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Episode 12: A Refreshing Look at Pharmacy Benefits (Part 1)
Manage episode 313694753 series 3282256
Cristy Gupton द्वारा प्रदान की गई सामग्री. एपिसोड, ग्राफिक्स और पॉडकास्ट विवरण सहित सभी पॉडकास्ट सामग्री Cristy Gupton या उनके पॉडकास्ट प्लेटफ़ॉर्म पार्टनर द्वारा सीधे अपलोड और प्रदान की जाती है। यदि आपको लगता है कि कोई आपकी अनुमति के बिना आपके कॉपीराइट किए गए कार्य का उपयोग कर रहा है, तो आप यहां बताई गई प्रक्रिया का पालन कर सकते हैं https://hi.player.fm/legal।
00:00 Intro
00:40 In today's episode
00:58 Vinay Patel of Self Insured Pharmacy Networks
02:16 What is a PBM?
02:32 PBM = claim processor just like a TPA on the medical side
03:15 but also rebate management, clinical management, etc.
04:17 what about the cost?
04:42 episode 8, "transparency"
05:08 Tim Thomas, quote on transparency
05:50 There's money in here, if you can find it--it's yours
06:02 Do we just need transparency? Or do we need a fiduciary?
08:00 It all depends on what's in the contract
08:56 Fiduciary principles mean I'm acting in the best interests of my client
09:57 NADAC = National Average Drug Acquisition Cost
11:09 University of Lynchburg Master's Program in Health Benefits Design
12:06 All things being the same, the price fluctuates by hundreds of dollars
13:00 Supply & Demand still exists but Rx prices can still be normalized
13:13 Manufacturers adjust brand names twice per year
14:17 Average Wholesale Price (AWP) means wholesalers are setting the prices
14:55 A little disruption might be in order here
15:25 We should have a buyer's market, not a seller's market
15:50 Direct Primary Care doctors are also dispensing Rx onsite
16:40 Let's step back and highlight DPC
17:20 Patients want a relationship with their providers, Providers want that too
18:12 Now that DPC has primary care handled, let's give them better access to Rx
18:57 A subscription model for Rx also
20:00 How many pharmacies are locally owned?
20:39 Answer = one third, about 22,000 pharmacies
21:47 A superior customer experience with care catered to the patient
23:40 Pharmacists in big box stores want to cater to patients but can't because of the system
25:30 A "concierge" pharmacist? Yes, it's possible
26:39 Local care team like Carl Schuessler says in the "Marcus Welby days"
28:12 Quadruple Aim means the physician/provider experience is important too
29:01 Cliffhanger--What's a day in the life of a community pharmacists?
29:08 That's all for today
29:16 Thank you, visit us at www.custombenefits.work, #letsfixhealthcare
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