Hannah Mamuszka and Lena Chaihorsky bring on Russell DuBose, VP of Human Resources at Phifer, a family-owned manufacturer in West Alabama, to tell an unforgettable story. In 2017 DuBose — a retired Army colonel with no healthcare background — took over benefits, and two months later stood in front of a CEO-chaired committee holding numbers he didn’t yet know were bad: over $12,000 per employee per year, fewer than 40% of members with a primary care physician, and prescription adherence he calls “in the cellar.” Asked what he intended to do about it, he applied the only method Phifer knew, the Lean Six Sigma strategy the company had used for twenty years. Dave Chase’s CEO’s Guide to Restoring the American Dream became the blueprint. His first conclusion was that his broker was his first problem — they worked for him, but he was not the customer — so he ran an RFP contingent on the winner signing a transparency agreement. What followed was a seven-year roadmap executed by a team of three: an on-site primary care clinic, direct contracts with prices that now haven’t risen in a decade, a nurse navigator who built a quality-ranked specialty network, a transparent pass-through PBM, an on-site pharmacy funded entirely by dispensing fees with no copay, physical therapy with no cost share and no visit limits. The costs: flat in absolute dollars across 2020–2024, down 4% in 2025, with compound annual growth under 1.4% over ten years. The care: over 90% with a primary care physician, over 95% pharmacy adherence, member out-of-pocket share down from 19% to under 7%. DuBose’s closing explanation is the thesis of the whole show — he didn’t spend new money, he removed waste, and he estimates the middle was taking 40 to 50 cents of every dollar.
October 8, 2026
Episode 8: Our Healthcare Costs Haven’t Gone Up in 10 Years- How to Think Differently with Russell DuBose, VP of HR at Phifer
