be more involved, more knowledgeable on these. Current affairs, the situations that are happening. Doing this background check on all of these big payers and hospital systems is so important. since then I have done some research and I now know a little bit about more about UnitedHealthcare and they've been in the news.
And we can talk about that a little bit, butI love this. This is such a great conversation, Cindy. I really hope that everybody listening is like turning up the volume.
Cynthia Ficara: Yeah, exactly. and while you are talking about the United Healthcare issue, there's probably some people out there that maybe like you were a couple months ago with like, wait, wait, what's going on?
Navigating Healthcare’s Financial Turbulence
So Jeff, can you just give us a little bit of an insight of what she's talking about, broad view and anything that as reps going into the hospital, we should know?
Jeffrey: Mm-hmm. Yeah, I think more generally you're gonna read more and more of these disputes, right? United obviously is financially. They pulled their guidance for the year.
Their CEO has recently stepped away. They're facing, some big time financial windfalls, we'll say, within their Medicare Advantage business. a lot of the reimbursement from the government on Medicare kind of shrunk over the last two years, Humana, and that now have lost some. Or left some unprofitable markets.
I think United was like, oh, good, we'll grab 'em. Well, a lot of those patients had not seen their PCP. They had a lot of deferred maintenance as patients. And then I think, yep. UHC walked right into that and, has kind of in a really bad spot. Additionally, I mean, obviously their U-H-C-C-E-O was, executed.
That's not been a, fun thing to follow and just the general theme and trend about United denying claims has become a very. We'll call it popular rallying cry amongst people on, X post social media, LinkedIn, and whatever. I think you said in, you know, earlier that it's all the stuff we're reading about them denying claims.
And so when times like this get tough for them financially, I think you're gonna see some scrutiny on them trying to pull in some of the spending. a lot of those Medicare. Expenditures. So 65 and older are, risk agreements, right? Where they're taking a flat stu from the government and they're gonna try to make sure that they don't lose too much money on it.
So I'm sure you'll see some denied claims more generally. Just touch on it quickly, you're gonna see more and more skirmishes between your hospitals and your payers because the cost of nurses, the cost of energy, the cost of. PPE for the hospitals has gone up. A lot of these contract negotiations are now new payers don't wanna pay more for this inflation we've seen since COVID, you've seen in the last 18 months.
I have seen more of these disputes between the hospital and United the hospital and Cigna, Aetna. Any hospital than I've ever seen. And it's because they're trying to find a happy medium of is this gonna be inflation that's sticky and stays forever or is this something that's short term? Obviously they're gonna say it's short term.
Your hospital's gonna say it's long term. They gotta find an agreement. Usually they're resolved within 30 days. So, if I was you and one of you walked in and your doctor was freaking out because. They weren't gonna be able to see Cigna patients, United patients Aetna patients. I would say calm down doc.
These usually resolve within 30 days. No one wants to lose one or the other. They both need each other. They're gonna find an agreement. Yeah, I covered a boatload there, but I did wanna touch on some of this stuff. just united more generally, and then some of these disputes we all are hearing about.
Anneliese Rhodes: I mean, it's nerve wracking, right?
it's unnerving. not just as a medical device sales rep, but as like. I have parents that are older. know patients that are undergoing certain things and they're having to fight tooth and nail. And then of course you read the stories on LinkedIn about this mother who's had to fight for her child who's struggling with this very rare cancer and they, she can't get anybody to.
reimburse her, cover her costs and she's thousands, hundreds of thousands of dollars in debt. And you're like, what are these insurance companies doing? And it really paints a very ugly picture and makes them out to be very, very bad. we all know there's always two sides to the story, but at the same time, you're like, when is this gonna stop?
when can we see a happy medium? And when do we feel comfortable enough? Or is this only gonna get worse? So it's good to know that they are getting resolved hopefully within 30 days for the most part. And you're right, everybody, one needs the other. we're not gonna be able to operate if Cigna and Aetna and United, all of a sudden just they all get together and they're like, screw it, we're not gonna pay for anybody.
I mean, That doesn't do anybody any good. So I appreciate you mentioning that because I think. We hear a lot about that and it's, again, it's important to be knowledgeable on all this. and you cover a lot of this in your newsletter too, right? In your substack you talk about all this kind of stuff and it's, you guys, this is a really great newsletter.
It's not expensive at all. It's like, isn't it like eight bucks a month or something like that?
Jeffrey: Yeah, I put it out there just to, it was more like free at first just because, I wanna just have sales reps or anyone calling on anywhere in the healthcare. Feel to have, be empowered by the information of like, here's some of the pain points that each of the stakeholders is dealing with.
Here's a way that maybe I could help them, or I could think of a way that could help it be better. Because I think everyone, you know, does have aging parents. Everyone does want it to get better. Everyone wants, the reason you're in this industry is, you could sell anything you wanted, but.
This is probably the one thing where you actually, if you do your job, you'll help a person not make an investment bank, more money or whatever it may be. You choose to sell this because it's usually near and dear to your heart.
The Power Players Behind the Curtain
Cynthia Ficara: I love that. And you know, and I really appreciate your curiosity because, you know, if you think about it, it's, your curiosity that led you to research.
I mean, it's kind of like you're doing this research for us and, it's so impactful and powerful in your sales process to have this knowledge to be able to, just have something to pull on more than just. Going in with your product knowledge. and I really hope that's what all of our listeners are getting from today.
so, you know, when we talk a little bit about current affairs, well so far, we've had the opportunity to talk about United Healthcare. We've had the opportunity to talk about bringing in your device to a hospital. Is it inpatient? Is it outpatient? Is it D-R-G-C-P-T codes to think about.
So, in the broad spectrum of things, what other current affair or what other, point of interest should we all kind of have top of mind or think about, that could help us sales reps.
Jeffrey: Probably the biggest thing happening right now in healthcare is just the, vertical integration and like how that's gonna impact people calling on clinics.
Because when you think about United, group owns United Healthcare and they own Optum, which owns, Optum Health. Well, Optum Health is the largest, Employer of physicians in the US they have over 65,000. Oh, wow. So, wow. Some of these centers that you might be calling on, if they're owned by Optum Health, that may impact, your ability to sell into them.
Right. So the decisions may not be local decisions. And I think, if you think about all of our sales infrastructure, it was built. Before that. Right? And so collaboration within your teams, within your payer, people, within your healthcare economics teams. I think if you could figure out a way to meet with them as your sales rep once a month, even if it's a 30 minute, round table, I think what you'll see is they'll be able to help you.
think more like them and then maybe get some good access points into your accounts. Because I think the way that we always think in sales is like, oh, we're the salespeople. They do this, they do that. Well, you have to understand that's a 20 to 30-year-old, infrastructure. The way these were all designed, and if you think about vertical integration, it was really.
Obamacare kind of drove that and when that was passed back in 2010 to where we are today, it is changed the landscape. You know, if US healthcare spending is $5.4 trillion this year, the big six payers that I write about, they're gonna end up with 1.4 to 1.5 trillion, almost 30% of that money.
Wow. Back up 10 years ago, they were getting 3% of that money. Right. So. They are owning PBMs, they're owning physicians, they're owning home health, they're owning specialty medications. And so you have to know, where you fit. You may be trying to sell a doctor locally that has no control over it.
Yeah. So that to me is the biggest theme. And the reason, Obamacare and the Affordable Care Act drove that, is the medical loss requirements, which is, Every dollar 80, 85 cents has to be spent on care. So United takes in the dollar. Can you, can you
Cynthia Ficara: repeat that? So we hear that and No understand that.
So will you repeat that please?
Jeffrey: Yeah. So every dollar in premiums that United Healthcare takes in for premiums they have to spend on the care of the patients. And so the way they look at it, yeah, they look at it and say. We can spend that 85 cents in assets we own and turn, oh, what's now an expense into a revenue stream.
So if you think about, Amazon, they have AWS, which is their web services. The reason they have that is they're spending so much on web services, so they turn that into a revenue source. So same thing here. You they were like, Hey, we should buy A PBM. We'll buy, I think it was, okay, so
Cynthia Ficara: tell everybody what A PBM is.
Jeffrey: Pharmacy bene. So Pharmacy Benefit Manager, which is, uh, you know, which
Cynthia Ficara: everybody knows.
Jeffrey: Yep.
Cynthia Ficara: I didn't know. I didn't know. I had to ask before, I didn't know either. I'm like, what is that? I'm like, wait, somebody else might not know that.
Jeffrey: Yeah, so they like, because they're gonna spend money to provide drugs for.
Medicare Advantage, they're gonna use that to, provide drugs for their commercial lines of business. again, they're gonna funnel that 85 cents towards assets they own. So they're gonna use OptumRx to be the pharmacy benefit manager, or they're gonna use Optum Health where they can, which is the doctors that they own.
Right? And they're gonna use, every. Asset. They own LHC, which is in home care, palliative care. the more that they can use that, it's basically funneling money to themselves. And that's important. Yeah. Because you might be knocking on the wrong door and you're like, I've never been able to get anywhere with this account.
And then someone says, well, we got bought by Optum two years ago. You may. Be able to connect with someone in your payer team that has a relationship with Optum who says, let me reach out to Ryan, who I work with at Optum and see if we can't get a meeting on the books to talk about why this will add value.
Sothink knowing some of that, the other thing, you know, I think is the tighter you get within your org the better. Whereas before you could app operate in a silo, I feel like now you need collaboration more than ever.
Anneliese Rhodes: This is awesome, dude. I don't want this to end like, oh my gosh.
Jeffrey: No, I appreciate, I appreciate you having me on.
I, I always think about like the organizations that I've worked for, right? Like we have sales and then like everybody else, and it, sometimes you, we don't get. Brought all together to help each other. because then I think there's the work backwards where you guys run into someone at a grocery store that's like, oh, I run all the finance for tenant health, and he lives in your neighborhood.
Right? And then you payer guy has been dying to meet with him and now you're the introduction. So I think it works both ways.
Anneliese Rhodes: Networking. Keep your ears to the ground. I love this. This is so awesome. We're gonna have to have you back on again, Jeffrey. I'm just saying we're just having you back on again.
I, I'm serious, but
Cynthia Ficara: if so, if
Anneliese Rhodes: anybody else
Legacy, Learning & LinkedIn
Cynthia Ficara: is feeling the way Lisa and I are and they just wanna get more right now. Jeff, can you tell us where everybody can find you and your newsletter?
Jeffrey: add me on LinkedIn. I usually like to put it all out there just to make sure it all started, I was at a company where my boss was kind of like.
Not as, diligent. And so he would be saying Medicare or Medicaid's gonna continue to grow. Well then I was reading, you know, my mail brew of like, it was like, Medicaid's gonna shrink 'cause they're gonna like start to kick people off of post COVID, Medicaid. So. Then I was like, I need to make sure my management team knows some of this stuff.
So I put it out on LinkedIn and then I would've 'em follow me on LinkedIn and then, go on Substack and look for the healthcare economy. I write about those big six payers. I write a lot about digital health. I sometimes get lost in some detailed finance stuff, but, for the most part it is healthcare focused.
And, I really love, you guys having me on, the coolest thing about meeting you is, you know, trying to like, help people. Like, I think, you know, the biggest thing that I think about is like, what's your legacy? What are people gonna say about you? And I think for you all, it's like, you're now making me a listener and then you're gonna influence me, right?
And. Beyond the grave, you'll have given me a pearl or two. Right. So I think, well, thank you. You know, what you're doing is really probably one of the neater things. When you guys were telling me about it, when we had had met just as amy mind was blown and so was my, partner Amy. We both were like, that is the coolest, quest.
And I think, you guys should keep it up and make sure, you keep following your dream because I think it's gonna be, it's gonna work out well for both of you.
Anneliese Rhodes: Well, thank you. We hope so. I mean, you know, it was born out of the fact that we had no support and we're like, we are going to help everybody else know they're not alone and they have all the support in the world here on the Secrets of Medical Device Sales podcast.
So thank you. Before you go though, you are so smart in your ways and you are very curious, which makes you an amazing leader. can you tell us, and I didn't even let you know that I was gonna ask you this, but can you tell us maybe one or two books that you are either currently reading or that you have read that has made such an impact in your life that you would love to share with our listeners?
Jeffrey: Yeah,my favorite by far. And it's usually number one on every, business book list is Zero to One by Peter Thiel. and so, I'm sure you guys have, probably, read it. And then obviously I like Ray Dalio Principles is a really good one that kind of changed my life. Read that. he was just like, one of the better,
Equity traders just has a really interesting philosophy about how he thinks about life. And, I guess I'll pose the questions to you. I usually try to read like 40 to 50 business books a year. So what
Cynthia Ficara: Awesome is
Jeffrey: your, give me both your top two and let grab a aan.
Cynthia Ficara: Yeah. So my, favorite was, or is from a long time ago, it's your ship and it's actually about leadership.
Have you read it?
Jeffrey: Yeah. My, yes. Yes. I actually wrote it. That's a great one. Four years ago.
Cynthia Ficara: Yeah. But I wanna read it. There's something real and grounding about that, it comes to mind a lot when certain situations happen. it's a great book for everybody to read. It's called, it's Your Ship.
Anneliese Rhodes: Yeah. you've told me about that, Cindy and I have absolutely read that. The one I'm reading right now is be the unicorn. Because I think that there are certain people in the world that have that IT quality. And I'm so curious on what that IT quality is and if I have it right, everybody wants to know if they have the IT quality.
So this book kind of outlines, how to be the unicorn and those IT quality. So I've enjoyed that. And then of course the Let Them Theory by Mel Robbins, that might be my favorite part of all time, just because I love her. But you know, it's, a lot of fun and I love that you read so much.
Cindy and I talk about that a lot. We share books back and forth. It's so important to be curious. It's so important to continue learning, stay knowledgeable, and this conversation today, Jeffrey has really incentivized me to do more research and to really make myself more knowledgeable when I have these conversations with the people.
At the top, not just the VAT committees, but the CEOs and the CFOs. And it's funny because as I've gotten older in my career, I find myself actually having conversations with these people that I never thought I would've had 10 years ago. So I just, I loved our conversation today. You thank you so
Cynthia Ficara: much.
Me too. Thank you, Jeffrey. This was, so awesome and I really hope our listeners enjoyed something different today. Yes. And we hope you took a lot of knowledge help. So we can't thank you enough.
Jeffrey: No thanks for having me on there. Probably like, that was really boring compared to my usual sales stuff, but, most people are payer stuff is really boring, so, that's funny.
Anneliese Rhodes: Awesome. It was awesome. It was great. Thank you so much. Thank you.
Thank you.
