"The most unused cash in the country right now is the money you're wasting on healthcare... If you save a million dollars a year, that's $20 million in market cap."

Is your company treating its healthcare spend like a business strategy, or are you just writing a blank check to the major insurance carriers every year?

In this episode, I was (finally) joined by Mark Cuban, Ann Lewandowski, and Matt Miron.

After answering how he would approach healthcare for a hypothetical company on Shark Tank, Mark broke down his exact playbook for mid-market employers: why you should fire traditional networks, the massive ROI of hiring an internal "Healthcare CFO" to negotiate single-case agreements, and why "carve-out" is the most important phrase for your benefit strategy this year.

Together, we also discussed the dark side of healthcare economics, including the exorbitant spread pricing of PBMs and distributors, how to use AI (like Claude or ChatGPT) to find the hidden "gotchas" in your ASO contracts, and the terrifying legal liabilities CEOs face when their carriers deny life-saving treatments.

This one has been in the works for years, and I hope it doesn’t disappoint. Tune in!

Thank you to our 2026 sponsors!

ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more.

Samaritan Fund: A program that connects those who need help to the support they need. We are proud to offer the Samaritan Fund Program. Visit SamaritanFundProgram.com to learn more.

Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more.

Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com.

Chapters:

(00:00:00) Introductions: Mark Cuban, Ann Lewandowski, and Matt Miron

(00:01:08) Mark Cuban's Healthcare Playbook for Shark Tank Companies

(00:05:54) Single Case Agreements and Hiring an Internal Healthcare CFO

(00:10:08) Why the Keyword for 2026 is "Carve Out"

(00:14:32) Fiduciary Duty and Waiving Employee Deductibles

(00:20:52) Starting with Out-of-Network Negotiations

(00:25:09) The No Surprises Act, IDR Arbitration, and Secret Payouts

(00:29:12) Why Mark Started Cost Plus Drugs (and Cost Plus Wellness)

(00:32:10) How Distributors and PBMs Inflate Drug Prices

(00:36:49) Using AI (Claude/ChatGPT) to Audit Your Carrier Contracts

(00:37:52) The 340B Scam and Fiduciary Lawsuits

(00:44:27) Increasing Enterprise Value: Why Healthcare Savings = Market Cap

(00:47:46) CEO Liability for Life-Threatening Claim Denials

(00:50:37) The Perverse Economics of Prior Authorizations and Appeals

(00:52:59) Final Takeaways: Watch Your Money and Carve Out

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