Podcasts about idns

Play Episode Listen Later Apr 23, 2024 29:10

Patient assistance programs can make a huge difference for patients who need expensive medicines but can't afford them. In this episode, Jeff Stewart talks with Dave MacLeod, Managing Director, Value & Access at Syneos Health about the benefits and challenges of patient assistance programs, which provide free or low-cost medicines to eligible patients. They discuss how these programs can improve access, adherence, and outcomes, as well as the operational and regulatory issues involved in running them. Covering key topics such as the Inflation Reduction Act (IRA), the impact of technology and AI in patient services, and the challenges posed by copay accumulators and maximizers, Dave sheds light on the complexities of navigating copay assistance optimization and the strategies employed to mitigate the effects on patients and manufacturers alike. For more from our Value & Access experts, check out these topics: Syneos Health Podcast | Real Talk About the Inflation Reduction ActBLOG: Industry Cheers “Co-Pay Accumulator” Ruling, Should Prep for What's Next Potential Impact of European Pharma Legislation on Commercialization and Access of New Therapies BLOG: What Can We Learn From ICER's New Value Framework Syneos Health Podcast | Market Access for Weight Loss Drugs MM+M Podcast | Gaining Access and Delivering Pull-Through in IDNs and Key Accounts The views expressed in this podcast belong solely to the speakers and do not represent those of their organization. If you want access to more future-focused, actionable insights to help biopharmaceutical companies better execute and succeed in a constantly evolving environment, visit the Syneos Health Insights Hub. The perspectives you'll find there are driven by dynamic research and crafted by subject matter experts focused on real answers to help guide decision-making and investment. You can find it all at insightshub.health. Like what you're hearing? Be sure to rate and review us! We want to hear from you! If there's a topic you'd like us to cover on a future episode, contact us at podcast@syneoshealth.com.

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Real Talk About the Inflation Reduction Act

joe biden drawing managing directors real talk inflation reduction act commercialization health outcomes inflation reduction act ira syneos health idns

Play Episode Listen Later Apr 17, 2024 28:39

The Inflation Reduction Act (IRA), signed into law by President Joe Biden in August 2022, brings significant changes to the U.S. pharmaceutical market as it rolls out over the next 10 years.Today we dive deep into the IRA with Tiffany McCaslin, Managing Director, Value, Access and Health Outcomes at Syneos Health. Drawing from her extensive background in healthcare policy and industry strategy, Tiffany offers invaluable insights into the practical implications of this landmark legislation for the pharmaceutical industry. From dissecting the intricacies of price negotiation to unraveling the complexities of data collection requirements, this episode provides a clear roadmap for pharmaceutical companies and life sciences firms navigating the post-IRA era. For more from our Value & Access experts, check out these insights: BLOG: Industry Cheers “Co-Pay Accumulator” Ruling, Should Prep for What's Next Potential Impact of European Pharma Legislation on Commercialization and Access of New Therapies BLOG: What Can We Learn From ICER's New Value Framework Syneos Health Podcast | Market Access for Weight Loss Drugs MM+M Podcast | Gaining Access and Delivering Pull-Through in IDNs and Key Accounts BLOG: What ICER's Draft Sickle Cell Disease Report Means for CGT Pricing The views expressed in this podcast belong solely to the speakers and do not represent those of their organization. If you want access to more future-focused, actionable insights to help biopharmaceutical companies better execute and succeed in a constantly evolving environment, visit the Syneos Health Insights Hub. The perspectives you'll find there are driven by dynamic research and crafted by subject matter experts focused on real answers to help guide decision-making and investment. You can find it all at insightshub.health. Like what you're hearing? Be sure to rate and review us! We want to hear from you! If there's a topic you'd like us to cover on a future episode, contact us at podcast@syneoshealth.com.

EP424: Five Things for Hospital System Execs to Get Real About in 2024, With Peter Hayes

The Dad Edge Podcast (formerly The Good Dad Project Podcast)

Play Episode Listen Later Jan 18, 2024 45:07

For a full transcript of this episode, click here. Here's a quote from Ann M. Richardson, MBA. She wrote it on LinkedIn, and I love it: Quiet the noise that doesn't add value. Surround yourself with intelligent and respectful people who can deliver endless opportunities. Celebrate brilliance and new beginnings. Together, we've got this. Thanks for this beautifully stated call to action (I wish I would have written it myself) because it is also precisely the goal of Relentless Health Value and my hope for the Relentless Health Value Tribe—those of you who have connected with each other by way of this podcast vis-à-vis LinkedIn, or maybe you've met each other at an online or live event. For sure, subscribe to the weekly email to get notified of such goings-on. Now, this aspirational vision doesn't mean putting the onus on just any given individual to fix the systemic failings that get talked about on the podcast, but we can start somewhere. We can sit with ourselves; we can ask ourselves some big questions. We can decide the legacies we want to leave and what we want our life's work to add up to. That is what this show should, I hope, help you accomplish. And, yeah … together, we've got this. In this healthcare podcast, I am speaking with Peter Hayes; and we talk about five realities of 2024 for hospital chains, integrated delivery networks, health systems. Now, to make one thing very clear, as I have said many times on many Relentless Health Value shows: Not all hospital chains or hospitals are the same. There are large, consolidated, extremely rich, extremely politically and economically powerful organizations who are called health systems. And then there are rural or urban institutions that are barely scraping by and serving huge vulnerable patient populations. And despite the many aforementioned names for hospital chains and their associated outpatient facilities and owned physician groups and urgent care centers, all these names for these big care delivery entities are flabbergastingly meaningless because they do not separate the consolidated rich ones from the very desperately not rich ones. Today on the show, we're talking about the first kind of health systems: the big rich consolidated ones which are taking over every geography where there's money to be made. These are the ones where you read about their bad behavior in the New York Times or hear about them in YouTube videos like this one. Peter Hayes talks about the five things that these behemoth entities may really need to start thinking hard about, even in the face of their fierce and often-unrelenting market power and the political hold that they have over many local communities and all the regulatory capture that goes along with that. So, here's Peter's list in a nutshell—the five things to get real about: 1. Health systems need to get real about the CAA (Consolidated Appropriations Act) and its implications that plan sponsors only pay “fair and reasonable” prices for medical services. Now, before I dig in on this, jargon alert: When we say plan sponsors, that means entities such as self-insured employers—sponsors of health plans, if you will (the purchasers, the ones who are actually paying the bills). Peter explains the quick version of what the Consolidated Appropriations Act is in the show that follows, so do listen. But for more info on this really, really meaningful bit of legislation that is the law as of 2021, go back and listen to the episodes with Chris Deacon (EP342 and EP408) or check out the myriad of LinkedIn posts from Jeff Hogan. Also, others like Darren Fogarty, Justin Leader, Jamie Greenleaf, and others have some great words of wisdom that you will be able to find that really explain what the point is of the CAA, the Consolidated Appropriations Act, and its sprawling implications. 2. To survive on reduced commercial reimbursements, health systems need to get real about becoming ruthlessly aggressive in driving administrative and technology efficiencies. 3. They need to get real about pivoting from fee-for-service reimbursement to episode-based care based on taking real downside risks for good clinical outcomes. They need to pivot from a mindset of maximizing patient revenue to maximizing patient health. They need to move from a sick care reimbursement model to a healthcare reimbursement model based on health. 4. They need to get real about being completely transparent and accountable in reporting how they are using the value of their tax-exempt status. Similarly, they need to account for and report how they're using the estimated $55 billion in net margins that they're realizing off the 340B drug program. 5. They need to get real about quality and patient safety. We still have about 46% of our hospitals that have a C or lower Leapfrog rating. And, by the way, the chance of having a fatality on an avoidable error is 90% higher at a C or lower-rated Leapfrog entity versus a Leapfrog entity that has an A or a B. Now, some of you—and by some of you, I mean practically everybody listening—are thinking of reasons why any one of these “get real about” things is arguable or how one of the above is not holding up in some market. I think Peter would tell you the same thing that I would: You're not wrong. But trying to predict a zeitgeist or the next pet rock never works well because it's always a confluence of right time/right place where the whole is way more than the sum of its parts. Think about Malcolm Gladwell's The Tipping Point. It's about how small changes can have enormous effects if the context is right. So, now contemplate these five things that Peter brings up. All these forces are pushing in the same direction. Put it all into a stew where 48% of Americans have delayed or forgone care due to cost. Listen to the show with Wayne Jenkins, MD (EP358) for more on that. Or, you have the article John Tozzi just wrote in Bloomberg. Here's a quote: “In one California community, teachers have to pay an extra $10,000 a year to upgrade to insurance that covers the local hospitals. Teachers who can't afford it … give birth outside the county.” Meanwhile, insurers are making record profits, along with hospital CEOs and C-suites. At the same time, you know who I think is the third-biggest group with medical debt in this country? Yeah, it's people who work in hospitals—nurses, others. There's this frothing lack of trust for hospitals and what goes on there: 30% of physicians do not trust the leadership of their health system. And no wonder. There are examples of healthcare executives sitting up there in their palatial offices acting more like mobsters than the nuns they took over the hospital from. So, to orient your context, you are here. Peter Hayes is the newly retired former president and CEO at the Healthcare Purchaser Alliance of Maine. He is a national presence in healthcare strategy, innovation, and a keynote speaker. For more on the wild-ass problems with hospital pricing, check out this list of shows. But, spoiler alert, some of these are hair-raising. Encore! EP249: The War on Financial Toxicity in North Carolina as a Case Study Everybody Should Be Keeping Their Eye On, With Dale Folwell, North Carolina State Treasurer EP395: Consolidated Hospital Systems and Cunning Anticompetitive Contracts, With Brennan Bilberry EP390: What Legislators Need to Know About Hospital Prices, With Gloria Sachdev, PharmD, and Chris Skisak, PhD EP389: The Clapback When Hospitals Cannot Constrain Their Own Prices, With Mike Thompson EP346: How Did Health Systems Get Addicted to the Inflated Prices They Charge Employers and Some Patients? 2021 Update, With Peter Hayes, President and CEO of the Healthcare Purchaser Alliance of Maine EP394: Spoiler Alert: It Is Counterintuitive Which Hospitals Offer the Most Charity Care, With Vikas Saini, MD, and Judith Garber, MPP Also mentioned in this episode are Ann M. Richardson, MBA; Chris Deacon; Jeffrey Hogan; Darren Fogarty; Justin Leader; Jamie Greenleaf, AIF, CBFA, C(k)P; Wayne Jenkins, MD; John Tozzi; NASHP (National Academy for State Health Policy); Gloria Sachdev, PharmD; Chris Skisak, PhD; Leon Wisniewski; Cora Opsahl; Rik Renard; John Rodis, MD; Rob Andrews; Al Lewis; Eric Bricker, MD; Vikas Saini, MD; Judith Garber, MPP; Lown Institute; RAND Corporation; Dale Folwell; Brennan Bilberry; and Mike Thompson. You can learn more by following Peter on LinkedIn. Peter Hayes recently retired as the president and CEO of the Healthcare Purchaser Alliance of Maine and formerly a principal of Healthcare Solutions and director of associate health and wellness at Hannaford Supermarkets. He has been recognized as a thought leader in innovative, strategic benefit design for the past 25+ years. He has received numerous national awards in recognition of his commitment to working collaboratively with healthcare providers and vendors in delivering health benefits that are focused on value (high-quality efficient care). He has been successful in this arena by focusing on innovative solutions for patient advocacy, chronic disease management, and health promotion programs. Peter has also been involved in healthcare reform leadership roles on both the national and regional levels with organizations like Center for Health Innovation, Care Focused Purchasing, and Leapfrog. He's also co-founder of the Maine Health Management Coalition and has been appointed by two different Maine Governors to serve on Health Care Reform Commissions to recommend public policies to improve the access and affordability of healthcare for Maine citizens. 08:04 Why do hospitals need to get real about the implications of the Consolidated Appropriations Act? 10:09 What is considered fair pricing for hospitals? 13:00 EP390 with Gloria Sachdev, PharmD, and Chris Skisak, PhD. 15:59 The medical transparency tool, Billy. 16:34 How does lowering prices become more challenging with consolidated hospital systems? 18:07 What is one of the solutions available to combatting this now? 19:31 Why do hospital systems need to get real about administrative and technology efficiencies? 22:27 EP373 with Cora Opsahl. 26:51 Why do hospitals need to get real about pivoting from fee-for-service reimbursement to episode-based care? 30:16 EP415 with Rob Andrews. 30:53 Why do hospitals need to get real about the 340B program and their tax-exempt status? 35:38 EP394 with Vikas Saini, MD, and Judith Garber, MPP. 38:19 What are the ethical and moral issues that are coming to a head with healthcare costs? 39:03 Why do hospitals need to reexamine their care quality and patient safety? 40:05 “We just need to make sure that the health industry is as accountable as some of our other industries.” 42:53 Why does Peter think it's going to take regulation to move the dial? You can learn more by following Peter on LinkedIn. @pefhayes discusses #hospitalsystems and what their executives need to do on our #healthcarepodcast. #healthcare #podcast #pharma #healthcareleadership #healthcaretransformation #healthcareinnovation Recent past interviews: Click a guest's name for their latest RHV episode! Joey Dizenhouse, Benjamin Jolley, Emily Kagan Trenchard (Encore! EP392), Cora Opsahl (Encore! EP372), Jodilyn Owen, Ge Bai, Andreas Mang, Karen Root (Encore! EP381), Mark Cuban and Ferrin Williams, Dan Mendelson (Encore! EP385)

The Super Powers within a Tribe with Seth Ramser

Play Episode Listen Later Oct 20, 2023 58:17

Seth Ramser is a Dad Edge Alliance member, and the Director of Business Development at SignatureMD. He is also an accomplished healthcare executive with a 10 year track record driving business development, operational efficiencies, innovation and growth strategies to physicians, health systems, self-insured companies, IDNs and ACOs. In this episode, Larry Hagner is joined by Seth Ramser to explore the pivotal role of relationships and accountability in personal growth and fatherhood. Seth Ramser highlights the immense value of authentic friendships and stresses the importance of a robust support system in our lives. Drawing from his dojo experience, he showcases the transformation that occurs within a supportive community, promoting personal growth. The analogy of towers reinforces the need for mutual support and accountability in our lives, paralleling how towers depend on each other for stability. Seth Ramser shares poignant personal stories that underscore the reciprocity of support and encouragement among friends. The conversation also delves into Seth's journey to sobriety, emphasizing the role of relationships and accountability in overcoming challenges. The episode also discusses three fundamental tools from the dojo that profoundly impacted his family life: self-care, a strong marital relationship, and intentional quality time with children. In conclusion, this conversation reiterates the significance of prioritizing family and fostering meaningful connections. It leaves a lasting impression of how our actions and choices can profoundly impact the lives of those we care about. www.thedadedge.com/alliance www.thedadedge.com/friday126

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Rebate Management in Healthcare | E. 90

The Healthcare Leadership Experience Radio Show

Play Episode Listen Later Oct 18, 2023 22:41

Hospitals are under continued pressure to reduce costs and deliver better care. CoFounders of Rebate Insight, Tony Garcia and Jonas Langvad, explain the benefits of rebate management to Jim Cagliostro. Episode Introduction Tony & Jonas explain why 100% of rebates go straight to the bottom line, share the 3 Ms of rebate management, and highlight how Rebate Insight's SaaS solution is increasing hospital rebates by 26% or more. They also explain how ‘'dark data'' blurs visibility into rebate management and celebrate being part of SpendMend. Show Topics Rebate management should be a priority in healthcare Manual processes make it difficult to track rebates The 3 M's of rebate management Dark data and the pain points of rebate management Benefits of Software-as-a-Service (SAAS) The value of SpendMend 02:29 Rebate management should be a priority in healthcare Tony said in times of financial pressure, rebates go straight to the bottom line to boost margins. ‘'I think I'll start a little bit at the high level, to get to the 10,000-foot level for hospitals. The financial performance of a hospital is always important, and I think we've had a few interesting years in the past here, coming out of, first of all, covid introduced a lot of additional costs for hospitals, labor shortages, and product shortages for sure that spiked prices. Then after that, we've seen a great deal of inflation and products increasing dramatically in price, so that's really impacted hospitals in a big way. I think right now, just the financial situation, everyone's looking to see what can be done to reduce cost, stay competitive. When it comes to rebates, rebate management, it's historically been one of those areas that maybe hasn't been looked at that closely because it is a little bit of a complex area to manage. I think what ends up happening is when you think about, if hospitals are looking for areas to save money in, to reduce costs, they can have different initiatives. On the revenue side, if you end up increasing revenue by let's say a few million, only about 2% to 4% of that ends up going to the bottom line, because that's usually the margin of a hospital. It's very low-margin on the revenue side. However, if you're able to increase rebates on the cost side, 100% of that is going to go to the bottom line. You have a huge upside potential if you're able to manage rebates well and increase those rebates.'' 05:53 Manual processes make it difficult to track rebates Jonas explained the benefits of automation in rebate management. ‘'I come with 25 years of healthcare experience. I've been a director at a health system in Southern California, and this is how this was all created. It was so difficult to track rebates, and the benefit of tracking them and knowing what is owed and what the vendor should be paying you and if you're going to meet your market share was so important and critical, but it was just too hard because the process has always been manual. Historically to this day, we've had many discussions with very large IDNs, some of the largest IDNs in the nation, and also on the lower end with smaller hospitals, and they all have the same issue. They're all using a manual process. They all have teams of staff that do different things, so it's always been difficult to track rebates. I think now, historically, we created this software that automates that process, where you're not having to go to a spreadsheet every other day, where it's giving you notifications in real time. You're always aware of what's going on in your contracts, where your market share, where your spend is, and just giving you a lot of insight into rebates and making sure that the vendors are paying you out, paying you on time, and also that you're meeting their commitment through the agreement as well. It really helps the materials team handle all that.'' 08:02 The 3 M's of rebate management Tony explained the importance of monitoring, managing, and maximizing and how Rebate Insight helps hospitals to achieve all three. ‘'Looking at this product and taking all the different information that you receive, we found that by monitoring, managing, and maximizing ... those are our three M's. Those really, if you were to see the demo or if you were to see the dashboard, it really kicks in, and you're able to ... under the whole monitoring is monitoring what your health system's doing. How are you handling every contract that goes into Rebate Insight, giving you at a high level all the information you need, and then going into the managing piece where it's more detailed specific to each agreement. Then going into the maximizing, where you're able to go in and if it is fifteen days, five days before your quarter ends or your annual commitment ends and you have to make a decision, you're able to do this all through the software, in real time, in a point-click SaaS product. You're able to effectively go into this product and make decisions or see where you currently stand, all in real time.'' 11:11 Dark data and the pain points of rebate management Tony said hospitals share many common pain points. ‘'Some of the common pain points are we don't know what is owed to us. We don't have any expertise and rebate insight. We work kind of siloed. We don't know what AP is receiving. Checks are going everywhere. We're receiving credit memos that people are not aware of. There's just a lot of that what I say is like dark data out there, and no visibility for the health system as a whole. One thing we found while we were creating this is how many people are involved and how many people should be in the process of rebate tracking that are not, just because you have someone like the director negotiating agreements, putting rebates in place, but you have, on the other side, AP that is receiving the checks, or maybe the vendors are bringing the checks to the director. Just a lot of mismanagement of also where checks are. A lot of times checks are lost, so there's nothing really that connects everybody. That's what's so great about Rebate Insight. It's all built in that platform where AP has a module, where directors can have access to that dashboard, and then the materials team has access as well.'' 13:56 4 Benefits of Software-as-a-Service (SAAS) Jonas said Rebate Insight can help to support renegotiating contract terms with suppliers. ‘'Really, I think when we think about value is we think about it almost in different buckets, right? We think about I should say it goes under financial leakage, is you make sure you receive what you're owed. That's a big piece. Second is if you can speed up the actual payment, receive it earlier, then you can gain some value from having that cash on hand. Then third, what we think about is if you can maximize your existing agreements, you have opportunities at a given time throughout the year where you might be able to go to a higher tier because you're so close. You spend a little bit more money to get a bigger benefit. Then finally, when you have a tool like this ... and I think Tony can speak to this as well ... is you get that visibility into all your agreements. That enables you to just have discussion with suppliers and vendors and say, "Why don't we renegotiate our terms? Give me a little bit higher rebate," which when you can track it, that's a huge benefit for the health system and you're going to see that financial return.'' 19:22 The value of SpendMend Tony and Jonas agreed that being with SpendMend feels more like a partnership. ‘'At first, there's always a little hesitation of selling your creation, right, but the value that SpendMend brings to the table with their 30 years experience in the health system, it has just been so great for at least speaking for myself, and I know Jonas will talk a little bit of this as well. I mean, when you really partner with ... and that's what it really feels like. It doesn't feel like, "Hey, you got bought out and that's it." No, it really feels like we partnered with SpendMend, and it just really opens up a lot of doors for us. Again, with that experience, being able to go to certain leaders in the organization and able to have a sales team, a marketing team, is huge. Those all have been great benefits, and super excited and really almost privileged to have that opportunity.'' Connect with Lisa Miller on LinkedIn Connect with Jim Cagliostro on LinkedIn Connect with Tony Garcia on LinkedIn Connect with Jonas Langvad on LinkedIn Check out VIE Healthcare and SpendMend You'll also hear: Understanding rebates: ‘'For those not familiar with rebates, right, it's basically a supplier that offers you an incentive on a contract. If you buy X number of products, they'll give you let's say 5% back on a rebate. Usually there's some criteria tied to it, but that's sort of the starting point there.'' The benefits of Rebate Insight's SaaS tool: ‘'… we're seeing how systems that are using Rebate Insight increase their rebates by 26% or more by using the tool.'' How Rebate Insight transforms rebate management: ‘'It's subscription-based, cloud-based, which makes it very easy to sign up for, implement. There are no expensive servers …it pulls together all the data from different sources… It really gives you that real-time view of this is where you stand today. You can monitor all your rebates, all your contracts this way, all your compliance.‘' Rebate Insight tracks trends and tiers for hospitals: ‘'Rebate Insight tracks your trends. You could go back and look at the quarter and say, "Wow, my trend for last quarter was tier two, but we're still signed on tier one. Oh, this quarter is tier two as well. The vendors don't tell you that. The vendors rarely come back and say, "Hey, you've been achieving tier two, go ahead and click on it because now your price is dropping 20%." What To Do Next: Subscribe to The Economics of Healthcare and receive a special report on 15 Effective Cost Savings Strategies. There are three ways to work with VIE Healthcare: Benchmark a vendor contract – either an existing contract or a new agreement. We can support your team with their cost savings initiatives to add resources and expertise. We set a bold cost savings goal and work together to achieve it. VIE can perform a cost savings opportunity assessment. We dig deep into all of your spend and uncover unique areas of cost savings. If you are interested in learning more, the quickest way to get your questions answered is to speak with Lisa Miller at lmiller@spendmend.com or directly at 732-319-5700.

Market Access for Weight Loss Drugs

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Play Episode Listen Later Sep 21, 2023 21:06

One of the biggest trends making headlines and impacting the healthcare industry to date is the rising popularity of GLP-1 drugs. Initially developed for diabetes management, these products have recently gained traction for weight loss indications. But with promising efficacy and growing popularity, is the healthcare industry truly prepared for the challenges posed by these drugs becoming such a hot commodity in the market?Tom Albers, Vice President of Strategy at Syneos Health company Spherico, joins the podcast to discuss his insights on the future of weight loss drugs – payer challenges, the transformative potential of these drugs, and the need for smart investments in data and evidence.For more content on value and access, check out these insights: MM+M Podcast | Gaining Access and Delivering Pull-Through in IDNs and Key AccountsSyneos Health Podcast: The Inflation Reduction ActBuilding a Market Access Case for Real World Evidence in OncologyThe views expressed in this podcast belong solely to the speakers and do not represent those of their organization. If you want access to more future-focused, actionable insights to help biopharmaceutical companies better execute and succeed in a constantly evolving environment, visit the Syneos Health Insights Hub. The perspectives you'll find there are driven by dynamic research and crafted by subject matter experts focused on real answers to help guide decision-making and investment. You can find it all at insightshub.health. Like what you're hearing? Be sure to rate and review us! We want to hear from you! If there's a topic you'd like us to cover on a future episode, contact us at podcast@syneoshealth.com.

Episode 64: Interior Designers of Nova Scotia

Atlantic Construction Podcast

Play Episode Listen Later Sep 5, 2023 66:53

Atlantic Construction Podcast - In Association with Procore Technologies https://www.procore.com/en-caOn today's episode we are joined by, Emma Woodhull, President, Lori Arnold- Vice President, Mireille Metwalli – Director at Large, Social Media and Awards Committee.From its beginning in 1975, IDNS has promoted the profession of interior design. It's members are also affiliated with Interior Designers of Canada (IDC). An act passed by the Nova Scotia Legislature limits the use of the title “Interior Designer” to registered members of IDNS.IDNS is committed to the advancement of the interior design profession. It is the association's mandate to promote and support both the interests of the public and the interior design industry. IDNS strives to;Protect the health, safety and well-being of the general publicDevelop and maintain standards of practice of interior designEncourage excellence in interior designProvide courses for the continuing professional development of interior designersUphold the Code of Ethics for the professional practice of interior designPromote and extend the profession of interior design by providing a liaison between the profession and the publicFind ACP on:Instagram: https://www.instagram.com/atlanticconstructionpodcast/Facebook: https://www.facebook.com/atlanticconstructionpodcast/LinkedIn: https://www.linkedin.com/company/atlanticconstructionpodcast/?viewAsMember=trueTikTok: https://www.tiktok.com/@atlanticconstructionpodTwitter: https://twitter.com/ACP_PodcastYouTube: https://www.youtube.com/@atlanticconstructionpodcast/videosFind IDNS on:Instagram: https://www.instagram.com/interiordesignersofnovascotia/?hl=enFacebook: https://www.facebook.com/interiordesignersofnovascotia/Website: https://idns.ca/

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Season 5 Episode 5 : Childhood Illness

The PQI Podcast

Play Episode Listen Later Aug 31, 2023 31:58

This week we sit down with Matt Saylor, PharmD, BCOP to discuss his personal brain tumor story and his career path into pharmacy. Matt has had a passion for healthcare from an early age and developed his interest in oncology based on many of his personal experiences and a fantastic oncology mentor in school. Matt earned his Doctor of Pharmacy from The Ohio State University and then went on to complete 2 years of training – PGY1 at the VA in Columbus (OH) and then PGY2 Oncology at Emory in Atlanta. After residency, he practiced at 2 large IDNs in North Carolina – Wake Forest in Winston-Salem and then Novant Health in Charlotte. For the past 5 years, Matt has been a Medical Affairs Director for Health Systems Oncology at Merck, where he gets to blend his interest for advancing the oncology landscape and providing medical information to fellow pharmacists and other healthcare professionals.

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#161: Guiding Health Care Organizations with a Targeted Leadership Approach, with Laurie Lee Smith

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Play Episode Listen Later Aug 18, 2023 51:05

Holding more than 20 years of experience in healthcare leadership, Laurie Lee Smith is the founder of Laurie Lee Leadership and former system CNO of Billings Clinic. Her expertise lies in supporting healthcare professionals to overcome challenges, shift mindsets, uncover blind spots, and sustain progress by incorporating the neuroscience of human behaviors. She has developed the Elevating Healthcare Leadership Impact program and the STAR methodology, both of which have proven to be instrumental in transforming teams and driving tangible results. Laurie holds a BSN from the University of Alaska aAnchorage, a masters of science in nursing administration from the University of Mary, and executive coaching certifications from the Hudson Institute of Coaching and the International Coaching Federation. John Marchica, CEO, Darwin Research GroupJohn Marchica is a veteran health care strategist and CEO of Darwin Research Group. He is leading ongoing, in-depth research initiatives on integrated health systems, accountable care organizations, and value-based care models. He is a faculty associate in the W.P. Carey School of Business and the graduate College of Health Solutions at Arizona State University.John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is an active member of the American College of Healthcare Executives and is pursuing certification as a Fellow.About Darwin Research GroupDarwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin's client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

How to Sell the Concept of Supply Utilization Management to Your Senior Leadership

Power Supply

Play Episode Listen Later Jul 26, 2023 2:57

On this week's episode of Power Supply Articles On-the-Go, Bob Yokl discusses the not-so-true things we tend to tell ourselves related to supply utilization in our hospitals: "There are many myths, half-truths, and misinformation floating around the healthcare marketplace about supply utilization management. This misinformation is holding back hospitals, systems, and IDNs from embracing this new supply chain discipline. To help dispel some of these untruths, here are five myths about supply utilization management that you need to know about..." Tune in for the full article! Loving the #PowerSupply conversations? You can now download our free mobile app: Apple: https://zcu.io/sx2h Android: https://zcu.io/xJSJ And listen at: iTunes -> https://zcu.io/3Zef Spotify -> https://zcu.io/eBXx Stitcher -> https://zcu.io/2gMi Amazon Podcasts -> https://zcu.io/Xo2S Google Podcasts -> https://zcu.io/O8SY #PowerSupply #Podcast #Education #SupplyChain #Healthcare #Purchasing #Contracting #ValueAnalysis

Gaining access and delivering pull-through in IDNs and key accounts, a podcast presented by GSW

The MM+M Podcast

Play Episode Listen Later May 31, 2023 16:52

Keys to tailoring interactions for more effective, efficient engagement.

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A Conversation with Dean Erhardt, president & CEO of D2 Solutions

Mercalis in Motion

Play Episode Listen Later Apr 27, 2023 39:58

In this episode of TrialCard TALK, Landy and Eric welcome to the studio Dean Erhardt, President & CEO of D2 Solutions. D2 is a healthcare solutions company that leverages consulting expertise with SaaS-based technology tools to drive revenue, enhance operational efficiency, and decrease exposure to regulatory risk for pharma and biotech manufacturers, specialty pharmacies, payers, and hospitals/IDNs. Mr. Erhardt has over 30 years of strategic marketing and management experience across both the consumer product and pharmaceutical arenas. His experience has spanned several Fortune 500 organizations, including Express Scripts, Cardinal Health, and U.S. Healthcare.Download this episode to learn more about the everchanging healthcare landscape and what Mr. Erhardt sees ahead for life science companies, payers, and patients.

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Part 2: Enrique Estrada Sr Director Health Industry Solutions VMware

PopHealth Week

Play Episode Listen Later Mar 20, 2023 28:00

On today's episode of PopHealth Week, co-hosts Fred Goldstein and Gregg Masters welcome Enrique Estrada, Senior Director of Healthcare Solutions for VMware, a leading provider of multi-cloud services for all applications. Enrique weighs in on the qualities and characteristics that enable digital store fronts to potentially position retail footprints as 'medical homes' or health hubs (generically speaking) that mimic intergrated delivery systems (IDNs), ==##==

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Keynote: Healthcare Community Transformations: Are Pharmacists the New Primary Care Providers?

This Week in Health IT

Play Episode Listen Later Feb 24, 2023 30:10 Transcription Available

February 24, 2023: The nature of healthcare is changing and many, including Frank Harvey, CEO of Surescripts, have some predictions. Physicians will take up the role of primary care provider once again and the legislature will shift to aid in preventing physician burnout. This is a big problem because what happens when 150,000 physicians pull out of the occupation? How will these transitions impact the big players like CVS and how will it impact IDNs? With pharmacists peaking patient's trust and time, we need to better our compensation structures and legislature. What does the new competition in the field, Walmart and Minute Clinic mean for healthcare? How will hospitals grow their interoperability? Will specialty medications play an even larger role? There is a cooperative future in healthcare and we are working towards closer working relationships all over. Key Points:20% of primary care physicians plan to retire over the next two years.In the first half of this year, over 10 and a half million messages have gone back and forth between physicians and pharmacistsThe pharmacists see patients on average 35 times a year while their primary care doctor sees them only 4 on average.30% of rural healthcare systems will close within the next year21st Century Cures' requirements on the providers and payersSurescriptsHealthcare needs innovative ways to address staffing shortages from clinical to IT employees. Are you curious about how technology can help support your Healthcare staff? Join us on our March 9 webinar, “Leaders Series: The Changing Nature of Work,” to explore how Health IT can be used to supplement Healthcare professionals https://thisweekhealth.com/leaders-series-the-changing-nature-of-work-remote-hybrid-onsite-shortages/Subscribe: This Week HealthTwitter: This Week HealthLinkedIn: Week HealthDonate: Alex's Lemonade Stand: Foundation for Childhood Cancer

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PopHealth Week: A Conversation with Enrique Estrada Senior DIrector Health Inductry Solutions VMware

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Feb 12, 2023 25:59

Co-hosts Fred Goldstein and Gregg Masters welcome Enrique Estrada, Senior Director of Healthcare Solutions for VMware, a leading provider of multi-cloud services for all applications. Enrique weighs in on the qualities and characteristics that enable digital store fronts to potentially position retail footprints as 'medical homes' or health hubs (generically speaking) that mimic integrated delivery systems (IDNs). To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio.” Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

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A Conversation with Enrique Estrada Sr Director Health Industry Solutions VMware

PopHealth Week

Play Episode Listen Later Feb 8, 2023 26:00

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A Conversation with Enrique Estrada Sr Director Health Industry Solutions VMware

This Week in Health Innovation

Play Episode Listen Later Feb 8, 2023 26:00

This episode of PopHealth Week with co-hosts Fred Goldstein and Gregg Masters featrures Enrique Estrada,Senior Director of Healthcare Solutions for VMware, a leading provider of multi-cloud services for all applications. Enrique weighs in on the qualities and characteristics that enable digital store fronts to potentially position retail footprints as 'medical homes' or health hubs (generically speaking) that mimic intergrated delivery systems (IDNs). ==##==

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Podcast 71 - Healthcare Value Analysis Software Mistakes That Can Be Costly

management mistakes cost healthcare hospitals va software supply analysis chain costly vas utilization idns value analysis healthcare value

Play Episode Listen Later Jul 29, 2022 18:20

Now that the value analysis community has embraced value analysis software (VAS) as a best practice, more hospitals, systems, and IDNs are acquiring this easy to master technology. However, for those value analysis practitioners contemplating purchasing value analysis software in the future, here are some of the top mistakes to avoid that can be costly when deciding on your own VA software:

5 Tips On Establishing Your Own Hospital Supply Utilization Management Program

Power Supply

Play Episode Listen Later Jul 21, 2022 3:29

On this week's episode of Power Supply Articles On-the-Go, Bob Yokl talks about activity based costing (ABC), supply chain training, supply validation, and more: "As hospitals, systems, and IDNs see fewer savings results from their GPO or local new and renewal contracts, more and more healthcare organizations are preparing to launch their own Supply Utilization Management Program to make up for these shortfalls. To this end, here are five tips on establishing your own Supply Utilization Management Program that might make this transition to new and better savings even easier..." Tune in for the full article! Loving the #PowerSupply conversations? You can now download our free mobile app: Apple: https://lnkd.in/gzg_s8H2 Android: https://lnkd.in/g_Bs3B72 And listen at: iTunes -> https://lnkd.in/gj3HTbUG Spotify -> https://lnkd.in/gVRx6vNa Stitcher -> https://lnkd.in/gh3ZQifn Amazon Podcasts -> https://lnkd.in/gDhPJDgh Google Podcasts -> https://lnkd.in/gisj3y2R #PowerSupply #Podcast #Education #SupplyChain #Healthcare #Purchasing #Contracting #ValueAnalysis

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Hospital Supply Utilization Management Myths

Power Supply

Play Episode Listen Later Jun 30, 2022 3:38

apple management loving hospitals myths android supply utilization idns

Getting Access

senior director distribution pbms drug pricing market access nams syneos health msls idns

Play Episode Listen Later Apr 27, 2022 21:13

The medicine may be “transformational,” but doctors won't write the script if payers don't reimburse.And there's a veritable alphabet soup of players – everything from KAMs to NAMs, MSLs to MSOLs, PBMs to IDNs, and more – involved in negotiating the path to reimbursement and, ultimately, access for innovative therapies when they hit the market. Jon Haas, Senior Director, Market Access at Syneos Health, discusses the complex process, how companies can best position their product for access and what really matters to payers in the long run.For more on value and access in biopharma, check out:How Competition Affects Market Access for Rare Disease Therapeutics, Part 1How Competition Affects Market Access for Rare Disease Therapeutics, Part 2Future-Forward Planning: What Drug and Device Manufacturers Need to Know About Preventive Drug Lists2021 Update: Non-Personal Promotion: What Do Payers Want?The Other Path to Access: Strategies for Direct Employer EngagementThe Syneos Health Podcast: Trade and Distribution in Pharma: It's ComplicatedWhat to Expect on Drug Pricing in the Democratic Trifecta If you want access to more future-focused, actionable insights to help biopharmaceutical companies better execute and succeed in a constantly evolving environment, visit the Syneos Health Insights Hub. The perspectives you'll find there are driven by dynamic research and crafted by subject matter experts focused on real answers to help guide decision making and investment. You can find it all at insightshub.health.Like what you're hearing? Be sure to rate and review us! We want to hear from you! If there's a topic you'd like us to cover on a future episode, contact us at podcast@syneoshealth.com.

Special: Russia-Ukraine War Update 07 March 2022

ShadowTalk by Digital Shadows

Play Episode Listen Later Mar 7, 2022 24:03

ShadowTalk host Chris alongside Stefano and Rory bring you the latest on the escalating tension between Russia and Ukraine. This episode they cover: * IDNS rejects Ukraine's request to block Russian Internet content * Anonymous claimed to have hacked Russian channels to broadcast footage from Ukraine ***Resources from this special podcast*** News and Updates Related to the Russian Invasion of Ukraine https://resources.digitalshadows.com/russian-news-and-updates Donate to the Ukraine crisis via Red Cross https://donate.redcross.org.uk/appeal/ukraine-crisis-appeal Digital Forensic Research Lab medium.com/dfrlab

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PopHealth Week: Meet Nate Maslak, Co-Founder & CEO, Ribbon Healh

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Mar 6, 2022 29:06

Hosts Gregg Masters and Fred Goldstein meet Nate Maslak, co-founder and CEO of Ribbon Health. Ribbon Health is tech enabled, solutions company with products for referral management, care navigation, provider directory and health plan enrollment solutions. They discuss Ribbon Health's platform as a remedy for chronic issues faced by both providers, payors or IDNs. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play HealthcareNOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

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The impact of Sunsetting 3G on Healthcare with Connect America CEO Janet Dillione

B-Time with Beth Bierbower

Play Episode Listen Later Jan 25, 2022 16:41

Today we are going to discuss the impact of cellular carriers sunsetting their 3G networks this year. You may wonder why the sunsetting of 3G is an appropriate topic for a podcast focused predominantly on healthcare, so here's the answer. The sunsetting of 3G networks has a significant impact on the elderly and low-income populations. Many devices such as older phones, personal emergency response systems and home alarm systems including carbon dioxide alarm systems will cease to work. Many individuals cannot afford to replace these devices. In addition, COVID has significantly slowed the ability for service workers to upgrade systems in the home. As healthcare leaders, is this issue on our radar screen? Will we find it more difficult to contact chronically ill members whose phones no longer work? Will we see increased costs due to the failure of a PERS device to signal for help? With us today to educate us on the 3G sunset issue and what is being done to help people upgrade is Janet Dillione, CEO of Connect America which brings digital health connected solutions into the home to improve the safety, care and quality of life for the elderly who want to remain living independently as long as possible. Janet has a long history in digital health serving in the past as President & CEO of Siemens Medical Solutions, EVP & GM of Nuance Communications Healthcare Division and President and CEO of Action Management Technologies and Bernoulli. Show Notes: Books The Leadership Moment by Michael Useem. Podcast: The Spycast Podcast.

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Leveraging Telehealth To Optimize and Support Integrated Healthcare Delivery With eVisit CTO & Co-founder Miles Romney

B-Time with Beth Bierbower

Play Episode Listen Later Oct 26, 2021 31:42

eVisit CTO Miles Romney shares his vision of how Telehealth can be leveraged to support and optimize the concept of Integrated healthcare delivery. The use of telehealth increased significantly during the pandemic but the need exists to ensure that this technology is used to support an integrated care team. Show Notes: Favorite Books: The Castrato by Martha Feldman; Hit Refresh by Satya Nadella; Cash & Dash: How ATMS And Computers Changed Banking by Bernardo Batiz-Lazo; The Everything Store: Jeff Bezos And The Age Of Amazon by Brad Stone. Favorite Podcasts: Dr. Nick: The Incrementalist; Stuff to Blow Your Mind; Soft Skills Engineering; This American Life.

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Podcast 62 - 5 Tips On Establishing Your Own Hospital Supply Utilization Management Program

management cost healthcare hospitals reduce establishing supply analysis clinical expenses utilization management program gpo idns

Play Episode Listen Later Oct 22, 2021 25:41

As hospitals, systems, and IDNs see fewer savings results from their GPO/local new and renewal contracts, more and more healthcare organizations are preparing to launch their own Supply Utilization Management (SUM) Program to make up for these shortfalls. To this end, here are five tips on establishing your own Supply Utilization Management Program that might make this transition to new and better savings even easier:

EP330: What Is Going On Over at Health Systems? With John Marchica, CEO at Darwin Research Group

Play Episode Listen Later Jul 22, 2021 31:51

In this health care podcast, I'm interviewing John Marchica, who is the CEO at Darwin Research Group. Starting last year in the middle of the worst of the COVID pandemic, Darwin Research Group conducted a study about what was going on at health systems or integrated delivery networks (IDNs), and they've updated it every quarter since then. The goal was to try to stay on top of the effects of COVID-19 on care management and the business of care delivery. I loved having this opportunity to quiz John about what health systems are saying about how they are doing and what they are doing, both strategically and reactively, coming out of the pandemic and in response to the pandemic. Now this is a half-hour conversation about an extensive research report, so we're kind of aggregating all of the health systems in one big bucket. Said another way, we're obviously not going to play the deep cuts here. No worries—the insights that John lays out are fascinating and give an insider's look into what's going on at these really powerful institutions. By the way, when I say powerful institutions, I just was looking at some stats the other day. Something like 50% of all prescriptions these days run through IDNs (that was in 2020). And also in 2020, aggregate IDN market size was $1 trillion. And by 2027, their anticipated combined revenues may exceed $2 trillion. That's double. (I know, that was some quick math by me. You're welcome.) We'll see, though, what the recent Executive Order yields—the one to look into the market power that some of these consolidated IDNs wield. Regardless of who you are, it is tough to deny the mountain of evidence showing that IDN health system consolidation considerably jacks up prices that patients, employers, and taxpayers pay in any geography where consolidated IDNs, otherwise known as monopolies, have destroyed all competition. Probably the most striking takeaway I had from this conversation was how much there is to read between the lines. At the end of the day, IDNs are, and are run, like businesses; and regardless of whether they have a nonprofit on the door or not, that is still true. Before I get into this, let me just clearly say that my heart goes out to the frontline workers—doctors, nurses, everybody else—and all they have done and continue to do for us, and I mean that with three underlines. While I really admire and support some of the rural and urban truly safety net hospitals who are trying to cobble together positive net revenue against all odds, I am far less sympathetic to some of the huge institutions who will engineer an “it's good for patients, honestly” cover story for any and all endeavors which all seem to have one thing in common: their profitability. Like, nobody mentioned 340B revenue opportunities or how much money there is in specialty pharmacy when explaining the rationale for standing up specialty pharmacies within some health systems' walls. Maybe it goes without saying. Here's my conversation with John Marchica, CEO of Darwin Research Group and host of the Health Care Rounds podcast, by the way. You should check that out. You can learn more at darwinresearch.com or by emailing John at jm@darwinresearch.com. You can also listen to the podcast Health Care Rounds wherever you listen to podcasts. John Marchica is a veteran health care strategist and CEO of Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. He's a two-time health care entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest-growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade. John did his undergraduate work in economics at Knox College, has an MBA and MA in public policy from the University of Chicago, and completed his PhD coursework at The Dartmouth Institute. He is a faculty associate in the WP Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives. 03:50 What were John's top three health system findings during COVID? 05:24 What is priority for integrated delivery network health systems right now? 08:57 Why do health systems have a renewed focus in primary care? 10:07 How did infusion centers manage throughout the pandemic? 13:58 “It's not just in cancer, people not getting screened and being diagnosed; it's in other areas as well.” 14:17 Which of these telemedicine changes are permanent? 19:39 “A visit is a visit … so why would you reimburse at a lower rate?” 19:57 “Telemedicine … is, by its nature, more efficient … and they should be able to figure out how to make money.” 27:17 What are health system plans that own their specialty pharmacy groups doing right now? 29:57 What does Darwin Research Group focus on? You can learn more at darwinresearch.com or by emailing John at jm@darwinresearch.com. You can also listen to the podcast Health Care Rounds wherever you listen to podcasts. @johnmarchica of @DarwinHealth discusses #virtualhealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth #virtualfirst #healthcaresolutions What were John's top three health system findings during COVID? @johnmarchica of @DarwinHealth discusses #virtualhealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth #virtualfirst #healthcaresolutions What is priority for integrated delivery network health systems right now? @johnmarchica of @DarwinHealth discusses #virtualhealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth #virtualfirst #healthcaresolutions Why do health systems have a renewed focus in primary care? @johnmarchica of @DarwinHealth discusses #virtualhealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth #virtualfirst #healthcaresolutions How did infusion centers manage throughout the pandemic? @johnmarchica of @DarwinHealth discusses #virtualhealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth #virtualfirst #healthcaresolutions “It's not just in cancer, people not getting screened and being diagnosed; it's in other areas as well.” @johnmarchica of @DarwinHealth discusses #virtualhealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth #virtualfirst #healthcaresolutions Which of these telemedicine changes are permanent? @johnmarchica of @DarwinHealth discusses #virtualhealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth #virtualfirst #healthcaresolutions “A visit is a visit … so why would you reimburse at a lower rate?” @johnmarchica of @DarwinHealth discusses #virtualhealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth #virtualfirst #healthcaresolutions “Telemedicine … is, by its nature, more efficient … and they should be able to figure out how to make money.” @johnmarchica of @DarwinHealth discusses #virtualhealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth #virtualfirst #healthcaresolutions What are health system plans that own their specialty pharmacy groups doing right now? @johnmarchica of @DarwinHealth discusses #virtualhealth on our #healthcarepodcast. #healthcare #podcast #digitalhealth #virtualfirst #healthcaresolutions

EP325: The Show in Which Dr. Mai Pham Disagrees With Three of My Value-Based Care Premises

Play Episode Listen Later Jun 10, 2021 37:11

First of all, a shout-out to all of you listeners who have shared this show with colleagues and LISTSERVs—really appreciate it. It's because of you and your efforts to share that Relentless Health Value maintains its spot as one of the top podcasts reaching health care executives, executives who take the insights shared by our guests to drive actual change and transformation across our industry. So, thank you. Leaving a rating and/or a review on iTunes is also the bomb and really helps our RHV team stay motivated and keep it going. Weekly shows take a ton of work! Feedback is super appreciated. On to the topic this week: Who has read that white paper put out in February by the University of Pennsylvania, specifically, Penn's Leonard Davis Institute for Health Economics? It's called “The Future of Value-Based Payment: A Road Map to 2030.” I mentioned this paper last week, too. So, if you still haven't read it, go back after this show and take a look. There's links in show notes. As with every interesting white paper, while you're reading it, you start thinking of more questions. That's why I was thrilled to get a chance speak with Mai Pham, MD, MPH. She is one of the paper's authors, a physician, and a trained health services researcher. Dr. Pham is a former chief innovation officer at the Centers for Medicare & Medicaid Services (CMS). She also spent time at Anthem doing value-based care (VBC) work for the enterprise on a national level. Further, she's the parent of an autistic child and founded the Institute for Exceptional Care to transform health care for people with IDD (meaning intellectual developmental disabilities), which I'll get to in a second. Here's some highlights from my discussion with Dr. Pham: Markets get distorted when insane quantities of dollars rush in. I'm thinking about Medicare Advantage and all of its attendant suppliers right now. Think about all of the amazing brainpower captivated by figuring out how to upcode at scale, which, by the way, only a minority of the time corresponds to actual spend. Dr. Pham has some words on this. Attaining value-based care results and adoption has a big problem. As a policy maker, you can't just keep trying to sweeten the value-based care pot. You don't want to plow even more money into the system. So, at a certain point, we all have to get real and realize that for the cost-driving entities in this country—those IDNs (independent delivery networks) with huge market clout—to get on the VBC bandwagon, value-based care probably has to be a mandate; and it also will mean making FFS (fee for service) much less attractive. Thirdly—and here's something I never considered—commercial prices drive up Medicare prices. You have hospital systems pointing to growing disparities between commercial rates when they negotiate for higher Medicare rates, when the hospital systems themselves created those deltas with their private-sector negotiations. Lastly, we chat national versus local health care reform and about indie doctors and the “why” behind consolidation. It aligns quite a bit, our conversation in this health care podcast, with the insights from the show last week with Nicole Bradberry and Kelly Conroy (EP324). The last 6 minutes of this podcast is Dr. Pham's insight about the scope and impact of not caring adequately for people with neurodevelopmental disabilities. We're talking about somewhere between 10 and 16 million people, as Dr. Pham notes for perspective. That's the number of new cancer cases each year. Collectively, we spend as a country somewhere between 1% and 2% of the GDP all in on this patient population. You can learn more at ie-care.org. Hoangmai (Mai) H. Pham, MD, MPH, is a general internist and national health policy leader. She was vice president, provider alignment solutions, at Anthem, Inc., responsible for value-based care initiatives at the country's second-largest health insurance company. Prior to Anthem, Dr. Pham served as chief innovation officer at the Centers for Medicare & Medicaid Services, where she was a founding official, and the architect of Medicare's foundational programs on accountable care organizations and primary care. She was co-director of research at the Center for Studying Health System Change and has published extensively on provider payment policy and its intersection with health disparities, quality performance, provider behavior, and market trends. Dr. Pham serves on numerous advisory bodies, including the National Advisory Council for the Agency on Healthcare Research and Quality, the Maryland Primary Care Program, and the National Business Group on Health, and was a member of the Board Executive Committee at the Health Care Transformation Task Force. Dr. Pham earned her bachelor's degree from Harvard University, her MD from Temple University, and her MPH from Johns Hopkins University, where she was also a Robert Wood Johnson Clinical Scholar. 04:22 What are the nuances within the promises of value-based care? 05:34 “For the first 10 years of … value-based care, it was right in order to generate momentum and get as much participation as possible.” 06:41 “When you leave yourself open to tackling prices, now you open up a whole world of possibilities in terms of how you could redirect sources.” 08:00 “Not all providers are the same.” 09:24 “It's time to stop tracking the phenomenon and actually pay for change.” 10:29 “We haven't done our best to actually make the alternative to value-based payment as bad as it could be.” 12:14 What's the path forward in value-based care, especially for specialists? 15:43 “There has been tremendous business opportunity in Medicare Advantage, not to the benefit of the trust funds.” 17:13 “As a citizen, I gotta ask, ‘How much is enough?'” 19:03 “It's not like we're talking about replacing a really superlative gold standard.” 19:34 EP263 with Andrew Eye from ClosedLoop.ai. 22:02 “It's not just about taking dollars away from certain subsectors; it's about reallocating some of those dollars.” 23:34 “Policy making itself tends to be siloed.” 25:02 “This is about paying some people in health care modestly less.” 25:35 “Most of the costs are driven by fixed costs.” 29:25 “Value-based care is not what has driven consolidation.” You can learn more at ie-care.org. @HoangmaiPham discusses #valuebasedcare on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc What are the nuances within the promises of value-based care? @HoangmaiPham discusses #valuebasedcare on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc “For the first 10 years of … value-based care, it was right in order to generate momentum and get as much participation as possible.” @HoangmaiPham discusses #valuebasedcare on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc “When you leave yourself open to tackling prices, now you open up a whole world of possibilities in terms of how you could redirect sources.” @HoangmaiPham discusses #valuebasedcare on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc “Not all providers are the same.” @HoangmaiPham discusses #valuebasedcare on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc “It's time to stop tracking the phenomenon and actually pay for change.” @HoangmaiPham discusses #valuebasedcare on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc “We haven't done our best to actually make the alternative to value-based payment as bad as it could be.” @HoangmaiPham discusses #valuebasedcare on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc “As a citizen, I gotta ask, ‘How much is enough?'” @HoangmaiPham discusses #valuebasedcare on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc “It's not like we're talking about replacing a really superlative gold standard.” @HoangmaiPham discusses #valuebasedcare on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc “It's not just about taking dollars away from certain subsectors; it's about reallocating some of those dollars.” @HoangmaiPham discusses #valuebasedcare on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc “This is about paying some people in health care modestly less.” @HoangmaiPham discusses #valuebasedcare on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc “Value-based care is not what has driven consolidation.” @HoangmaiPham discusses #valuebasedcare on our #healthcarepodcast. #healthcare #podcast #digitalhealth #vbc

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#131: Post-COVID Partnerships Between Pharma and Integrated Delivery Networks, with Sean Brusky

Proximity Health: Insights to Access

Play Episode Listen Later Apr 16, 2021 52:52

Sean Brusky, health care entrepreneur, executive advisor, strategist, and former head of health care delivery innovation at Genentech/RocheSean’s career has developed around a central theme: How can we innovate to help Pharma become true partners in value-based care? Over the course of 15 years in various leadership roles with Genentech/Roche, Sean has lived experience attempting to solve the problems at the core of this challenge, directly engaging key market stakeholders from the seat of one of the world’s largest integrated health care companies, focused on both innovative new medicines and novel diagnostics, and real-world data solutions. Sean has built and led teams responsible for brand-focused marketing and sales, managed care marketing, channel contracting and engagement, integrated health system engagement, government and commercial payer engagement and, most recently, digital health partnerships and novel approaches to health care delivery. He spearheaded Genentech’s efforts to execute value-based pricing models in collaboration with health systems and group practices. He has directly initiated and executed more than 20 novel commercial and medical partnerships in the personalized medicine, digital health, and value-based contracting space. This unique blend of business development, commercial, managed care, medical affairs, and strategy experience has contributed to Sean’s unique perspective on what is broken about the current pharmaceutical pricing, purchasing, and partnership model and how we can fix it. John Marchica, CEO, Darwin Research GroupJohn Marchica is a veteran health care strategist and CEO of Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. He’s a two-time health care entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest-growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade.John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives. About Darwin Research GroupDarwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz., with a satellite office in Princeton, N.J.

Engaging with IDNs - Pt. 2

Play Episode Listen Later Feb 4, 2021 18:56

In the second of this two part series, Lee and Michael reflect on past experience working in or with Integrated Delivery Networks. Michael shares frameworks for two primary account management strategies and offers examples from past experience working with manufacturers' account teams.

engaging idns

Engaging with IDNs -Pt.1

Proximity Health: Insights to Access

Play Episode Listen Later Feb 3, 2021 21:08

In this episode, Lee sits down with Michael Hillman of DriveTrain Learning to discuss strategies for engaging with large complex Integrated Delivery Networks. In the first part of this two part series, Lee and Michael highlight key frameworks for developing account management strategies.

engaging idns

How TCO Can Win You Customers with David Newton

Med Tech Gurus

Play Episode Listen Later Jan 6, 2021 26:08

Why would you ever want to discuss Total Cost of Ownership for your product? Why would you want to illustrate the CAPEX and the OPEX. In this episode of Med Tech Gurus we have Mr. David Newton Vice President of Supplier Relationships and catalog for Attainia with us. David discuss the importance of this transparency. In his world the IDNS are going to look for your number and if they cant find it they will develop their own. Seriously, which would you rather them have. David discusses some of the best practices Attainia has developed and how they can help since a positive light on your product portfolio, Gurus, you will love the value that David brings us!

gurus customers ownership capex opex total cost david newton idns

Behind the scenes of .eu: Giovanni Seppia im Interview (Part 1)

Snapshot – Digitale Themen auf den Punkt gebracht

Play Episode Listen Later Nov 27, 2020 30:35

In Snapshot #24 sprechen wir mit Giovanni Seppia, External Relations Manager bei der Registrierungsstelle EURid, über die Top Level Domain .eu und die Zusammenarbeit mit der europäischen Kommission. Außerdem geht es um IDNs und die Einführung der kyrillischen Endung von .eu. Diese Folge wurde produziert von Nadine Jäger und Natalie Berrisford.

european union behind the scenes diese folge zusammenarbeit einf kommission top level domains idns endung

Innovation in Care Delivery with Aneesh Chopra

The Dish on Health IT

Play Episode Listen Later Nov 4, 2020 39:19

This episode features guest Aneesh Chopra, the first Chief Technology Officer of the United States and more currently, the co-founder and president of CareJourney. Hosts Gary Austin and Ken Kleinberg sit down with Aneesh to discuss smarter choices the industry can make to move more quickly towards value based care, specifically direct contracting and third party apps.Aneesh first gives some background on his company CareJourney. He explains that CareJourney is, in many ways, the private sector implementation of his passion of serving in government around open data, open APIs and payment reform. His primary mission is to make sure we use all these open resources to help patients, through the organizations they trust, make smarter decisions throughout the healthcare delivery system.Gary asks Aneesh to overview direct contracting as well as what's to win here for providers. Aneesh says direct contracting is ripping the band-aid off the move to value-based care. Direct contracting is Medicare Advantage-like, but without the insurance company and without the consumer changing their actual insurance benefits. They retain all their Medicare benefits, but they have their capitated dollar. They can bring their resources to a primary care group and integrated delivery network to help them better manage their care without taking away any of their rights to see any doctor they wish. This model is a leapfrog from training wheels to full downside capitated risk. Aneesh explains that remote patient monitoring could be a category. CMS explicitly invites applicants who have proposals who can reduce the cost burden and improve quality for high needs patients, especially those who have historically fragmented care. The model allows for these entrants to drive the process and bring along a physician network that may help administer some of the services. Aneesh thinks it is traditional doctors and networks applying from Medicare Shared Savings to direct contracting.Gary asks Ken how interoperability plays into these arrangements. Ken says risk is about what you know and what you can control. The more you know, the better you can control that risk. Interoperability can bring in all kinds of data about that patient, traditional clinical data, social determinants of health and claims data. We can pull information from many different sources and understand our population in ways we've never been able to before. That gives you the power to control risk and do a better jobGary asks Aneesh what he thinks of the “patient gets everything from everyone, on demand, delivered anywhere model.” Is it good for the marketplace? Aneesh says it's great for the marketplace. It builds the healthcare data sharing infrastructure on a foundation of “must share.” One of the challenges we've had for the last 20 years is that we've built all these data sharing networks and policies that try to square a complicated circle. We are saying we want all of the information flowing where it's needed, but we have to honor the HIPPA minimum data necessary provisions. So, the broader the network, the broader the use cases, the weaker the signal because by definition, someone is on the network to do something that is only entitled to a minimum amount of data. If I have to join a network where I've got to meet the lowest common denominator, I'm not going to get the information I need nor am I going to help make better decisions for people because limited information, limited affect. What we need is a mechanism to right size the information sharing to the legal frameworks under which those information sharing provisions exist. The consumer's right to access health information by being bedrock as a foundational right in HIPPA. Now technically materializing through these two rules is a smarter method of sharing data because no matter what I am entitled to my full medical record and if I choose to share it with my primary care doctor, that's my choice and that's my right. Gary asks Aneesh how to get payers moving along. Aneesh suggests that instead of just working to meet the letter of the rule, payers should ask themselves what they are doing to meet the spirit of the rule and how that benefits the strategic plans of their organizations. His overarching message is shift from defense to offense. How can the investments you're making advance the goals you have? What apps are you putting in the hands of your consumers? Are you working to get those apps connected to every single EHR in your network? Ken agrees with Aneesh on the compliance. He says these organizations often ask themselves what is their bigger fear? Is it financial penalty? Losing some business? Will we do the best by just giving the minimum possible? In the end, what you're really trying to do is meet the business objectives, which is increase your brand and gain loyalty. You do that by providing information in a format that's more usable. That's where a lot of these technologies can play a role. That's where we get into these apps. You have the potential to give people information in a format that's usable to them. Gary moves the conversation to third-party health apps. Aneesh views CommonHealth and Apple Health as infrastructure. He notes there is a hypothetical fear that Google, Amazon, or Apple are going to swoop in and take over healthcare, but he does not believe that is the case. Aneesh says if anything, Google, Microsoft, and Amazon are going to be infrastructure partners to existing players in healthcare or these new direct contracting entities who are managing risk, building clinically integrated networks and engaging patients.Gary asks Ken what he thinks of third-party apps. Ken agrees with Aneesh in that trust starts with primary care physicians. Primary care physicians are likely going to go with apps that work with the EHRs and the portals that they are already familiar with. With regulations coming up, some consumer-type apps may surface that tend to do a better job than what might have been offered to the physician and their EHR vendor. As community pressure builds, the physician may go back to their EHR vendor and ask why they can't support this. That can drive some advance here. Gary asks Aneesh if this is an opportunity for payers to engage their members more deeply. Aneesh explains that high need patients suffer from terrible care fragmentation. It's so obvious that the plan can do a better job here. The decision support to go from fragmentation to coordination is best done by an entity that is trusted by the consumer to do that coordination. You want to trust an app that can be connected to a portal, get the updated feeds and have other context about my healthcare needs. Gary asks Ken for his closing remarks. Ken says this really has been a long journey, measured in decades. He is optimistic that things are getting better. Interoperability in the past decade or two has been like the wild west. Now, he thinks we are aiming with FHIR, projects like Da Vinci and USCDI to be much more practical. That's going to benefit everyone.Aneesh shares in Ken's optimism. We don't have the luxury of waiting decades for this chapter to have success. So, while it does take decades, we must move faster and make smarter decisions to comply with the rules, embrace value-based care and better engage consumers. These things will help accelerate that timeline. Let's do it smarter, together.

Podcast 58 - 4 Reasons Why Supply Utilization Savings Are Better Than Price Savings

Play Episode Listen Later Aug 7, 2020 27:45

I was just made aware by my staff last week that they are now seeing annualized price savings for even the most contract compliant hospitals, systems, and IDNs that have shrunk to 1% to 2% from 2% to 4% of overall budget over the last decade. This is a startling change in supply chain economics that I would credit to the positive impact of national and regional GPO contracts over the last ten years. However, these price reductions (1% to 2% annually) aren't nearly robust enough to move the needle on supply expenses in today's unstable healthcare economy. That's why it is mission critical for healthcare organizations to formalize, operationalize, and institutionalize (see explanation video) their supply utilization programs (SUM) to close their price gap. To sell this concept to your senior management, here are four reasons why supply utilization savings are better than price savings in our ever-changing healthcare marketplace:

price supply savings sum utilization gpo idns

Podcast 58 - 4 Reasons Why Supply Utilization Savings Are Better Than Price Savings

This Week in Health Innovation

Play Episode Listen Later Aug 7, 2020 27:44

I was just made aware by my staff last week that they are now seeing annualized price savings for even the most contract compliant hospitals, systems, and IDNs that have shrunk to 1% to 2% from 2% to 4% of overall budget over the last decade. This is a startling change in supply chain economics that I would credit to the positive impact of national and regional GPO contracts over the last ten years. However, these price reductions (1% to 2% annually) aren’t nearly robust enough to move the needle on supply expenses in today’s unstable healthcare economy. That’s why it is mission critical for healthcare organizations to formalize, operationalize, and institutionalize (see explanation video) their supply utilization programs (SUM) to close their price gap. To sell this concept to your senior management, here are four reasons why supply utilization savings are better than price savings in our ever-changing healthcare marketplace:

price supply savings sum utilization gpo idns

Meet Bob Matthews CEO MediSync.com

Play Episode Listen Later Jul 17, 2020 28:00

My guest is Bob Matthews President and CEO of MediSync a leading management and solutions provider building an engaged network of medical group senior leadership pursuing better outcomes via analytics, planning and sustainable solutions. We get his take on the impact of Covid-19 on U.S. healthcare operations and insights into the advancement of value based healthcare.. Bob is a veteran healthcare executive with extensive experience as Executive Director of three medical groups for over 13 years. During his tenure, the groups expanded physicians three fold, increased payer contracts by more than 45%, and developed and deployed chronic disease management programs that led the nation in outcome results. He helped to greatly enhance medical group financial performance, resulting in increased physician compensation. Prior to MediSync, Bob had a national healthcare consultation practice with leading medical groups, hospitals and insurance companies, focused upon medical group formation, development, and performance. For more information on Bob and Medisync's work in the value based healthcare economy go to: www.medisync.com

covid-19 ceo executive director acos value based healthcare accountable care idns bob matthews

EP284: When Prescribers Know How Much a Drug Will Cost Patients at the Point of Prescribing, With Carm Huntress, CEO and Cofounder of RxRevu

covid-19 healthcare medical supply chief strategy officer cme idns

Play Episode Listen Later Jul 16, 2020 34:46

There is a transparency zeitgeist kicking off right about now. In June was the biggie, the one where health systems now have to divulge their contracted rates with insurance carriers starting January 1, 2021. But this zeitgeist is flowing into drug prices as well. Surescripts just released their real-time prescription price transparency tool. This price transparency tool allows detailed cost and alternative drug information to be seen in real-time. Surescripts, by the way, is owned by several large PBMs (pharmacy benefit managers). Can the prescriber see how much drugs will cost the patient as they are writing the prescription? The answer is yes if that prescriber is using a tool to display the prices in their EHR (electronic health record) or e-prescribing system. That is pretty cool and could save a whole lot of rigamarole and time for both the prescriber and the patient who doesn’t now have to go the whole way over to the pharmacy to figure out the drug price is unaffordable. I just want to bring up one point to be aware of: Surescripts is, as aforementioned, owned by some PBMs. PBMs are not exactly non-profits. They do a great job for their shareholders collecting middle-man dollars from pharma and pharmacies and patients alike. The copay amount a patient pays is a decision that is made, in many cases, by a PBM. So, showing the PBM-set patient price at the point of care to doctors increases PBM leverage in conversations with at least pharma. You see what I mean? Maybe that’s good if the PBM actually takes the dollars it shakes out of pharma and gives it to employers or the patients, the government or pays pharmacies they don’t own fairly. Maybe it’s bad if the PBM uses its additional leverage to, I don’t know, start its own GPO (group purchasing organization). In Switzerland. Wait, what?! Yeah, that happened. All I’m saying is, this is a tangled web we weave with implications for pharma, pharma's PBM negotiations, pharmacies and patients as patients and also patients as members of plans. Here’s a really important point that I need to make. Nobody in the health care industry is conflict free. Not PBMs, not IDNs (integrated delivery networks), not you, not me. I love transparency and I love sparing doctors and clinicians administrative burden. If I were a provider organization, I would definitely use this tool. But here’s what I need to say… in addition to transparency showing the copay of a drug and the best pharmacy to get it at, these systems also make transparent the underlying levers of the system itself if you look at them in a kind of pattern-wise way. So, if I’m a doctor and I find it weird that the lowest price is always at the pharmacy owned by a PBM, for example. Yeah, it’s up to you to start asking questions. My hope is that everyone sticks with the spirit of the endeavor and gets to the heart and the potential of transparency and chooses the path that benefits the patient the most. To that end, I am speaking in this health care podcast with Carm Huntress, who is the CEO and cofounder of RxRevu. We talk a lot today about how showing prescribers how much drugs cost can really help patients avoid financial toxicity and/or a whole lot of running around getting prescriptions changed to drugs that are on-formulary. You can learn more at RXrevu.com. You can also connect with Carm Huntress on Twitter at @carmhuntress. Carm Huntress is CEO and cofounder of RxRevu. As CEO, Carm has successfully taken prescription decision support from a concept to a reality for physicians, payers, health systems, and patients. At the core of this work is to transform the value of health care through better prescribing decisions. At a national level, Carm has played a key role in supporting interoperability and patient access to data through the development of the Fast Healthcare Interoperability Resources (FHIR) standards and other projects with the Office of the National Coordinator (ONC). 04:25 The protracted way doctors prescribe drugs right now. 06:15 “What is the macro thing we want to have happen here?" 08:10 Where we are today. 08:38 Value-based contracts. 10:10 Who is hurt by higher-cost alternatives. 12:50 The number one thing doctors get out of drug cost transparency. 13:20 The second thing doctors get out of drug cost transparency: patient satisfaction. 13:55 The downside to drug cost transparency. 14:40 “We gotta back up and just say, ‘What do we want?’” 16:30 How real-world evidence is going to affect drug pricing and rationalization. 17:43 “They’re waking up to the new world.” 20:20 How copays play into this. 20:45 “What’s the total cost, what’s the patient cost, and what are the alternatives?” 22:00 The history of formulary and benefit. 26:41 The problem with specialty drugs. 29:30 “Can we just start with first principles here?” 29:40 “We don’t really think about socio-economic factors.” 29:43 “What can you really pay?” 31:00 Why do IDNs care about drug pricing transparency? You can learn more at RXrevu.com. You can also connect with Carm Huntress on Twitter at @carmhuntress. Check out our newest #healthcarepodcast with @carmhuntress of @RxRevu as he discusses patient cost for prescription drugs to the point of care. #digitalhealthcare #healthcare #podcast #digitalhealth The protracted way doctors prescribe drugs right now. @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth “What the macro thing we want to have happen here?” @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth Value-based contracts. @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth Who is hurt by higher-cost alternatives? @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth The number one thing doctors get out of drug cost transparency. @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth Patient satisfaction with drug cost transparency. @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth Is there a downside to drug cost transparency? @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth “We gotta back up and just say, ‘What do we want?’.” @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth How is real-world evidence going to affect drug pricing and rationalization? @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth “They’re waking up to the new world.” @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth How will copays play into drug cost transparency? @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth “What’s the total cost, what’s the patient cost, and what are the alternatives?” @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth “Can we just start with first principles here?” @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth “We don’t really think about socio-economic factors.” @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth Why do IDNs care about drug pricing transparency? @carmhuntress of @RxRevu discusses patient cost for prescription drugs to the point of care. #healthcarepodcast #digitalhealthcare #healthcare #podcast #digitalhealth

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The State of The Medical Supply Industry with Cindy Juhas

Champions of Care

Play Episode Listen Later Jul 15, 2020 35:35

Healthcare systems find themselves needing to maximize operational efficiencies to remain viable in a period when the COVID-19 pandemic makes everything a heightened challenge. Even before the pandemic struck, estimates projected that 50% of the healthcare industry in the U.S. will be part of the top 50 IDNs due to the need to realize economies of scale and survive. Cindy Juhas, Chief Strategy Officer for CME Corp, spoke about these challenges and how the medical supplies industry is coping with the situation. Like most medical suppliers, the onslaught of COVID-19 and the spike in specific equipment and supply needs proved challenging to manage, even for Juhas's company. “The demand was so great that we couldn't meet the demand. No one could,” Juhas said. “Everybody was back-ordered. We were sourcing all over the place.” Even an item most take for granted, thermometers, was sourced from over 15 different suppliers. The pandemic showed that the nation's healthcare systems need better preparedness while streamlining processes to keep costs down. Now, more than ever, healthcare systems need medical suppliers' help to handle the logistics end and are ready to help with supplies at a moment's notice. Juhas said customers recognize the need to work on their emergency preparedness plans, and CME wants to help them in that area.

42: Do Something to Make a Difference, with Ken Paulus, President and CEO, Prime Therapeutics

Fireside Chat with Gary Bisbee, Ph.D.

Play Episode Listen Later Jun 30, 2020 37:16

Transcription:Ken Paulus 0:03Caregivers will be put back in a position to drive these big complicated specialty treatments instead of throwing these patients over the wall to us. And I think pharma will move from a sales model to a knowledge model where their job is to put information in the hands of caregivers, health plans, and members to make the right decisions at the right time in the right placeGary Bisbee 0:28That was Ken Paulus, President and CEO Prime Therapeutics, discussing the fragmented nature of today's healthcare system. I'm Gary Bisbee and this is fireside chat. Ken has been a health plan and large IDN CEO and now leads a pharmacy benefit manager with 30 million lives. He's in a unique position to comment on integration between pharma health plans and providers. Let's listen to Ken express the need for an air traffic controller to manage care for the patientKen Paulus 0:57I'm most concerned about fact that today, for any given American, there's really no captain of the ship. There's really no clear advocate or some person, entity-relationship that is air traffic control for a patient in need.Gary Bisbee 1:17Our conversation includes Ken describing the role of the PBM. And its value equation, barriers to quality and outcomes confronting caregivers, the need for physicians to be in charge complicated care paradigms, how Prime Therapeutics work with the federal government to ensure specialized drugs remain available during the COVID crisis, and the importance of developing a long term relationship with the patient. Let's listenKen Paulus 1:42COVID has shown us that we need somebody to focus on that long term relationship and it's just not happening today. Again, with great challenges come great opportunities now that's a big one. And if I was running a health plan business or an IDN right now I’d be running like heck, to solve that problem and fill that void. Our nation needs it now.Gary Bisbee 2:05I'm delighted to welcome Ken Paulus to the microphone. Well, good afternoon, Ken, and welcome.Ken Paulus 2:16Gary, Thanks for the invite. And I really look forward to talking to you today.Gary Bisbee 2:20I've interviewed you in person a couple of times with live audiences. So we're delighted to have you at the microphone. Let's get right into your background if we could. I know you grew up in the Chicago area. What was it like growing up? You had five siblings, six of you in the family? What was it like growing up with that group?Ken Paulus 2:38It was a very special upbringing, in a way. I'm from a middle-class family. My dad was a grocery store manager. My mom ultimately was a homemaker became a teacher, but neither one of them finished college. Kind of a classic Catholic family where they started having a family early both of them had to quit and basically raised the family. It was kind of a values-based upbringing. In even though we didn't have a lot, it was rich and full and positive and supportive and ended up being what gave me a lot of my resilience and in a lot of ways, feeling supported regardless of the circumstances. It's all good. I mean, I say I had a very good upbringing and nothing I look back on in a negative sense, other than maybe I was a little bit of a rebel and got myself into a little bit of trouble as a teenager.Gary Bisbee 3:25Well, there's learning there as well.Ken Paulus 3:28Yes, there is. I have some scar tissue from those days. But I was blessed in so many ways.Gary Bisbee 3:32Right. We were talking before and you indicated you basically worked your way right from the very early days right through school, that that turned out to be a good experience, any lessons learned there?Ken Paulus 3:43It was interesting. My parents didn't finish college. So it was very clear with them that we were all going to college and there is an expectation you go to college and you go to grad school or medical school or law school, so you're not stopping at a four-year degree and I'm thinking, well, who's paying for that? And the answer was you are. And the only way to pay for it was to work basically every free moment. So I had a paper route until I was 13 or 14 and then I became a busboy at an Italian restaurant and believe it or not, was owned by the mafia, and worked there for two or three years. And then when I was old enough to get a real job, I became various jobs within the grocery business because my dad had friends that could give me jobs. And I did everything. I was literally a night crew worker. I was an apprentice meat cutter a couple of summers, I did it all. And I learned a ton the learnings from how and when you saw good management was fairly readily observed if you were willing to observe us and I have to say I learned a lot about management from all of those crazy jobs. It's a good experience.Gary Bisbee 4:52Six siblings in the family. You're all in healthcare. How did that work out?Ken Paulus 4:57Well, it was interesting. My mom in particular had three things that she expected of us and I'll never forget it. And it really rang true for all of us. One was going to college, as I mentioned, the second one was critical. And she said, and both of them actually did this. They said, You really have to do something where you're making a difference. And then the third one was just an oddball thing. They're both smokers. They both quit in their middle-age years. And the third thing was don't smoke, please. And if you don't smoke by the time you hit 21, you get $100. So, I'm like wow, okay, well, that's worth it. And I never got my hundred dollars, but I never smoked so that was good. So this making a difference. Standard and expectation are what I think led us all into the helping profession of healthcare and it's been exceedingly rewarding and I'm so happy I'm in this business. I really love it.Gary Bisbee 5:46Well, after college at Augustana in Illinois, off to the University of Minnesota, the MHA program was the leading MHA program at that time, what got you to the Minnesota MHA program?Ken Paulus 6:01Gary, it was mostly that it was that they were the best in the nation at the time. I think they're still probably top five or so. And I was a science major. I was a human physiology major. But I have an entrepreneurial business streak in me. And I was literally trying to find an industry that married science with business. And healthcare is really the perfect combination away for me. Once I figured out that that's what I wanted to do, and I wanted to work in the nonprofit side of things. Then I just went on the search for the best program and this program in Minnesota was the best program and I have to say, it was an eye-opener and a critical event in my life to open my eyes to a much bigger opportunity set. It really was very possible.Gary Bisbee 6:47What was your first job then out of the MHA program?Ken Paulus 6:50So this 21 or 22-year-old kid, having never stepped foot in a hospital before this point in time has only worked in grocery stores and restaurants. I literally stepped foot into this hospital as a fellow post-graduate school and became an assistant vice president of a hospital that's part of Catholic healthcare West in Los Angeles. And it was quite the experience. I literally remember the first day on the job, the CEO said, Well, Ken all of your direct reports are waiting for you up in the conference room on the seventh floor. Introduce yourself. I said, Okay. I walked into the meeting. There were 10 folks around the table all roughly in the 40s and 50s. mostly women, as it turns out, running departments like occupational therapy and PT and nursing leaders. And I sat down at the head table and they looked at me and the first woman said, well, who are you? And I said, Well, I think I might be in charge of all these departments and they laughed out loud. No, like They laughed and they said, Are you kidding me? They all had 20 years on me. But I will say, Gary, I made one critical move that was probably saved my career. I just said, Hey, listen, I don't know anything about management and leadership. I've really never done it before. So if you all are willing to teach me, I'm willing to learn and I will try not to annoy. And they became just stunningly good leadership group. And they taught me management and leadership, these middle-aged men and women, mostly women and healthcare, taught me how to lead and forever I will be thankful and in gratitude for that experience, it was really special.Gary Bisbee 8:40What took you from that start to Partners Community Healthcare in Boston.Ken Paulus 8:44I had worked in California for the better part of probably a decade or more. And actually, my boss, the CEO, was pinged by a recruiter to come out to Partners Healthcare System, which is a brand new system that was just been formed. And they wanted him to lead the creating the risk-bearing entity partners called Partners Community Healthcare, Inc. and he declined. And he's a California guy, he's not leaving the state. And in an incredible show of support of me, he said, Ken, I hate to even bring this up to you because you are like, my number two, go-to guy. But I actually think this might be a really great job for you. And I don't want you to go I don't want you to take this wrong. I just want you to know that I'm a mentor, and I'm your friend. I think you should at least have a conversation if you can work for the mass general of Brigham in Harvard Medical School and have that on your CV it's probably gonna change your life. I said, Really? You're telling me you think it's a good idea? He said I don't want you to leave. But I think I owe it to you to take a look at it. So I did and next thing you know, I was In my car driving cross country and working at Partners. As probably the fourth or fifth employee hired post-merger, the Brigham in general.Gary Bisbee 10:07Wow, that was a terrific opportunity. What did you learn about managing risk there?Ken Paulus 10:12Oh, gosh, scary. I have so much scar tissue from those days. We built this risk network, this group of physicians and acquired a number of primary care practices, married them in our network to all the specialists of the Brigham and the general and then took full risk, full capitation risk, but with Blue Cross of Massachusetts. And we proceeded to get our hats handed to us. We just got crushed. We lost so much money so fast that we literally had to go to Blue Cross, we said that we just have to tear up this contract. We can't, we can't do it. And we did. They agreed, thankfully, to tear up the contract and start over. And what I learned was we were ill-equipped to take full risk. We've had no data. I had no systems to manage risk. No way to track patients and patient care. The incentives are completely wrong. Our teaching hospitals nationally Brigham wanted to bring everybody into a tertiary center. And that's just doesn't work with a risk insurance business. So we were just upside down in terms of our ability to take on risk and we lost a lot of money. It was quite a learning experience. I never want to repeat it. But again, that scar tissue is invaluable. And there's so much to be learned from the process.Gary Bisbee 11:28Great foundation, though, ultimately, you made your way to become the CEO at Allina in Minneapolis, what caused you to want to tackle a leading health system?Ken Paulus 11:38It had been on my mind Gary for a while that I was looking for a place where the physicians, the hospitals, and all the ancillary services of pharmacy and lab and home care and hospice and all that could all reside under the same roof. And if I had a chance to run a company that had all those pieces in one place, could I do something different and special to really put a dent in what I think are many intractable problems in healthcare. So that's what attracted me. And I think secondly, I'm from the Midwest, I had always wanted to come back to the Midwest at some point. But it was mostly this engaging opportunity of having all the pieces in one place. And it was quite a good ride. It was there for just under a decade, and I really, really liked it. It was good fun. And I think we made a ton of progress.Gary Bisbee 12:26If you could identify one main lesson that you learn to lead a large health system, what would it be Ken?Ken Paulus 12:32It was plus-minus Gary, On the plus side. I think having the physicians as part of the health system was crucial. I can't imagine a day where we'd ever go back or the caregivers, not just doctors, but doctors and nurse practitioners and all the people that take care of patients every day, day in and day out. Having them on the team was critical and crucial. And I think that allowed us to do some things that we wouldn't have been able to do otherwise, I think the negative or the downside of at least our idea was we were still so acute care centric, that limited our ability to innovate. And we were hooked on the drug of fee for service medicine. And because of that, all of our profits came from our hospitals. And the more acute, the more complex, the more of a specialty nature of treatment. The more we did, the more we made. And we could not get off that treadmill. And I gotta tell you, I'm a fairly transformative thinker. And I like to find ways to disrupt healthcare. I put my shoulder to that wheel, and I made some progress, but not a lot. And it's just part of how healthcare is delivered that acute care was the center of the universe. That's where all the money was. And it was hard to ever leave that and we didn't really make much progress against that. Unfortunately, you know, for that I'll forever have some regrets.Gary Bisbee 13:59You've got an interesting background and just regionally, Los Angeles, Boston, Minneapolis Midwest, and you had some unrest there in Minneapolis. How do you kind of think about the balance between management outcomes, maybe unions, how would you factor all that in with what happened there in Minneapolis?Ken Paulus 14:20Well, it's interesting in all of the markets have worked in, they've all been very high concentrations of union activity. And I'm very neutral on unions. I think they play an important role in some ways. And I'm not anti-union. I'm not pro-union. I think it's part of the system and it can work. It has worked, and most of the places I've worked, it's been a really good outcome. What's really stunning to me in terms of what's happened here with the racial unrest in Minnesota, and particularly this behavioral issue with the police, is that we're finding as we dig deeper into it, that much of the problem lies with management's inability to To act and to deal with poor performance, and the union's ability, or at least creation of a structure that would keep management from moving out poor performers. And unfortunately, the lead actor in this most recent event was a poor performer with multiple examples of performance issues, and he could not be removed. And I think what it tells me is there has to be a new day with how management and labor work together. And we have to have more of a collaborative partnership model. And both parties need to be held accountable for performance. And we're lacking that today. It's more of an advocacy model today. And I think we have to move to a performance model and it's a real opportunity. And it's also one of the root causes of probably ended up where we are, at least in Minnesota, and how policing takes place here. And it's unfortunate but from every bad circumstance comes an opportunity. progress. I think that's what this is going to prove to be.Gary Bisbee 16:02Well, on a happier note, let's talk about Prime Therapeutics. You recently celebrated your one year anniversary with Prime. Will you describe Prime Therapeutics for us?Ken Paulus 16:13It's a very interesting industry and company, we're in the pharmacy benefit management space. And I've always been in the IDN side of things. I spent some time in the health plan business at Harvard Pilgrim Health Care when I was running the physician side of the staff model. So I know the health plan side, I know a lot about risk and capitation. Having done that, in many places across the country, we sit squarely in the middle between pharma, providers, caregivers, IDNs, if you will, and health plans and we are a construct of a broken system in some ways. The fact that the interest of pharma the interests of providers and caregivers and the interests of health plans are not aligned. And as such, the PBM industry came before and we're in the middle trying to get pharma care to reduce prices, through rebates and other management formularies, passing those savings on to health plans and then working with providers to manage utilization. And it is purely a construct of a system that doesn't work. And in the ideal world, if the United States healthcare system really was efficient, there's no need for us. Unfortunately, we aren't efficient, we're not aligned, the incentives don't really work, and we actually are critical right now to make sure that the cost of medicines does not spiral out of control. So we're a reflection of a broken system that's still compartmentalized and still has incentives that don't deliver the outcomes that our nation needs, which is a stunning thing for me to say as a CEO of a PBM. But that's quite frankly where we are.Gary Bisbee 17:48So why the transition to pharmacy benefits manager to Prime, why did you do that Ken?Ken Paulus 17:54Gary, I had run my course of working in the IDN side of things. And I have mostly worked with physicians and caregivers throughout my whole life. And I've loved it. I've absolutely loved it. But I really needed to see a different side of healthcare, I needed to get out from under the IDN space, and see how others view it. And mostly I'm seeing health care from the payer, and PBM pharmacy management space now. And I'll have to say some of the things I'm seeing I wish I would have known as an IDN leader. The fact of the matter is, we're missing some very important issues on the provider side that you don't see when you're in the middle of it. And now that I'm not in it, it's like, wow, it's very apparent that there's an opportunity. So I absolutely love it. I never thought I would. But it's a great learning experience. I've learned a ton about how this system works. And it's very interesting to see how insurance organizations and health plans view the health care world. It's quite different and quite important.Gary Bisbee 18:56So how does Prime work with the patient? How do you work with blue plans?Ken Paulus 19:02The plans really come to us to work with pharma to stand between them and pharma to make sure that they're getting a reasonable deal. That's basically in a nutshell what we do. So they at Prime we represent 30 million Americans across 23 states 23 blues plans, and our job is to make sure we represent with pharma with pharmaceutical industry, that block of business and we buy and procure and source all of the medications and treatments that pharma represents. we acquire those treatments on behalf of our health plan partners and try to do so to create efficiencies, and it's very effective. I have to say, I know there's a lot of unusual perceptions around the PBM space because it is so opaque. The fact of the matter is in at least in our case, we're transparent PBM we pass through everything to our health plans, which you see is what you get. We don't have a lot of these arcane structures to move money around within the system. And we do play a critical role I can tell you, there are billions of dollars of savings that come through to health plans, and then to employers and then ultimately to patients and members. That wouldn't be there, at least in today's healthcare industry, if we weren't doing our jobs. So very interesting. And it's a critical role that said here, I have to say there's some aspects of this business that are incredibly inappropriate and broken, that create undue friction, and actually, harm quality in some ways. Those are some of the things that I'm very excited about working on.Gary Bisbee 20:37How do you work with the IDNs then?Ken Paulus 20:40That's where I do think that we're creating barriers to the very best quality for patient care. And there are two ways I can see with the IDNs that we should be integrated and working with them. One is what I call the friction model. Our model today is built on creating, you know, I hate to say this but barriers and gates for providers and caregivers to get through to make sure that they follow a formulary so that we can then use that formulary to lever pharma to get a better price. And it's a crazy way to do business. But it's the only way we have right now. So we have a very high friction model that we use with caregivers and patients to put them through these barriers and gates if you will hurdles. And that forces the system to drive to an outcome that again, we can use then to save money. That's one big problem. I'm not a fan of using friction for caregivers and patients. And having worked on that side for 30 plus years, the friction is untenable. We are putting caregivers through so many hoops and barriers that they can barely get their jobs done now. So that's one major problem. I think the other major problem or maybe opportunity, is that what's happening and pharma is the science is stunningly good. I mean, if there's one industry in this world that we actually lead-in, it's this bioscience, this creation of new solutions to pithy, complicated healthcare problems through incredible advances in science. And I think we're gonna look back and say this is the golden era of development. It's like when antibiotics were created back 50 years ago, this whole business of using the genome to unlock opportunities to treat patients in very different ways. It's really stunningly good. What's remarkable about that is that while we're breaking through on a daily basis with science and finding these new solutions, they're very complicated. They're very expensive, and there's no integration between pharma what we do and what caregivers do. I think the second big opportunity is for the health plan and the PBM leaders organizations to work very closely with pharma and the provider side to create partnerships in ways that we don't have today. We're basically buying cooperatives now that's interesting. It's a short term solution to a big puffy, complicated, expensive problem. But I just don't think it's going to deliver us to Nirvana, I think we're going to need a very close relationship with providers. And once we have that, and we bring pharma into the equation, I think two really important things will happen. One is caregivers will be put back in a position to drive these big complicated specialty treatments instead of throwing these patients over the wall to us. And I think pharma will move from a sales model to a knowledge model where their job is to put information in the hands of caregivers, health plans, members, to make the right decisions at the right time in the right place. And boy, if those two things happen, we will advance quality lower costs substantially in our healthcare system. So that's what I'm really excited about those two things, taking unnecessary friction out of the system, and bringing in a partnership level perspective for pharma and providers and what we represent so that we can create a breakthrough. And that's what's exciting about this job.Gary Bisbee 24:20Very exciting. What's your guess, I mean, we talking three years, five years, 10 years for this change to unfold?Ken Paulus 24:26Unfortunately, Gary, I'm 61. And I can't do this forever. I am in a hurry. We have got to show improvement and progress on this in the next three, four years, we have got to put a down payment on this. So for lots of different reasons. One is it's what the healthcare system needs. Two, it will save substantial money. Three, it will vastly improve quality. And I think probably most important, if we don't do it, I just can't imagine how this fragmented healthcare system will survive. I just I'm not seeing it. I just don't think it's working today and we have so much to improve. This is probably my last chance to run a big healthcare organization that could make a difference. I have got to go out in good form, I have got to be able to look back and say I was part of the solution not part of the problem?Gary Bisbee 25:16Well, we're looking forward to that. We have some confidence you will make a difference can let's move on to the COVID crisis. What observations from your current vantage point? What observations have you made about trends that might have already been in occurrence but that the COVID crisis accelerated?Ken Paulus 25:34There really is one big one that has me quite concerned. And you can worry about our inability to track infectious disease and our lack of preparedness and all those things. They're all things that we need to improve. But I have to say I'm most concerned about the fact that there's today for any given American there's really no captain of the ship, there's really no clear advocate or some person, entity-relationship that is air traffic control for a patient in need. And this crisis brought that to bear. I mean, if you are sick during this COVID crisis, you couldn't reach a primary care doctor's office, it wasn't clear who you'd go to for advice on well, do I do this test or not? Do I go into urgent care now or not? It is a fragmented combination of solutions and you had to do the best you could. Do I call telehealth? Do I go drive into my office? Do I go to the ER, it just wasn't clear. And we are in this position where COVID put a light on this incredibly broken system of no coordination. And there's really nobody in charge. So the patient's left to his or her own devices. And man that is just not a way to run a healthcare system. And that's what we've got today. And I think What you're seeing across the nation is any number of approaches to how to manage this crazy thing. And we're, of course, we're not getting much leadership from the government, not that that would have made much difference, but there certainly isn't much leadership from healthcare either. The industry hasn't done a great job and we are very fragmented and we're paying the price the fragmentation right now.Gary Bisbee 27:20Did COVID affect Prime's business model at all or Prime's economics at all?Ken Paulus 27:26Not really, because I think we acted relatively quickly. One of our first worries was the run on the bank for medications and there was one early on. And people were so nervous about getting their medications, chronically ill patients that needed their medications that they were stockpiling. And we had to immediately lay in rules that would manage the supply so that they were 30-day supplies or shorter supplies so that we didn't have patients with years of supply and not having other patients that needed medications and they couldn't get them. So we immediately worked with the government to put in rules and structures to manage the stockpile run on the bank kind of circumstance, and we avoided that, thankfully. So we didn't really run into shortages. It was close. There were some shortages around the hydroxychloroquine run that took place after the President made his comments. But they were short-lived. And I think we've managed through them pretty well. So I think, for the most part, we got through it, and we avoided any really significant problems. Thank God.Gary Bisbee 28:26It's evident that public health is now part of national security. We just never thought about it that way. How do you think about that, Ken?Ken Paulus 28:34I think public health has never gotten it's appropriate do in our system? It harkens back to our earlier comments, scary when you ask question around well, how IDNs work, you know, whatever. Public Health just isn't rewarded. Our nation doesn't really prioritize it. Now, I think we're realizing a pandemic. It's critical. And countries around this globe that are really good at public health has have done a great job of managing and pandemic in an incredibly difficult circumstance. We have no public health assets really, in terms of the scale or the integration or the coordination of public health in this country, we don't have it. So we ended up with our fragmented system which we already know isn't really well-coordinated doesn't communicate, put through the wringer. We have no public health system really to rely on and we ended up with the mess we've got and you get what you pay for. We got what we paid for. We've never prioritized public health. So I think we're gonna have to find a balance in the future between acute care, public healthcare, centricity of a patient, where is the place where cares delivered, acute care can be the center of the universe any longer. It's not even urgent care. It's not even home or maybe I think it might actually be virtual that there's a virtual system and public health has to be tied into that virtual system. So we're all coordinating and gosh, it's going to be so hard for us. Our political parties and our constant bickering back and forth, somehow we're gonna have to break down these barriers. And I'm not sure exactly how that's gonna play out.Gary Bisbee 30:08It is hard to see. But I totally agree with you. We need to get there. Well, let's turn to leadership, you've ideally positioned in the sense that you've led a variety of different kinds of companies. All in healthcare, of course, but when you first became aware of the COVID crisis, what was your first thought?Ken Paulus 30:28I really think my first thought was two concerns, one, protect my employees, and to make sure patients get their medication so we don't cause havoc. And I think those two things I thought oh my gosh, we have got to make sure that those two things are intact. And it's a scary time and critical time.Gary Bisbee 30:51So moving from that to what are the most important characteristics of a leader during a crisis, Ken?Ken Paulus 30:57There's much to be written about this. But for me, the first thing was calm in a storm. I mean, we're in a frightening circumstance, we still are, we don't understand it. And I think leaders must stay calm. We can't panic. I think the second thing for me was very regular, transparent, and high levels of communication. At a time of uncertainty. People need to know what's going on. Even if you don't have the answers. It's okay to say that you don't. I think third, it requires action. I mean, you really have to have a propensity to act. Assuming you're calm. Assuming you're highly communicative. I think you have to have some courage to make some tough calls and move. And I think that's critical. So I think for me, those three things really are like the three legs of a stool to get through a crisis. There's that great line from Rahm Emanuel during the financial crisis that I ascribed to and they were going Through with Obama and Rahm Emanuel going through this process of the Great Recession, and he said, You never want to, I'm paraphrasing, but you never want to let a good crisis go to waste. It's your opportunity to do great things. And that's really what we have here is an opportunity to great things. And the question is, do we have the courage to do it? That's really what's gonna come down to and I hope our leadership does and I hope I do. That's really what we need to accomplish today.Gary Bisbee 32:28Well, it's all about leaders at a time like this. No question about that. Has the COVID experience change you as a leader in any way or as a family member?Ken Paulus 32:37For sure it points to the importance of relationships and in health care, we're in the relationship business. It's critical. You can't optimize health for somebody that that's one of your charges, somebody you're responsible for without a really good trusting relationship. And I think we all now are looking at our relationships differently and realizing how important they are to us. I think that's probably the key takeaway for me, Gary is social distancing has put a spotlight on either the ability to maintain or the importance of those relationships and also the some of the challenges of not having a social connection that is a critical part of the human beings needs. So I do think it's all about relationships and social connection. And if I had to say on health care, the patient relationship or not even before they become patients and individual relationships, that trusting relationship is up for grabs. It will be very interesting to see who owns that for a lifetime. Will it be IDNs? Will it be primary care doctors? Will it be some health care, air traffic controller? Will it be a health plan? I don't know. But somebody is going to play that role. And I'll tell you, there's a lot of disruption in healthcare because nobody has stepped in to fill that void. COVID has shown us that we need somebody to focus on that long term relationship and it's just not happening today. Again, with great challenges come great opportunities. Now that's a big one. And if I was running a healthcare business or an IDN right now, I'd be thinking, we have got to be running like heck, to solve that problem and fill that void. Our nation needs it now.Gary Bisbee 34:23That's a terrific finding. This has been an excellent interview. Ken, thanks so much. I have one last question. If I could. You're a board member. Of course, you sit on the board of Teladoc, but you've been experienced boards throughout your career. What are the key questions a board members should be asking in a crisis like this?Ken Paulus 34:41I think it's really a couple things. One is definitely getting through the acute phase of crisis. We're in that now. And it takes all of those leadership skills that we talked about. I think those are really important and staying steady at the helm, communicating the heck out of it and acting and moving, and having the courage to make some really critical, tough decisions. I think that's really important. actually think the bigger opportunity is envisioning what your organization will look like when this thing's all said and done. And this is one of those unique opportunities to take a completely fresh look. blank sheet of paper, we're going to come out of a crisis, a very changed nation in a lot of ways. And could you do something substantially different, that would really advance your organization, your service, your connection to consumers, whatever. I think this is one of those rare moments in all of our careers where you can basically be bold, and go for it. The second thing I suggest to all leaders of the boards I sit on is to get through the crisis phase. But while you're doing that, put equal time in the recovery phase. And in that recovery phase, it's a chance for just incredible transformation. Take advantage of it, run with it. That's where the action is going to be with this.Gary Bisbee 36:00Well said, thanks, Ken, terrific interview much appreciated Good luck to you and Prime as we move forward.Ken Paulus 36:07Thank you so much, Gary. It's been a pleasure talking to you.Gary Bisbee 36:09This episode of Fireside Chat is produced by Strafire. Please subscribe to Fireside Chat on Apple Podcasts or wherever you're listening right now. Be sure to rate and review fireside chat so we can continue to explore key issues with innovative and dynamic healthcare leaders. In addition to subscribing and rating, we have found that podcasts are known through word of mouth. We appreciate your spreading the word to friends or those who might be interested. Fireside Chat is brought to you from our nation's capital in Washington DC, where we explore the intersection of healthcare politics, financing, and delivery. For additional perspectives on health policy and leadership. Read my weekly blog Bisbee's Brief. For questions and suggestions about Fireside Chat, contact me through our website, firesidechatpodcast.com, or gary@hmacademy.com. Thanks for listening.

#105: ENCORE Partnering with IDNs and ACOs, with Scott Hylla

Healthcare Supply Chain Radio with John Pritchard

Play Episode Listen Later Jun 26, 2020 29:57

Scott Hylla, Director; Health Systems Scott Hylla is the Director of Health Systems for Sunovion Pharmaceuticals Inc. He has served in various roles spanning a 28 year career in the pharmaceutical industry, most recently in leading the Sunovion Health Systems team in the development and execution of collaborative strategies in the transformational IDN marketplace.Scott has a BS in Biology from St. John’s University and an MBA in Healthcare Management from the Opus College of Business, University of St. Thomas. He is a member of American College of Healthcare Executives and is a corporate participant in the Health Management Academy and Advisory Board.John Marchica, CEO, Darwin Research GroupJohn Marchica is a veteran health care strategist and COO of Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. He’s a two-time health care entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest-growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade.John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University and is an active member of the American College of Healthcare Executives.About Darwin Research Group Darwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

Healthcare Supplychain Radio: Managing Inventory Post-COVID

Play Episode Listen Later Jun 16, 2020 16:47

Host: John Pritchard, Publisher, The Journal of Healthcare Contracting (JHC) Participants: • Angela McNally, Vice President of Provider Solutions, Owens & Minor • Patrick McMahon, Vice President of Services, Owens & Minor As the COVID-19 pandemic swept across the world, many hospitals quickly stockpiled supplies they had never sourced before, and now they have items they didn’t use during the peak of the pandemic. How do hospitals get their COVID-19 stockpile in order? Angela McNally and Patrick McMahon of Owens & Minor discuss this challenge and more with John Pritchard of The Journal of Healthcare Contracting (JHC) in the second part of a two-part series covering hospitals and IDNs resuming surgeries. It’s the latest Healthcare Supplychain Radio podcast called “Managing Inventory Post-COVID.” “Hospitals face dynamic challenges moving forward due to carrying large amounts of inventory with unpredictable demand,” said Pritchard. “Angela and Patrick speak to post-COVID strategies that can prepare hospitals for the long-term and for future epidemics.” To learn more about inventory management solutions for providers, visit: https://www.owens-minor.com/our-solutions/provider-inventory-solutions/

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Podcast 54 - Value Analysis Evolution: The Commitment to Excellence

evolution va commitment excellence idns value analysis

Play Episode Listen Later Mar 16, 2020 28:48

The dynamics of value analysis in healthcare have radically changed for the better in the last 20 years. We have watched as healthcare organizations moved from “sole practitioners” managing this VA function to vice presidents (in some healthcare organizations) determining the relative worth of the products, services, and technologies they are buying. Yet, with few exceptions, hospitals, systems, and IDNs have not reached the “Superior Performance Stage” of evolution in this supply chain discipline.

Podcast 54 - Value Analysis Evolution: The Commitment to Excellence

evolution va commitment excellence idns value analysis

Play Episode Listen Later Mar 16, 2020 28:47

PopHealth Week: Meet Rushika Fernandopulle

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Feb 2, 2020 27:38

Hosts Fred Goldstein and Gregg Masters, MPH welcome Rushika Fernandopulle MD, co-founder & CEO Iora Health. Dr. Fernandopulle is a physician who has spent decades improving the quality of healthcare delivered to patients. He was the first Executive Director of the Harvard Interfaculty Program for Health Systems Improvement, and served as a Managing Director of the Advisory Board Company. He serves on the faculty and earned his AB, MD, and MPP from Harvard University. He completed his clinical training at the Massachusetts General Hospital. He discusses the value proposition the Iora Health model contrasting with DPCs, ACOs, and global riaks bearing IDNs, as well as the macro market shift to value based healthcare and the implications for provider positioning strategies and continued relevance of our current 3rd party payor model. Want to stream our station live? Visit www.HealthcareNOWRadio.com. Find all of our show episodes on your favorite podcast platforms. https://www.healthcarenowradio.com/listen/

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What is a GPO (Group Purchasing Organization)? with Dr. Mark Walsh

Talk to Your Pharmacist

Play Episode Listen Later Dec 29, 2019 23:44

In this episode, we have guest Dr. Mark Walsh, who is currently the Corp Head of Pharmacy Sourcing for HealthTrust where he is involved with the development and execution of clinical contracting strategies for more than 1,700 hospitals and roughly 35,000 outpatient service centers. Mark leads HealthTrust's Drug Shortage Taskforce, provides clinical oversight and site assessments for the 503B Outsourcing Facility Program, serves as project lead for the Supply Interruption Mitigation Strategy initiative, leads the HealthTrust Pharmacy Operations Advisory Board, and negotiates contracts for pharmacy operations related services and equipment. Mark has served in a few different capacities prior to his role at HealthTrust which include Director of Pharmacy, Interim Chief Operating Officer, and Clinical Coordinator at a multi-campus facility. He is also a residency preceptor for the PGY-2 Corporate Pharmacy Leadership Residency at HealthTrust. Topics discussed include: Group Purchasing Organization, what exactly does a pharmacist do there? o GPOs aren't commonly discussed as career paths for pharmacists and many aren't familiar with what they actually do. The aggregation of healthcare and the role that pharmacist can play in it o IDNs are expanding rapidly and with those expansions (both from an acute care and outpatient perspective) there are tremendous opportunities for pharmacist to play a role. Efficiencies of scale are being taken for granted in current reimbursement models so there are constant pressures to innovate and streamline processes which are skills that are inherent to pharmacy. · Other roles within a health system besides a Director of Pharmacy in the Hospital o There is a growing trend of hospital systems identifying pharmacy as a leadership pool to draw on outside of just pharmacy. Pharmacists are being promoted to VP of Operations or COO roles due to the convergence of clinical insight (including working with the doctors) and operational performance. Guest - Mark Walsh PharmD, BCPS Host - Hillary Blackburn, PharmD www.pharmacyadvisory.com https://www.linkedin.com/in/hillary-blackburn-67a92421/ @talktoyourpharmacist for Instagram and Facebook @HillBlackburn Twitter

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Episode 04: Dee Donatelli

National Accounts Today: A Podcast

Play Episode Listen Later Dec 16, 2019 32:03

On this episode John Pritchard talks with Dee Donatelli. Dee is the foremost expert on value analysis committees and processes in our nation’s IDNs. Dee joins us today on National Accounts Today to help suppliers learn how to make value analysis an advantage. Any National Accounts Executive that presents to Value Analysis Committees will benefit from the conversation with Dee Donatelli.

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A Top Down Bottom Up Approach to Launching New Med Tech w/ Bryan Eckard

Med Tech Gurus

Play Episode Listen Later Oct 30, 2019 28:22

In this episode Bryan Eckard brings incredible value discussing the best practices of working with regional specialty distributors. Bryan adds additional value by going into detail with working with clinical specialists to help build trust and to enhance the sales message. Bryan then brings it home by laying out awesome strategies with a top down bottom approach with IDNs.

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#68: Our Take, August 26, 2019

Play Episode Listen Later Aug 26, 2019 10:18

In today’s Our Take read-in, here’s our lead story: Good Neighbor Pharmacy tops the list of chain drugstores in customer satisfaction, according to a new survey by J.D. Power and Associates. The network of independent pharmacies received the highest overall score among brick-and-mortar chain store pharmacies, with a score of 914 out of 1,000 possible points, followed by Health Mart (893), Rite Aid Pharmacy (865), Walgreens (840), and CVS (834). To sign up for the weekly email brief, click here. Note that we’re not uploading a read-in next week due to the Labor Day holiday. Other briefs include: CMS announced that quality star ratings for qualified health plans offered on the Health Insurance Marketplace will be available in 2020. Signify Health and Remedy Partners signed a definitive agreement to merge. SSM Health formed a joint venture with Denver-based Paladina Health to offer direct-to-employer primary care in the St. Louis area. Three new drug approvals for AbbVie, Genentech, and Nabriva Therapeutics. About Darwin Research Group Darwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

IDN Podcast Series, Episode 4: EHR Systems and Barriers

barriers podcast series ehr idns

Play Episode Listen Later Apr 24, 2019 19:26

In this fourth episode of our Integrated Delivery Networks podcast series, "EHR Systems and Barriers," hear from Rory Martin and guest Lisa Blanton about electronic health record systems used in IDNs and how they can impact treatment.In this episode you'll learn:How EHR systems are diverse and the interoperability challenges this createsHow treatment guidelines get into EHR systemsWhat can go wrong in the EHR process and solutions to address the issues

IDN Podcast Series, Episode 5: Learning about IDNs through Primary Market Research

learning primary podcast series market research idns

Play Episode Listen Later Apr 24, 2019 23:05

In this final episode of our Integrated Delivery Networks podcast series, "Learning about IDNs through Primary Market Research," hear from Rory Martin and guest Paul Villa about primary market research and how it can help us understand IDNs.In this episode you'll learnHow primary market research is complementary to analytics and how it can help us understand the "why" behind the "what"How we can use analytics like segmentations to help choose the right health systems to interview

IDN Podcast Series, Episode 3: Oncology

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Play Episode Listen Later Apr 24, 2019 10:39

In this third episode of our Integrated Delivery Networks podcast series, "Oncology," hear from Rory Martin about the connection between IDNs and oncology.In this episode:We'll learn how IDN penetration in the oncology market is one of highest of any disease areaDiscuss a case study involving different cancer types

IDN Podcast Series, Episode 2: Affiliations

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Play Episode Listen Later Apr 24, 2019 18:28

In this second episode of our Integrated Delivery Networks podcast series, "Affiliations," hear from Rory Martin and guest Brian Martin about how we describe the networks that form IDNs. In this episode you'll learn:How affiliation data are used to define IDNsHow the data are captured and refreshed

#40: Partnering with IDNs and ACOs, with Scott Hylla, Sunovion Pharmaceuticals

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Play Episode Listen Later Mar 14, 2019 29:58

Welcome to Season 2 of Health Care Rounds. In this episode, John Marchica speaks with Scott Hylla, Director of Health Systems and Managed Markets with Sunovion Pharmaceuticals. Scott and John discuss the state of pharma-IDN partnerships, pharma attitudes toward ACOs, and the future of industry-provider relations. Key questions include: How does pharma align with integrated health systems (IDNs), and what are IDNs looking for in a partnership? Should pharma partner with ACOs, and if so, why? What are the key trends in health care delivery that drive pharma toward higher-level partnerships? Speaker Bios Scott Hylla is the Director of Health Systems for Sunovion Pharmaceuticals Inc. He has served in various roles spanning a 28 year career in the pharmaceutical industry, most recently in leading the Sunovion Health Systems team in the development and execution of collaborative strategies in the transformational IDN marketplace. Scott has a BS in Biology from St. John’s University and an MBA in Healthcare Management from the Opus College of Business, University of St. Thomas. He is a member of American College of Healthcare Executives and is a corporate participant in the Health Management Academy and Advisory Board. John Marchica is a veteran health care strategist and CEO of Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. He’s a two-time health care entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade. John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives. About Darwin Research Group Darwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

Health Systems – IDN And GPO Collaborative Models

CMR Institute iBrief

Play Episode Listen Later Dec 6, 2018 31:58

Today’s buyers use specific processes for acquiring products & services. The ability to navigate new processes and collaborations must be learned and adopted as part of your overall market strategy. And the need to manage and implement contracts that come from these new collaborations is incredibly important as well. CMR, along with its expert panelists, will help you position your company to become a key part of growth opportunities available in this changing market. You’ll learn how your company’s products and services can address key areas being measured by value-based care and how to present this data in a way your customers will respond to. In this 30-minute podcast Bob DeVol, Director, Healthcare Innovator’s Collaborative, Premier, Inc. explains how the focus on cost, quality, and outcomes is changing the way IDNs and GPOs bring products into health system. You’ll also learn how best to collaborate with them to provide the information they need before they can consider the products you bring to them.

INBW20: Can Pharma and IDNs Collaborate? A Conversation With Stacey Richter and Dave Dierk, Co-Presidents at Aventria Health Group

Play Episode Listen Later Nov 15, 2018 32:49

When not hosting the show, Stacey is co-president of Aventria Health Group, a marketing agency and consultancy. Aventria specializes in helping pharmaceutical, employer, pharmacy, and health system clients improve patient outcomes by creating and leveraging collaborations with other health care organizations. For more than 20 years, Stacey has innovated better-coordinated health solutions benefiting all stakeholders and, most of all, the patient. Dave is a 30-year veteran of managed-markets marketing. After working in consumer marketing with AT&T and health care publishing with Elsevier, Dave made the move to medical advertising and communications at KI Lipton, Inc. Subsequently, he became a cofounder of Pinnacle Health Communications. Dave is an accomplished strategist, providing innovative customer marketing, access, quality, and health intervention solutions for large clients and has directed the development of numerous industry-leading campaigns in primary care and specialty markets. He has supported clients in disease areas that include oncology (Bristol Myers Squibb [BMS], Novartis, Eisai), virology (BMS, Merck & Co.), pharmacy (American Pharmacists Association, Merck, Novartis), and blood disorders (Novo Nordisk), to name a few. Dave has helped more than 15 clients achieve top rankings in their respective categories. He is also an active member of the Pharmacy Quality Alliance. 00:30 Collaborating with “large organized customer groups” aka IDNs and health care stakeholders. 01:36 Pharmaceutical companies working with IDNs. 04:58 “Historically, Pharma trained ... their representatives on the brand; secondly ... on [their] selling skills.” 05:17 “What they don’t do well ... is training them on understanding customer objectives and needs.” 05:56 “What a customer wants to buy is impact.” 07:57 “It’s basically Pharma meeting on a level playing field with peers.” 08:42 The more stakeholders take on risk, the more they will demand seeing outcomes from Pharma. 09:09 “Pharma can’t ... prove its value in the absence of having collaborative relationships.” 09:30 One of the most important roles that Pharma can play. 10:42 The barrier with market share. 13:13 Enabling a brand to be successful. 13:39 Solving the customer's problems. 13:50 Creating a near-term and a long-term plan. 16:00 How Pharma can be a collaborative partner throughout the entire patient journey. 16:58 Pharma’s barrier in not striving for the ideal. 22:39 Barriers in pharma collaboration with IDNs. 24:28 “Consider these plans a living document.” 24:45 “It’s a commitment to invest the time, invest the energy.” 27:24 “The much more valuable brands are [the ones] that build upon their successes.” 29:44 “How can we work together to find a solution that is approvable?” 31:03 How Aventria might be able to help mitigate some of these challenges.

#33: A Review on exl's 12th Partnering with ACOs and IDNs Summit

MedicalWritersSpeak's podcast

Play Episode Listen Later Nov 8, 2018 9:34

John is taking the helm this week to share his experience presenting at a conference last week, and the lessons he learned from two days of sessions. We will return to our regular format next week. The conference, exl’s 12th Partnering with ACOs and IDNs Summit, included about 100 people, mostly represented by pharma, ACOs and health systems. The first part of his presentation covered what we learned from our annual ACO Executive survey, which includes what are their most pressing problems. The second part delved into the partnering, or lack thereof, of pharma companies with ACOs. About Darwin Research Group Darwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

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The risks associated with global Internationalized Domain Names | Salted Hash Ep 36

Salted Hash

Play Episode Listen Later Aug 23, 2018 13:22

Paul Vixie, CEO of Farsight Security, explains how global Internationalized Domain Names, or global IDNs, sparked the emergence of confusingly similar website addresses with nefarious goals -- and how to combat them.

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IDNS deceptive practices, IGTV is now live, cPanel now supports git.

Web Hosting Podcast

Play Episode Listen Later Jul 16, 2018 11:34

Today on episode 22 of Web Hosting Podcast. iDNS misdirection, this is a public service announcement for the alleged service provided by iDNS. This company may send out actual mail to you in an attempt to trick you into renewing your domain name with them. IGTV (Instagram TV) is now live, did you even notice? ... Read more IDNS deceptive practices, IGTV is now live, cPanel now supports git.

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Strategic Educational Alliance with IDN Summit

CMR Institute iBrief

Play Episode Listen Later Jul 17, 2017 4:11

To help suppliers better serve their customers in integrated delivery network (IDNs), CMR Institute has established a strategic educational alliance with IDN Summit. Through the partnership, we are providing in-depth educational content for attendees of the Fall 2017 IDN Summit. This alliance allows each firm to expand their reach beyond their respective primary markets. In this podcast, Lisa Ponssa, Executive Vice President of IDN Summit, explains the benefits of this strategic alliance. For more information, contact us at solutions@cmrinstitute.org or check out our blog page: www.cmrinstitute.org/news-and-insights/blog/

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Understanding the Healthcare Value Dossier

Play Episode Listen Later Jan 19, 2017 13:19

Understanding the healthcare value dossier. How to accelerate revenues and expand markets. Virtual or corporate onsite training for MSLs, MA professionals and Medical Writers. Nascent Medical LLC to offer a Six-week Course on Health Economics and the Health Outcome Liaisons on April 20th. The course will be led by Jennifer Williams PhD, JD, MBA, RN, MS a veteran leader in the field of Medical Science Liaison and Market Access. Corporate onsite training available. more info at http://nascentmc.com/blog/2017/01/11/msl-market-access-course/#more-3419 Six-Week Course on Health Economics and the Health Outcome Liaisons Course content includes: The role of the MSL and Health Economics Liaison Review Managed Care Models Review Value Development Plans (VDP) Review the components of a Value Dossier and Develop an individualized Dossier HEOR impact on Licensing and R&D Review Market Access Strategies to include pricing, research plans, and sales strategy Identify tactical outcomes research and economic models to demonstrate the clinical and economic elements Define the communication strategy and tactics for the diverse audience to include Government and Lobbyist, Health Plans, IDNs, Advocacy Groups, and KOLs Address price strategy and reimbursement Review new technologies to enable communication in the form of field tools such as calculators and dashboards What is a Value Dossier? A Value Dossier presents a summary of the clinical, economic, and humanistic value and supporting evidence (studies) for a new product in a disease area as well as background information on that disease. This includes the burden of illness and epidemiology The dossier development process involves the creation of value messages, an evaluation of the evidence supporting each of the messages, and identification of evidence GAPs The dossier can be instrumental as a guide the development of future research studies, publication strategies, and other evidence generation activities. What information is in the Value Dossier? Disease Description Global Epidemiology and Global Burden of Illness Summary of Treatment Pathways, Guidelines, and Competitor Landscape Unmet Medical Need and Place of New Product in Clinical Pathway Value Story Clinical, Economic, and Humanistic Value Messages and Statements Summary of Evidence Supporting Product Value Clinical Evidence: Summary of Safety and Efficacy Studies Humanistic Evidence: Summary of Outcomes Studies to include Quality of Life Studies

Episode #9 - Jamie Kowalski

Healthcare Supply Chain Radio with John Pritchard

Play Episode Listen Later Dec 14, 2016 45:26

In this episode we talk with Jamie Kowalski. Jamie’s career as a Supply Chain Management executive in community and tertiary hospitals began in 1972. He began his consulting career in 1980, founding Kowalski-Dickow Associates, Inc. (KDA), a leading hospital supply chain management-consulting firm. He has satisfied over 1700 hospital clients and over 180 IDNs. He has also consulted with dozens of supply chain related service provider companies, including Fortune 15 and Fortune 100 companies. He later served in senior executive roles with Owens & Minor, Inc., McKesson Provider Technologies and Aramark Supply Chain Management Services. Jamie is a Co-Founder and the first Board Chairman of The Bellwether League, Inc., the not-for-profit Hall of Fame for the Healthcare Supply Chain leaders. He was selected for the George R. Gossett Leadership Award by the Association of Healthcare Resource and Materials Management, in 2011. Jamie authored four and co-authored three more books on healthcare supply chain management, over 80 articles, and has spoken at over 125 national and international conferences on healthcare supply chain management. Jamie earned BS in Management and MBA degrees from Marquette University. He earned Fellow status in the American College of Healthcare Executives and the Association for Healthcare Resource and Materials Management.

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#Health2con 2016: Meet Murray Brozinsky @mbrozinsky

This Week in Health Innovation

Play Episode Listen Later Nov 28, 2016 5:00

The annual 'fall classic' aka the Health 2.0 Fall Conference convened at the Santa Clara Convention Center for it's 10th Annual gathering from September 25th - 28th, 2016. In this session Jessica DeMasa debriefs with Murray Brozinsky, Chief Strategy Officer, Talix who previews a model of smart analytics to better risk stratify and manage 'at risk' populations of ACOs, IDNs or other health plans. Segment filmed and produced for Health Innovation Media by Gregg Masters, MPH. Enjoy!

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Episode 95: The Missing Link to Interoperability, A Conversation with Jason Rose About the Inovalon and Quest Joint Venture, Data Diagnostics

Medsider Radio: Learn from Medical Device and Medtech Thought Leaders

Play Episode Listen Later Jun 16, 2016 30:04

Jason Rose is Chief Strategic Development Officer for Inovalon, a leading technology company providing advanced, cloud-based analytics and data-driven intervention platforms to the healthcare industry. Since joining the company in 2008, he has led a wide range of health-focused initiatives aimed at driving improvements in quality and financial outcomes through advanced data-analytics and technology platforms. In his current position, he is responsible for all aspects of introducing, launching, and expanding the Company's product and technology presence within the healthcare marketplace. In addition, he supports a wide range of corporate directives including corporate branding and communication, market expansion, and strategic partnerships and alliances Most recently, Mr. Rose has played a key role in forging the collaboration between Inovalon and lab-testing giant, Quest Diagnostics, to develop and launch Data Diagnostics™, an industry-first solution that provides real-time analytics at the point of care. The ground-breaking platform enables clinicians to request patient-specific analyses on demand within their existing workflow and receive results within seconds. The solution was designed to support the achievement of value-based care initiatives, quality improvement, cost reduction, risk score accuracy, and a host of additional goals during a patient encounter. Prior to joining Inovalon, Mr. Rose served as Senior Vice President of Public Programs, Health and Disease Management Services for APS Healthcare, Inc., a provider of specialty healthcare solutions, where he was responsible for overseeing all aspects of Health and Disease Management programs across the Public Programs division. He has also served in leadership roles at INSPIRIS, Inc., Ardent Health Services, Cap Gemini Ernst & Young (now Accenture) and Cerner Corporation. Mr. Rose earned his Master of Health Services Administration (MHSA) degree from The George Washington University School of Business. Mr. Rose received a Bachelor of Science degree in Psychology from Radford University. 00:00 Jason explains Data Diagnostics, the new joint venture between Inovalon and Quest Diagnostics. 02:30 The major challenges in making a shift from volume to value in Healthcare and empowering Health Plans, ACOs, IDNs, Practice Groups, and Physicians themselves in this change. 03:30 Getting data into a doctor's workflow and acknowledging how doctors are being valued. 04:30 How Inovalon and Quest Diagnostics came together to create Data Diagnostics. 07:00 “70% of Clinical Decisions are based on a lab.” 08:00 Interoperability challenges and getting data into an EHR. 08:30 Insuring accuracy in workflow data. 09:20 HEDIS & Quality Measurement. 09:50 Receiving real-time data and delivering it to the EHR with a quick and accurate turn around. 11:00 A Dual Patient scenario and Quality measures. 13:00 Giving specific Technical Guidelines in the EHR for Patient Care. 14:30 The real and dangerous problem of Alert Fatigue. 16:00 The limited data sets that feed into the issues of alert fatigue. 18:00 Creating a Working Data Flow with Claims Data. 19:20 Identifying the Primary EHR Systems for Quality Measurements. 20:00 Data Diagnostics initiative to work around the inability to share patient data directly between Health Plans, to make sure Doctors and Patients get the data they need in real-time. 23:00 The difference between Data Diagnostics and an HIE. 24:00 How Data Diagnostics is working to solve interoperability problems across the country. 25:30 Making Data Diagnostics available for every patient. 27:00 How Data Diagnostics works on a organizational level. 29:00 You can find out more by emailing Jason at: jrose@inovalon.com or calling him at 301.809.4000 ext.1531, or by checking out Quest's technology platform, Quanum, on their website, or datadiagnostics.com

Why Medtech Companies Should Care More About Sales Operations

Play Episode Listen Later Sep 17, 2014 44:43 Transcription Available

It’s safe to say that IDNs are important customers for the overwhelming majority of medical device companies. Therefore, it’s probably rational to assume that medtech companies do a good job of tracking the changing IDN landscape, right? Wrong. Based on the 2014 ZS Associates Commercial Operations Benchmark Study, only 56% of medtech companies track IDN...[read more]Related StoriesSubstantial and Sustainable – 2 Words That Medtech Companies Should Get Used ToSocial Media Best Practices for Marketing Medical DevicesAre Medical Device Models the Key to Building a Lean Medtech Startup?

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Investing in China’s New Domain Names – With Simon Cousins

DomainSherpa.com

Play Episode Listen Later May 12, 2014 67:24

The Chinese government evaluated all the new Chinese character top-level domains (TLDs) and decided that dot Chinese online (.在线) and dot Chinese website (.中文网) would earn their support and investment. Should it earn yours too?

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HonestReporting IDNS podcast, August 28, 2013. Check us out on honestreporting.com

Play Episode Listen Later Aug 28, 2013 3:03

Israel's perspective on the imminent U.S. strike on Syria, and the chemical weapons situation.

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HonestReporting IDNS podcast, July 29, 2013. Check us out on honestreporting.com

Play Episode Listen Later Jul 29, 2013 3:55

Israel Audio News Stream: Hamas is re-establishing ties with Iran and Hezbollah. What does this mean for Israel, the Palestinians, and the peace process?

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HonestReporting IDNS podcast, July 23, 2013. Check us out on honestreporting.com

Play Episode Listen Later Jul 23, 2013 2:58

Audio version of HonestReporting IDNS daily highlights, July 23, 2013 honestreporting.com

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IDNS Podcast, July 1, 2013

Play Episode Listen Later Jul 1, 2013 3:14

HonestReporting IDNS podcast, July 1, 2013. Check us out on honestreporting.com

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IDNS June 23, 2013

Play Episode Listen Later Jun 24, 2013 2:13

Audio version of HonestReporting IDNS, June 23, 2013 honestreporting.com

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How Are You Selecting Your Value Analysis Team Leaders and Members To Ensure Success?

selecting team leaders ensure success idns value analysis

Play Episode Listen Later Jan 8, 2013 18:07

Are you selecting your value analysis team leaders and members by chance, by their title or by their influence in your organization? If you are, and most hospitals, system and IDNs have been doing this for years, then you are missing an opportunity to have the most motivated, disciplined and creative people on your value analysis teams.

How Are You Selecting Your Value Analysis Team Leaders and Members To Ensure Success?