The "Wild West" of Peptides | with Rick Manuel

Half of what this pharmacy compounds is GLP-1s. The other half is a category most benefits professionals have never had to think about, and probably will within a few years. I got a tour of Optimal Balance Pharmacy's facility and sat down with co-owner Rick Manuel to talk through what peptides actually are, how the FDA's category two list works, and what happens if those compounds move to category one. We get into why BPC-157 has a better safety profile than ibuprofen and the mechanism behind

Everyone in this market is optimizing for the wrong thing. Consumers want the most weight loss for the cheapest price, and up to 40% of what they're losing is muscle. My guests this week are Nicholas Syhler, a former cardiologist who left his residency to work upstream of the heart attacks he was treating, and Paul Elsass, an exercise physiologist who spent years in startup land before landing on the one root cause nobody had solved. Their company, Embla, runs a coach-first GLP-1 program out o

Katy Talento ran healthcare at the White House Domestic Policy Council and helped push through the price transparency executive order. Now she runs health plans for a living, including for the convent where she once lived as a nun. She spends this episode on why a post-network world keeps hitting the same wall: the three-way contracts between carrier, TPA, and provider that make the network Plan A by force. She explains why she thinks those provisions violate the Sherman Act, what DOJ has start

My guest this week is Billy Potter, now CEO of Snellings Walters, and we spend this episode on "the Switch," his firm's process for moving employers from fully insured to self-funded. Billy explains why he thinks it has almost nothing to do with insurance and everything to do with changing who a business trusts to lead them. We get into why "does that make sense?" is the worst question in sales, why he asks prospects "where did I lose you?" instead, and why he believes most deals aren't lost on

"Generic drugs are not the costly drugs. A 100% increase on a relatively inexpensive generic may not even be noticeable." In this episode of Last Month in Healthcare, Producer Nathaniel and I sat down with Sean McGowan of Centivo to break down the biggest healthcare news stories of July 2026. We started with the proposed tariffs on generic drugs - 100% in 2028, 200% in 2029 - and what that actually means when India supplies roughly half of U.S. generic volume and China supplies most of the act

"If you're expecting to pay $50k, but it hits an outlier clause, you could be paying upwards of three, four, five, six hundred thousand dollars." What if the single biggest driver of your high-cost claims isn't your discount, your network, or your utilization, but a contract provision almost nobody in this industry has ever read? My guest this week is Ryan Bojrab, who leads new solution development at Aon and came into this business through a channel almost nobody uses: he started his career a