The only statewide PAC built by patients & independent medical providers to cut red tape, curb abusive insurance practices, & keep quality care close to home.
Springdale, AR
Joined November 2025
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Patients First PAC retweeted
For years, physicians were taught not to talk about money with patients.
The idea was that discussing cost would make medicine feel transactional and erode trust.
But here’s the problem: how can patients make informed decisions if they don’t know what their care will cost?
I’ll be honest...I didn’t truly understand the cost of healthcare until I opened my own surgery center and saw it firsthand. It changed the way I think about transparency, accountability, and the conversations we should be having with patients.
Talking about finances doesn’t undermine trust. It can build it.
Patients deserve to know what care costs. Physicians deserve to understand where healthcare dollars are going. And together, we deserve a system that’s more transparent and accountable.
That’s why I’m encouraged by efforts like the Patients Deserve Price Tags Act, which aims to bring more price transparency into healthcare.
I’m curious what you think.
Should doctors and patients be having more open conversations about the cost of care?
Patients First PAC retweeted
So once again my wonderful insurance company, and its PBM partner, @CVS is blocking a medicine I have been taking for over 5 years. Instead of just renewing it, pre authorization has held it up for over 3 weeks in the hope I will just pay for it out of pocket.
Patients First PAC retweeted
Do you know your plan's generic spread? Not the discount. The spread is the gap between what your PBM pays the pharmacy for a generic and what it bills you. Most plan sponsors have never been shown it, because it is rarely a line on the report.
Patients First PAC retweeted
Change IS possible.
Thank you @SenJeffMerkley for sharing your thoughts about why all elected leaders should take a hard look at Medicare “Advantage.”
#MedicareAdvantage #MedicareDisAdvantage
Patients First PAC retweeted
Insurance companies are suing to avoid giving patients access to care.
Three years ago, I testified in Texas to address a problem I was seeing every single day in my practice. Patients had insurance, but they still could not access the care they needed.
Health plans were being sold with networks that did not actually include enough doctors. More than 90% of plans were not even meeting basic network standards.
So we passed a law to fix it. The goal was simple. Real networks. Real access. Real accountability.
And when it came time to enforce it, insurance companies sued to stop it.
So when you are told you are not a candidate, that there are no options, or that you have to wait, it is not always about your care. It is often about whether your plan actually gives you access in the first place.
This is not a one-off experience. It is part of a much bigger pattern.
We already know what needs to change. The question is whether we are willing to actually enforce it.
Patients First PAC retweeted
Check your voter registration, find your polling place, and see who is on your ballot at voterview.ar-nova.org/VoterV….
Be informed when you vote and choose leaders who protect access to care and put Arkansas patients first.
#PatientsBeforeProfits #ArkansasHealthcare
Patients First PAC retweeted
This is your heads up about the new scams that PBMs and their related companies are pulling.
It is built on the following premise
"Whoever controls care decisions controls revenue."
The new "Rebate GPO" from PBMs is charging PEPM or PMPM fees to employers for "clinical services" .
Can someone explain to me any scenario where a Pharmacy Benefit Manager would be the best source of clinical management services like the following :
(PMPM)
Specialty Drug Management
$10 – $100
Coordination of specialty medications, utilization review, patient monitoring
Digital Health / Remote Care Programs
$20 – $40
Virtual care platforms, chronic disease apps, coaching programs
Care Navigation Services
$5 – $15
Member guidance, provider steering, benefits assistance
Medication Adherence Programs
$3 – $10
Outreach programs designed to improve prescription compliance
Clinical Analytics & Employer Reporting
$2 – $8
Data dashboards, utilization analysis, predictive modeling
Prior Authorization Administration
$1 – $5
Processing and management of prior authorization requests
Biosimilar Conversion Programs
$5 – $20
Drug switching initiatives and manufacturer coordination
Outcomes / Value-Based Contract Administration
$2 – $6
Tracking clinical outcomes tied to manufacturer agreements
I'll say it again. The new PBM scam is to control care decisions
WHOEVER CONTROLS CARE DECISIONS CONTROLS YOUR BENEFITS BUDGET. AND IT WONT BE YOU. IT WILL BE YOUR PBM
You have been warned.
@RepBuddyCarter @HawleyMO @SenWarren @RubenGallego @jamestalarico @SenSchumer @RFKJr_Official @modrnhealthcr @RosenthalHealth @chrisklomp @DrOz
Patients First PAC retweeted
This week we need to talk about something that’s quietly breaking American medicine and it has nothing to do with a scalpel.
I became an orthopedic surgeon to take care of patients; to fix broken bones, restore function, and give people their lives back. What I did not sign up for was spending a significant portion of my working hours on documentation, prior authorizations, insurance portals, and administrative tasks that have nothing to do with the patient in front of me.
I’m not alone.
The average physician now spends nearly 2 hours on administrative work for every 1 hour of direct patient care. Burnout rates among physicians have crossed 50%. Early retirement is accelerating. Medical school graduates are rethinking specialties based not on what they love, but on what comes with the least paperwork. Physicians are choosing employment over independent practice to avoid the headaches.
This is a systemic crisis with real consequences for patients who can’t get appointments, face longer wait times, or lose access to their physician entirely.
The system has spent years adding to physicians’ plates while calling it “efficiency.” It’s time to push back with data, with policy, and with our voices.
Follow along this week as I break down the issue and then provide solutions on Friday.
Reply with your biggest frustrations with administrative burdens in medicine
Patients First PAC retweeted
Pharmacists are literally filling prescriptions at a loss. Medicare Part D ‘DIR’ clawbacks alone have ballooned to nearly $13 BILLION/year taken after the sale. States are starting to claw it back: $60M+ repaid in WA and $5M+ in OK. Why is this business model legal?
🤖 Made with AI
Patients First PAC retweeted
The largest U.S. health insurance companies aren’t just insurers anymore.
They own hospitals, employ doctors, run clinics, operate pharmacies, and control pharmacy benefit managers (PBMs) that decide which drugs you can get and how much you pay.
In one revealing moment at a Senate hearing, executives were asked to raise their hands if their company:
- Owns/controls a health insurance division
- Employs providers or owns clinics/specialty pharmacies
- Owns/controls a PBM
- Has a legal duty to maximize shareholder value
Almost every major hand stayed up.
They diagnose, treat, dispense drugs, set prices, and decide coverage—all while legally obligated to prioritize profits over patients.
One entity now controls almost every step of your healthcare journey.
That’s not competition. That’s consolidation.
Patients First PAC retweeted
So much great information here.
Progress is being made!
Day 2 of our deep dive into the broken Prior Authorization (PA) system and how to fix it.
If we’re serious about reform, three non-negotiable principles have to come first. These aren’t “nice ideas.” They’re the baseline for restoring patient trust and allowing independent physicians to practice medicine instead of paperwork.
Transparency
PA criteria shouldn’t live behind paywalls, logins, or proprietary portals. Today, physicians waste hours hunting for rules that determine whether patients get care.
Real reform means public, searchable PA policies—no barriers. Patients deserve to know why care is denied, and physicians deserve clear rules before submitting requests. Without transparency, PA stays a black box that protects insurers—not patients. Sunshine is the best disinfectant
Evidence-Based Policies
Too many PA requirements are arbitrary, outdated, or most likely driven by cost, not science. Proven treatments get denied simply because a cheaper checkbox exists, ignoring allergies, comorbidities, or what the physician feels is best in this unique situation.
PA criteria must be:
•Based on current clinical evidence
•Developed by actively practicing physicians in the relevant specialty
•Updated when new evidence emerges
Medicine evolves. PA policies should too.
Real Peers for Review
“Peer-to-peer” is meaningless if the reviewer isn’t a peer. If I’m requesting a lumbar fusion, the reviewer should be a board-certified orthopedic spine surgeon actively in practice, not a non-specialist reading a script. When peers don’t match, denials increase, care is delayed, and burnout skyrockets. The data is clear: 93% of physicians report PA delays patient care and in many of these cases create or have the potential to create harm.
These three principles of transparency, evidence-based standards, and true peer review would turn PA from a profit tool into a legitimate utilization check.
Early feedback on WISeR shows that it is hitting the mark in many of these areas. This may create the benchmark of PA.
Let’s keep iterating and evolving to create a process that prevents overutilization while putting patient care and welfare first.
Patients First PAC retweeted
So few people realized how pro-monopoly Obamacare is.
It bans doctors from owning hospitals. Lawyers can own law firms. Chefs can own restaurants.
Doctors can’t own hospitals.
The result: large consolidated health systems that drive up the cost of care.
In March 2010,
Congress passed the Affordable Care Act.
Buried deep inside was Section 6001.
The provision banned new physician-owned hospitals from participating in Medicare.
It froze existing physician-owned facilities in place.
No new beds.
No new operating rooms.
No expansion.
The American Hospital Association lobbied hard for this provision.
Their argument: physician owners would self-refer patients to their own facilities, cherry-pick the healthiest cases, and leave traditional hospitals with the sickest and poorest patients.
Members of Congress were paid off.
The ban passed.
Physician-owned hospitals, which had grown from 67 facilities in the early 2000s to roughly 250 by 2010, suddenly stopped growing.
Patients First PAC retweeted
Whether you’re a community member, a patient, or a pharmacy professional or owner, staying informed matters.
Visit our PBM 101 page to better understand how PBMs impact patients and community pharmacies. Interested in getting more involved? Connect with us!
Patients First PAC retweeted
.@UnitedHealthGrp, @CVSHealth, @Cigna, and @ElevanceHealth, along with three other companies, raked in $543 billion in profits from 2014-2024.
Moreover, @CVSHealth spent $41 million solely on the compensation for two of the company's executives in 2024 ALONE. And yet, as @RepBuddyCarter points out, health care premiums continue to increase for families across America.
Patients First PAC retweeted
I asked health insurance CEOs to raise their hands if they’re penalized when patients are harmed by delays or wrongful denials.
Not. One. Hand.
Patients pay the price. Executives protect the profits. That’s the problem.
Patients First PAC retweeted
Health care monopolies on patient care screw over working families and destroy your ability to access affordable care.
All so corporate CEOs, like those from CVS Health, can pad their pockets.
We must break up big medicine. We need a Glass-Steagall for Health Care.
Patients First PAC retweeted
Great question. Easy to answer. No answer given
Healthcare CEOs would not talk to us, but they were hauled to Congress, where they were grilled under oath by both parties about our reporting on PBM GPOs, which hide billions meant to lower drug costs.
When asked by @RepHouchin about their profits, the CEOs failed to answer.
Patients First PAC retweeted
OptumRx President on why high-cost brands are preferred on its formularies over more affordable generic alternatives:
1/3
Patients First PAC retweeted
A renewed focus on pharmacy benefit managers, or PBMs, is also overdue.
forbes.com/sites/sallypipes/…
Patients First PAC retweeted
Proud to Serve our shared community and state with my friend and conservative champion Lt. Governor @LeslieRutledge #arpx