I’ve spent more than 30 years inside healthcare. Then I got to see it from the other side.
For most of my career, I saw healthcare as an executive and consultant. Then I got sick and experienced the system as a patient.
It changed the way I saw the work.
The complexity looked different. So did the costs. And the distance between how healthcare works on paper and how it feels to the person depending on it became impossible to ignore.
Because the decisions made in conference rooms eventually land on real people.
I’ve spent decades looking at healthcare through the eyes of executives, employers, consultants, physicians, and vendors. But experiencing the system as a patient changed the way I understood the consequences of those decisions.
What looks like a contract term, a pricing decision, or a benefit design choice can become a missed prescription, delayed care, financial strain, or a family trying to figure out what comes next.
That is why I keep coming back to the same questions: Where does the money go? What do the contracts really say? Who benefits from the incentives? And what can employers do differently?
My work is about helping leaders see those answers more clearly and use the leverage they already have to make better decisions for the people depending on them.
Four ways I’m trying to make healthcare easier to see, measure, and change.
Ditto & Associates
My independent platform for helping employers and fiduciaries think more clearly about healthcare strategy, incentives, governance, and accountability.
The Middleman’s Cut
The book and weekly newsletter for the people who sign the deals. The framework is durable. The conversation stays current.
Nautilus Health Institute
Working with employers, advisors, and industry leaders to improve PBM contracting, fiduciary practice, and healthcare accountability.
EXPLORE THE PBM WORK →
Contract X-Ray
Turning PBM contract language into something employers can see, compare, measure, and improve.
EXPLORE CONTRACT X-RAY →
Experience shaped the point of view.
The point of view shapes the work.
If you want to understand how I think about healthcare, start with the principles. If you want to see how those principles turn into action, see how I help.