Relentless Health Value

EP509: The 7.7% Wake-Up Call: A Roadmap to Align Finance Teams With Non-complacent Benefit Design, With Patrick Nelli

April 30, 2026·37 min
Episode Description from the Publisher

In Episode 509 of Relentless Health Value, Stacey Richter interviews former CFO and Aligned Marketplace CEO Patrick Nelli about why executives don't take bolder action on health benefits and offers a seven-step roadmap to align finance teams with non-complacent benefit design.  Key steps include ongoing CFO-benefits engagement, forecasting medical trend accurately at 7.7%+ (two to three points above CPI) as the status-quo baseline, and presenting win-win alternatives to bend the cost curve. Nelli explains employer medical inflation drivers including Baumol's Cost Disease and cost shifting from Medicare to commercial, and argues proven strategies like independent advanced primary care can reduce unit prices, downstream utilization, and future high-cost claimants.  Additional steps cover aligning incentives with safeguards, optimizing contracting (including direct contracting), and steering/tiering via risk stratification to focus engagement on high and rising-risk members. Nelli describes Aligned Marketplace's national value-based advanced primary care and specialty marketplace. === LINKS === 🔗  Show Notes with all mentioned links:   https://cc-lnk.com/EP509 ✉️  Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙  Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤  Listen on Apple Podcasts  https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤  Listen on Spotify  https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺  Subscribe to our YouTube channel   https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn   https://www.linkedin.com/company/relentless-health-value/ ✭ Threads  https://www.threads.net/@relentlesshealthvalue/ ✭ Bluesky   https://bsky.app/profile/relentleshealth.bsky.social ✭ X   https://twitter.com/relentleshealth/ 00:00 Introduction to this episode. 02:48 Roadmap Step 1 highlights. 03:07 Roadmap Step 2 highlights. 03:49 Roadmap Step 3 highlights. 04:15 Roadmap Step 4 highlights. 04:27 Roadmap Step 5 highlights. 04:58 Roadmap Step 6 highlights. 05:19 EP504 with Ryan Jacobs. 05:37 Roadmap Step 7 highlights. 06:28 Introduction to the conversation with Patrick Nelli. 06:36 Step 1 to Patrick's roadmap: Open the conversation. 07:57 What Patrick thinks is sometimes missing in health benefits. 09:07 What finance teams need in order to change their behaviors. 09:53 What Baumol's cost disease is. 10:58 EP341 with Gary Campbell. 11:14 EP492 with Sam Flanders, MD, and Shane Cerone. 12:18 The second item stacked against employers: Being price "takers." 13:49 The percent inflation employers should expect if they follow the status quo. 15:39 INBW46 with Stacey. 16:54 Proven strategies to bend the health benefits finance curve. 18:42 <a href= "https://relentlesshe

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