Kieran Carroll, DPT, MBA

don’t take it too seriously

[Anne Marie Flynn @AnneMarieFlynn2]

This is brilliant. The definition of being America. (Completely leaving politicians out of the discussion.)

[Kieran Carroll, DPT, MBA @KieranCarroll91]

Hear me out on this one… No.

[Watcher.Guru @WatcherGuru]

JUST IN: Meta patents AI that continues posting and messaging from deceased users' accounts by replicating past online behavior.

[Kieran Carroll, DPT, MBA @KieranCarroll91]

@heyrimsha AI

[Kieran Carroll, DPT, MBA @KieranCarroll91]

@DrJesseMorse This would be crazy…. If it was true

[Kieran Carroll, DPT, MBA @KieranCarroll91]

Whatever you think about the ICE shooting- you’re right. But also, ICE cannot command a US citizen non target to get out of their vehicle. Not in their jurisdiction.

Feel for the officer for being scared, but also the woman for a masked man jumping out of an unmarked vehicle.

[Kieran Carroll, DPT, MBA @KieranCarroll91]

@grok @Chesschick01 @grok thank you, it is advisable. But does the ice agent have police like jurisdiction to make you do this?

[Kieran Carroll, DPT, MBA @KieranCarroll91]

@grok @EndTribalism @grok since she reversed before proceeding to change angle and leave, does that change anything in terms of justification?

[Kieran Carroll, DPT, MBA @KieranCarroll91]

@NickHoopes_ Fact. I got one that cost that much. Realized I’d never repay it. Got an MBA, switched fields, paid it off in a few years.

They should only be hybrid undergrad direct to grad programs, 5 years total. IMO.

[Kieran Carroll, DPT, MBA @KieranCarroll91]

👏🏼

[Mario Nawfal @MarioNawfal]

🚨🇺🇸 MARK CUBAN EXPOSES PBM SCAM COSTING PATIENTS BILLIONS BEFORE SENATE

Mark Cuban just testified before the Senate explaining how Pharmacy Benefit Managers are a bigger monopoly than Amazon, controlling drug access for 270 million Americans while driving prices up, not down:

"PBMs auction off access to their formularies to the highest bidders.

Drug companies pay rebates and fees so their drugs can be covered.

The higher the list price, the more money PBMs make."

A $600 drug costs the manufacturer $240 after rebates.

Uninsured patients pay $600. Insured patients with deductibles also pay $600.

The PBM pockets the difference.

Cuban's solution: count cash payments toward deductibles, base out-of-pocket costs on net price, separate formularies from PBMs, and end specialty tiers.

The U.S. is the only country using PBMs.

That's why we have the world's highest drug prices.

Source: CSPAN, @mcuban

[Concerned PharmD 🇺🇸 @ConcernedPharmD]

A PBM-free or transparent fixed-fee healthcare model in the U.S. would conservatively save $90–130 billion per year—representing 14–20% of total prescription drug spending.

These savings come not from rationing care or suppressing innovation, but from eliminating opaque middlemen who profit from rebate distortions, spread pricing, and formulary manipulation.

#EndPBMs #PBMReform #PatientsOverProfit

Here’s the analysis:

[STLhighschoolsports @STLhssports]

Former Francis Howell standout Jake McCutcheon selected in 10th round by Marlins https://t.co/xN1bcEuf1e via @stltoday

[Saint Louis Baseball @SLUBaseball]

St. Louis 🛫 Houston!

Congratulations to our very own Charlie Weber for signing with the Astros!

[Kieran Carroll, DPT, MBA @KieranCarroll91]

Imagine joining a war just to keep conversation off the Epstein files. Wild times.

[Jake Scott, MD @jakescottMD]

RFK Jr. went on national TV and spouted egregious, dangerous falsehoods about vaccines. As a parent and infectious diseases doctor, I couldn't stay silent. @FoxNews might not fact-check him, but I will. I've reviewed the trials. I've catalogued them. I have receipts. 🧵

[Kieran Carroll, DPT, MBA @KieranCarroll91]

@timonealpt @Jerry_DurhamPT @Dizzy_DPT_Dad Finding it hard to find a time where shaming someone for their beliefs helped the situation. Not saying anyone here has any specific beliefs , but this has a 100% failure rate and waters down the meaning of “Nazi” & “confederate” to where ppl will stop reacting negatively to it.

[Gary Koepnick @garykoepnick]

In case you all forgot.

https://t.co/2ETvfzR9MK

[Mark Cuban @mcuban]

The brand name pharma mfgs HATE the big PBMs. My GUESS is they would lower prices BELOW MFN pricing if it dis-intermediated the big PBMs.
The rebate and fee $ are not public, but take PBms out of the middle and they make more money selling drugs for less

[EndGame Macro @onechancefreedm]

@mcuban @krassenstein @EdKrassen
The real lever of change here isn’t brute force price caps it’s dismantling the structural opacity that allows drug pricing to remain wildly inflated in the first place. Right now, the entire pharmaceutical pricing ecosystem is built on hidden rebates, confidential contracts, and a tangled web of incentives controlled by Pharmacy Benefit Managers (PBMs) and major insurers. These middlemen negotiate “discounts” and “rebates” behind closed doors, but the irony is that the final price to consumers often ends up higher than if no middleman were involved at all.

Hospitals exposed this dysfunction perfectly when they were required to disclose pricing under the prior transparency orders. What we found was shocking prices negotiated by the biggest insurers were often higher than the prices available to a self-paying individual with nothing but a credit card. That tells you everything you need to know about the perverse incentives at play. If that same spotlight of transparency is directed toward the pharmaceutical supply chain, PBMs lose their power to manipulate pricing through opaque rebate agreements.

This is where competitive forces kick in. If manufacturers are required to publish their net prices publicly or better yet, offer direct-to-consumer pricing models like we saw with generic drugs the cash price becomes the benchmark. Suddenly, consumers aren’t beholden to the broken insurance reimbursement model. And as more people opt to pay directly for cheaper generic and even brand-name drugs, the old system starts to collapse under its own inefficiency.

You don’t need government to fix prices; you need government to force honest pricing into the light. Once that happens, the market will do what it always does when real competition is allowed: prices will fall naturally, and innovation will refocus on delivering value rather than gaming the rebate system. This is exactly what happened when specialty generics were exposed to competitive cash pricing costs plummeted, and access improved.

The same can happen here. But it starts with breaking the stranglehold of the PBMs and dragging their practices out of the shadows. Transparency isn’t a side reform it’s the foundation that makes every other solution viable.