Podcasts about pharmacy benefit managers

Analyzing Trump's plan to roll back soaring drug prices for Americans; Sports bras eliminate bounce but may take a toll on women's backs; RFK Jr. targets the chemicals in our food; Do Americans really eat more animal protein than any other of the world's nations? Causes and treatments for pulmonary hypertension.

On this episode of “Raise the Line” we welcome Dr. Sheldon Fields, a trailblazer in the nursing field and the president of the National Black Nurses Association. In a candid conversation, Dr. Fields shares his inspiring journey from the bedside to becoming a prominent figure in nursing, HIV/AIDS prevention and academia and also shares the challenges he faced as a Black man in a predominantly white and female field. "I fell in love with a profession that has not always loved me back," he tells host Kelsey Lafayette. Dr. Fields brings over thirty years of experience as an educator, researcher, clinician, administrator, consultant, health policy specialist, and entrepreneur to his current role at NBNA, and as the inaugural associate dean for equity and inclusion at the College of Nursing at Penn State University, where he also serves as a research professor. Listeners will find Dr. Fields' insights on navigating a career in healthcare particularly valuable, as he stresses the importance of resilience, continuing education, and mentorship. It's a compelling listen for anyone interested in the intersection of health, policy, and social justice.Mentioned in this episode:National Black Nurses Association If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

Wednesday's second hour

God's Debris: The Complete Works, Amazon https://tinyurl.com/GodsDebrisCompleteWorksFind my "extra" content on Locals: https://ScottAdams.Locals.comContent:Politics, Pope's MAGA Brother, Macron Cocaine Controversy, Trump EO Pharmaceutical Prices, PBM, Pharmacy Benefit Managers, Mark Cuban, Trump Cost Reductions List, President Trump, Medicaid Restrictions, Apple iPhone Price Increase, Habeas Corpus, Ilhan Omar, James Carville, Jack Smith's Lead Prosecutor, Trump Approval Polls, Tesla Robotaxi, Trump Family Middle East Projects, Air Force One, SCOTUS Birthright Citizenship, India Pakistan Ceasefire, Putin Zelensky Meeting, Scott Adams~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~If you would like to enjoy this same content plus bonus content from Scott Adams, including micro-lessons on lots of useful topics to build your talent stack, please see scottadams.locals.com for full access to that secret treasure.

In this episode of Good Morning Liberty, hosts Nate Thurston and Charles 'Chuck' Carhartt Thompson discuss a range of hot topics starting with Trump's alleged new trade deal with China. They delve into the details, criticizing the lack of real concessions and Trump's claims of a 'total reset' in tariffs. The duo also talks about Trump's new executive order on reducing prescription drug costs, exploring the implications of a 'Most Favored Nation' policy and potential pitfalls including medication shortages and economic ramifications. Alongside these big-ticket items, the episode also touches on various weekend updates including a $400 million plane gift to the Department of Defense, a discussion on habeas corpus, ICE activities, and more. Join Nate and Chuck as they provide their unique Libertarian perspective on current events. (03:50) China Trade Deal Analysis (09:28) Trump's Executive Order on Prescription Drugs (25:16) Adjustments for Unhealthy America (25:37) Government's Role in Drug Pricing (27:04) Global Price Disparities (29:35) Pharmacy Benefit Managers and Market Inefficiencies (30:48) Direct-to-Consumer Sales and Mark Cuban's Initiative (31:52) Generic vs. Name Brand Medications (32:57) Trump's Most Favored Nation Policy (38:57) Potential Consequences of Price Controls (43:26) Free Market Solutions and Government Regulation (46:48) Conclusion and Final Thoughts   Links:   https://gml.bio.link/   YOUTUBE:   https://bit.ly/3UwsRiv   RUMBLE:   https://rumble.com/c/GML   Check out Martens Minute!   https://martensminute.podbean.com/   Follow Josh Martens on X:   https://twitter.com/joshmartens13   Join the private discord & chat during the show!   joingml.com   Bank on Yourself bankonyourself.com/gml   Get FACTOR Today! FACTORMEALS.com/factorpodcast     Good Morning Liberty is sponsored by BetterHelp! Rediscover your curiosity today by visiting Betterhelp.com/GML (Get 10% off your first month)     Protect your privacy and unlock the full potential of your streaming services with ExpressVPN. Get 3 more months absolutely FREE by using our link EXPRESSVPN.com/GML  

Gina Alsdorf has more than 15 years of experience in employee benefits, working on complex issues involving ERISA, employee benefit plans, and related laws. Her past clients include trustees, plan committees, plan sponsors, consultants, registered investment advisors, broker-dealers, banks, insurance companies, third-party administrators, and recordkeepers for retirement plans and individual retirement accounts. Gina received her JD, cum laude from University of Georgia Law School and was awarded an LLM in Employee Benefits with honors, from the University of Illinois, Chicago Law School.In this episode, Eric and Gina Alsdorf discuss:Evaluating PBM contracts with expert oversightPrioritizing transparency in pricing modelsAlign PBM incentives with participant outcomes, if possibleInvest in education and oversight for long-term successKey Takeaways:Engage legal and consulting professionals to analyze contract terms, ensuring alignment with fiduciary responsibilities and plan objectives.Understand the financial structure of PBM arrangements, favoring models that clearly show how costs and profits are distributed.Select partners and structures that place plan participant benefit above corporate profit, especially in vertically integrated PBM organizations.Encourage continuous learning and mentorship among benefit managers to adapt to a complex and evolving pharmacy benefits landscape.“ERISA does not give you the duty to go for the cheapest price. You're supposed to get the best service for the money for your people.” - Gina AlsdorfConnect with Gina Alsdorf:Website: https://www.carltonfields.com/team/a/gina-alsdorf LinkedIn: https://www.linkedin.com/in/gina-alsdorf/ Connect with Eric Dyson: Website: https://90northllc.com/Phone: 940-248-4800Email: contact@90northllc.com LinkedIn: https://www.linkedin.com/in/401kguy/ The information and content of this podcast is general in nature and is provided solely for educational and informational purposes. It is believed to be accurate and reliable as of the posting date, but may be subject to change.It is not intended to provide a specific recommendation for any type of product or service discussed in this presentation or to provide any warranties, investment advice, financial advice, tax, plan design, or legal advice (unless otherwise specifically indicated). Please consult your own independent advisor as to any investment, tax, or legal statements made.The specific facts and circumstances of all qualified plans can vary, and the information contained in this podcast may or may not apply to your individual circumstances or to your plan or client plan-specific circumstances.

We're honored to continue our global tour of medical education today with Professor Katarzyna Taran, MD, PhD, a pioneering interdisciplinary researcher of tumor cell biology, an award winning educator noted for her focus on student engagement, and -- in a first for a Raise the Line guest -- a shooting sports certified coach and referee. As Professor Taran explains to host Michael Carrese, these seemingly disparate professional activities require the same underlying attributes: patience, the ability to overcome barriers, openness and adaptation. She believes those last qualities are especially important for today's medical students to acquire given the accelerated pace of change in healthcare. “They need to be equipped with the ability for critical thinking, to analyze and synthesize, and to search for unconventional solutions.” Professor Taran tries to impart these skills, in addition to the medical and scientific knowledge students must know, through a high level of engagement. “Teaching is relational, so try to be familiar with students' concerns. Talk to them, listen to them and you will become someone they trust.” In this wide-ranging and engaging conversation, Professor Taran also discusses her work as the head of the Laboratory of Isotopic Fractionation in Pathological Processes in Chair of Oncology, the use of neurodidactics in teaching, and the connection between the science of pathology and the future of humans in space. Mentioned in this episode:Medical University of Lodz If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

How One Leader Came Out of Retirement to Transform Home Healthcare Jasper Freeman, Director of National Accounts at SC Pharmaceuticals, didn't just return to medical sales—he came back with a mission to change it. In this episode, Jasper shares how he helped launch Ferosix, a revolutionary heart failure treatment designed to keep patients out of the hospital and improve care at home. But that's just the beginning. We dive into: The untold story of Pharmacy Benefit Managers (PBMs) and their massive influence over drug pricing and access Why the insurance-sales-patient triangle is the key battleground in healthcare innovation What the U.S. can learn from other countries about lowering costs and improving care Bold reform ideas—from slashing med school tuition to rethinking drug distribution This is a rare, behind-the-scenes look at the business of healthcare, guided by someone who's lived it at the highest levels. If you're in medical sales—or trying to break in—this episode is a masterclass on what's next and how to lead the change. Connect with Jasper: LinkedIn Connect with Me: LinkedIn Love the show? Subscribe, rate, review, and share! Here's How » Want to connect with past guests and access exclusive Q&As? Join our EYS Skool Community today!

Dan Petrella from the Chicago Tribune joins Springfield's Morning News to discuss efforts to limit the power of "Pharmacy Benefit Managers" and the frenzy around Sen. Dick Durbin's future.See omnystudio.com/listener for privacy information.

The American healthcare system is complex, but two of the most urgent cost drivers offer places to start exploring possible reforms: prescription drug pricing and how providers are paid. In this episode, we examine the conflicting incentives at the heart of the U.S. healthcare system between insurers, providers, pharmaceutical companies, and patients. These competing priorities shape everything from access to care to drug affordability. Through conversations with healthcare experts, we unpack the role of Pharmacy Benefit Managers (PBMs) and compare fee-for-service and capitated payment models. PBM diagram referred to in the podcast: https://www.healthcarehuddle.com/p/drug-supply-chain. Healthcare policy articles by ScriptsPro CEO and journalist Ken Perez: https://www.hfma.org/author/ken-perez/.

We like to think of Osmosis from Elsevier as a global community of millions of learners, connected by a desire to serve humanity and an inclination to use a diverse mix of educational resources to help them become excellent healthcare practitioners. On today's episode of Raise the Line, we're going to learn how Osmosis has created an opportunity for hundreds of those students from sixty countries to actually solidify those connections through the Osmosis Health Leadership Initiative (OHLI). Our guide to this effort is Osmosis Community Specialist Alfred Collins, who brings a keen interest in developing tech solutions to power the future of human communication to his work with OHLI.“Technology collapses barriers to communication and to understanding the nuances behind culture, behind global perspectives,” he tells host Lindsey Smith. One example he cites is how OHLI members learn about variations in the way different cultures approach collaboration, an important insight to gain as they head into team-based healthcare environments. OHLI members convene regularly over video sessions to hear from leaders in healthcare and learn about hosting successful on-campus events, among other enriching content.  They also have an opportunity to provide feedback on improving the Osmosis learning platform, and this year they're participating in a “hackathon” aimed at improving the future of healthcare. Tune in to find out more about what the OHLI program offers, how to apply, and how Alfred thinks virtual reality and AI technologies will impact the future of community building. Mentioned in this episode:Osmosis Health Leadership Initiative If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

David Game remembers the days when the use of digital technology in education publishing amounted to putting a dictionary on a compact disc. Now, as the senior vice president of Product Management, Global Medical Education at Elsevier, he oversees a suite of learning materials that use artificial intelligence, virtual reality and 3-D modeling. “We've expanded into immersive technology with Apple Vision Pro that enables you to be inside the human body, to see and explore the human heart from the inside out and it is absolutely stunning,” says Game, whose long career in publishing includes experience in North America, the United Kingdom, Europe, China and India. As Game has witnessed first-hand, advancements in ed tech, including distance learning, have provided students with an array of options and modalities to choose from that accommodate different learning styles and life circumstances, and that puts a premium on being able to meet students where they are. “We want to make sure that students find learning from our materials engaging, efficient, and aligned with how they live their lives and do their work.” Join host Lindsey Smith for this fascinating episode of Raise the Line to learn how Elsevier is leveraging the innovations offered by Osmosis, Complete Anatomy and ClinicalKey Student to enrich the learning of medical students on their journey to becoming excellent clinicians.Mentioned in this Episode:Complete AnatomyClinicalKey StudentOsmosis If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

An interesting new study from the Geisinger health system in Pennsylvania examining if genomic screening in a large population increases the identification of disease risk prompted Raise the Line to re-release a previous episode about a textbook designed to help all medical providers understand the clinical applications of genomic testing. Genomics in the Clinic: A Practical Guide to Genetic Testing, Evaluation, and Counseling from Elsevier Science Direct dives into the use of this important tool in diagnosis and screening, indicating how individuals may respond to drug therapies, and more. “We really need to educate all healthcare providers about the practice of genetics because they're going to be involved directly or indirectly in genetic testing and conveying information about what the results mean to patients and their families,” explains co-author Dr. Ethylin Wang Jabs, enterprise chair of the Department of Clinical Genomics for Mayo Clinic. Jabs and her co-author, Dr. Antonie Kline, director of Clinical Genetics at the Harvey Institute for Human Genetics at Greater Baltimore Medical Center, chose a format that makes heavy use of case studies to help readers get a better grasp on this complicated field and they also include chapters on direct-to-consumer testing and the ethical and social implications in genomic medicine. “Any kind of potentially predictive testing can have ethical issues related to it, including insurance coverage, testing for family members, protections for minors, and more,” says Dr. Kline. Join host Caleb Furnas for an illuminating episode on an area of discussion in medicine that's growing in importance as the use of genetic testing rapidly increases. Mentioned in this episode: Genomics in the Clinic: A Practical Guide If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

Pharmacists from across Mississippi are calling for stronger regulations on the intermediaries between insurance providers and pharmacies.Then, some Mississippians join in a national boycott targeting major retailers over ending DEI initiatives.Plus, Mississippi has the highest rate of heart disease in the nation, it's worse in rural communities. What needs to change ahead. Hosted on Acast. See acast.com/privacy for more information.

To mark International Rare Disease Day, we're going to introduce you to a remarkable young woman, Zainab Alani, who is not letting her challenging rare condition stand in the way of her dream of becoming a physician. After noticing Zainab's struggles with muscle weakness and fatigue at age 15, her mother – a physician – took her to doctors advocating for a diagnosis of the rare autoimmune condition generalized myasthenia gravis (MG). Unfortunately, a series of clinicians attributed her symptoms to her menstrual cycle and other errant causes and even accused Zainab of being ‘a lazy teenager.' “Despite having that support and knowledge behind me, these doctors were dismissing my symptoms because of that deceiving label of rare,” Zainab explains to host Lindsey Smith. Wanting to spare others from this frustrating diagnostic odyssey, Zainab turned to advocacy once in medical school and is working with her sister and others through the organization Rare Aware Glasgow to raise awareness among the general public about rare conditions and to spur the medical community to adjust its perspective. “We don't expect medical professionals to know every single rare disease, we just want them to acknowledge their existence and not dismiss them when a family member or a patient brings them up as a differential diagnosis.” In this inspiring episode in our Year of the Zebra podcast series you'll also learn about intersectionality creating burdens in medical diagnosis and a questionable basis for patients being denied access to new treatments.Mentioned in this episode:Rare Aware GlasgowThe Myasthenia Medic If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

AlabamaSen. Britt praises Trump for his directive to make IVF more affordableAL House committee decides to delay vote on ADVA restructuring bill in order to provide more transparency2 bills in State senate deal with Pharmacy Benefit Managers and PharmaciesHanceville police department in utter chaos after charges from Cullman DAJefferson county teacher was arrested in sting operation in Blount CountyNationalTrump rags on Ukraine's President as "dictator who won't hold elections"Trump signs EO to stop federal funds/benefits from going to illegal aliensWH advisor Stephen Miller schools CNN once again on what DOGE is doingDHS and border czar Homan are closing in on leakers to recent ICE raidsTX federal judge officially strikes down Biden's rewrite of Title IX on genderDOGE finds that a grant of $2B involves Stacy Abrams non profit Part 3 of JD Vance speaking in Munich about restoring free speech

Having the ability to manage uncertainty is helpful in all professions, but perhaps especially so in medicine where uncertainty abounds and the stakes for managing it are high. Despite that, medical students receive little training in this area, something which our guest today, Dr. Jenny Moffett of RCSI University of Medicine and Health Sciences in Dublin, is working to change. “There are approaches to uncertainty that can be learned. We can change our perspective and perceptions around uncertainty, stepping away from always viewing it as something aversive, but perhaps maybe looking at it with a little bit more curiosity and openness, and that's definitely a transformation that faculty can make,” says Dr. Moffett, the program director of the Postgraduate Diploma in Health Professions Education. In addition to a perspective shift, Moffett also believes providers should develop skills to talk about uncertainty with patients in an open and honest way. “Clinicians can say, I'm on this journey with you. I don't have all of the answers, but we have paths, we have options, and I'll be there with you as we work them out.” Join host Caleb Furnas as he explores Dr. Moffett's fascinating work in this area which includes development of an immersive puzzle game that encourages students to address complex, ambiguous, and unpredictable issues.Mentioned in this episode:RCSI University of Medicine and Health Sciences If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

We were lucky enough to have Jon Jordan, an independent pharmacist join us to explain how Pharmacy Benefit Managers are screwing you and making themselves rich. Might be more information than you want to take in but it's super compelling.  

The Role of Clinicians in Addressing Climate Change: Dr. Catharina Giudice, Climate and Human Health Fellow, Harvard T.H. Chan School of Public Health “The healthcare system is in this interesting intersection when it comes to its roles and responsibilities as it pertains to climate change,” says our Raise the Line guest Dr. Catharina Giudice, a research fellow in climate and human health at Harvard University.  As she explains to host Hillary Acer, the medical industry is a major producer of the greenhouse gasses that are contributing to serious health impacts on patients, especially those who are already vulnerable due to pre-existing conditions and economic struggles. Giudice, whose academic work focuses on healthcare sector climate preparedness, believes this paradox requires a response from clinicians. “There's so many small things that you can do as an individual clinician to make a difference in the climate change intersection.” Options include working to change hospital practices, educating peers and patients on the health impacts of climate change, and advocacy in the public policy arena. In this thought-provoking installment in our NextGen Journeys series, you'll also learn how the healthcare delivery system is being affected by climate change, and about a new concentration in climate change and planetary health at the Harvard T.H. Chan School of Public Health.Mentioned in this episode:Harvard T.H. Chan School of Public HealthHarvard University Center for the EnvironmentPractice Greenhealth If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

We continue our NextGen Journeys series today featuring fresh perspectives on education, medicine, and the future of health care with an impressive medical student who was brought to our attention by a previous podcast guest, Dr. Michael Foti, whom we'd like to thank for the recommendation. Nikolas Bletnitsky is in his third year at Touro College of Osteopathic Medicine, Middletown, but that's just one element in his medical education. Over the last several years, Nick has done extensive work in the field of OB-GYN -- completing clinical electives in Paris, France and Bologna, Italy, in addition to the Mayo Clinic -- where he has pursued his intense interest in a variety of subspecialties, including maternal fetal medicine. “Right now I'm doing a lot because I'm young and I have the energy and I want to see a lot to give me different perspectives on things so that I can incorporate them into my own practice,” he tells host Michael Carrese. Join us for a wide-ranging conversation in which you'll learn about current practice in OB-GYN in the US and Europe, neonatal palliative care and advances in fetal surgery, along with what Nick has learned about having crucial conversations with the parents of patients when tough news needs to be discussed.Mentioned in this episode: Touro College of Osteopathic Medicine, If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/raisethelinepodcast

In this episode of Main Street Matters, Jordan and Toni discuss healthcare issues with Dr. Chris Stansbury, focusing on RFK Jr.'s confirmation hearings and his insights on food production and healthcare. They explore the impact of lobbyists on food and drug pricing, the role of pharmacy benefit managers, and the need for regulatory reform in the healthcare system. Dr. Stansbury emphasizes the importance of competition and reducing bureaucracy to improve healthcare outcomes and lower costs for patients. Main Street Matters is part of the Salem Podcast Network. For more visit JobCreatorsnetwork.comSee omnystudio.com/listener for privacy information.

Today, our ongoing global tour of medical education on Raise the Line stops in the Republic of Ireland by way of a conversation with the head of school at Trinity College Dublin School of Medicine, Dr. Colin Doherty, who is in the midst of revising the school's curriculum. In that process, particular attention is being given to how medical education needs to change to adjust to the potentially transformative impacts on health, healthcare and society from artificial intelligence, big data and climate change. As Dr. Doherty tells host Caleb Furnas, a recent creative workshop with internal and external stakeholders produced reassuring results. “It was really gratifying that central to the future of our workforce is not technology, but the humanity of the healthcare worker.” The widely-published epileptologist believes achieving that will require a regulatory framework that strikes the right balance. “Let AI help us with making the right choices for treatment, but don't put it between us and our relationship with the patient.” There is much to contemplate in this fascinating discussion of advances in understanding epilepsy, managing change in academia, instituting love as an outcome measure, and the many challenges and opportunities of leading a 300-year-old medical school into the future.Mentioned in this episode: Trinity College Dublin School of Medicine

On this episode of Raise the Line, we're going to learn about the organization behind one of the most important exams in healthcare: the NCLEX, which is the licensing exam for nurses in the US. The influence of the test, which is overseen by the National Council of State Boards of Nursing (NCSBN), is hard to overstate because of its role in driving what nursing students and educators focus on. That was made evident when the heavily revamped Next Generation NCLEX, launched in 2023, placed much greater emphasis on clinical judgment than had been the case on past exams. “I think the education transformation prompted by the new exam is still going on. The launch was more of a catalyst than I expected,” says Dr. Philip Dickison, CEO of NCSBN, who was director of Health Professions Testing at Elsevier before joining the Council in 2010. Through administering licensing exams and serving as the collective voice of nursing regulators across the country, Dickison says NCSBN strives to achieve its ultimate goal, which is building public confidence in the competence of nurses.  “I see our job at the Council as making sure there is a moment of trust between a patient and their nurse.” Join host Liz Lucas, Senior Content Manager for Nursing at Osmosis from Elsevier, as she explores the important work that goes on behind the scenes in the healthcare industry to help ensure public health and safety, and uncovers what Dickison learned as a military medic that still influences his work today.Mentioned in this episode:National Council of State Boards of Nursing 

Pharmacy Benefit Managers, or PBMs, have been blamed for hurting the bottom line of privately owned pharmacies. And those in the industry say it’s forcing such small businesses to close their doors. But what if the state made its own PBM? Brad Kutner has more from Richmond.

MS symptoms can worsen, and relapses can occur. And when that happens, how do you know whether you require immediate medical care? When is it time to go to the hospital? Dr. Kalina Sanders joins me to talk about when it's time to seek immediate medical care for MS. Dr. Sanders is a board-certified neurologist who specializes in multiple sclerosis and spasticity management at Baptist Health in Jacksonville Beach, Florida. We're also talking about MS care in the United Arab Emirates with Professor Bassem Yamout, the President of the Middle East North Africa Committee for Treatment and Research in Multiple Sclerosis. We'll explain why Bayer's new MRI contrast agent is good news for people with MS. We'll tell you about a new Federal Trade Commission report that calls out Pharmacy Benefit Managers for inflating the price of generic specialty drugs by thousands of percent. We'll share the details of a study that shows the profound impact of menopause on MS. And we're sharing two different opportunities for you to participate in MS research. We have a lot to talk about! Are you ready for RealTalk MS??! A word about Facebook posts  :22 This Week: Worsening symptoms? Relapse? When is it time to go to the Emergency Room?  1:46 FTC reports Pharmacy Benefit Managers have marked up generic specialty drugs 1000s of percent  2:20 Bayer's new MRI contrast agent contains 60% less gadolinium  4:57 Professor Bassem Yamout discusses MS in the United Arab Emirates  6:48 Study reveals menopause significantly increases the speed of disability worsening and brain cell damage in women with MS  15:08 Two opportunities for you to participate in MS research  17:38 Dr. Kalina Sanders explains when it's time to seek immediate medical care for MS     19:54 Share this episode  31:42 Have you downloaded the free RealTalk MS app?  32:02 SHARE THIS EPISODE OF REALTALK MS Just copy this link & paste it into your text or email: https://realtalkms.com/386 ADD YOUR VOICE TO THE CONVERSATION I've always thought about the RealTalk MS podcast as a conversation. And this is your opportunity to join the conversation by sharing your feedback, questions, and suggestions for topics that we can discuss in future podcast episodes. Please shoot me an email or call the RealTalk MS Listener Hotline and share your thoughts! Email: jon@realtalkms.com Phone: (310) 526-2283 And don't forget to join us in the RealTalk MS Facebook group! LINKS If your podcast app doesn't allow you to click on these links, you'll find them in the show notes in the RealTalk MS app or at www.RealTalkMS.com RealTalk MS on YouTube https://www.youtube.com/@RealTalkMS Federal Trade Commission Interim Report on Pharmacy Benefit Managers and Specialty Generic Drugs https://www.ftc.gov/reports/specialty-generic-drugs-growing-profit-center-vertically-integrated-pharmacy-benefit-managers Bayer Announces MRI Contrast Agent Gadoquatrane Meets Primary and Main Secondary Endpoints in Pivotal Phase III Studies https://www.businesswire.com/news/home/20250109869429/en/Bayers-investigational-MRI-contrast-agent-gadoquatrane-meets-primary-and-main-secondary-endpoints-in-pivotal-Phase-III-studies STUDY: Association of Menopause with Functional Outcomes and Disease Biomarkers in Women with Multiple Sclerosis https://www.neurology.org/doi/10.1212/WNL.0000000000210228 PARTICIPATE IN MS RESEARCH: Psychometric Properties of Sexual Difficulties Scales in People Living with Multiple Sclerosis https://qualtrics.kcl.ac.uk/jfe/form/SV_br1fVoYGqXnLooK PARTICIPATE IN MS RESEARCH: Efficacy and Safety Study of Frexalimab in Adults with Nonrelapsing Secondary Progressive Multiple Sclerosishttps://www.sanofistudies.com/SR0A/ Join the RealTalk MS Facebook Group https://facebook.com/groups/realtalkms Download the RealTalk MS App for iOS Devices https://itunes.apple.com/us/app/realtalk-ms/id1436917200 Download the RealTalk MS App for Android Deviceshttps://play.google.com/store/apps/details?id=tv.wizzard.android.realtalk Give RealTalk MS a rating and review http://www.realtalkms.com/review Follow RealTalk MS on Twitter, @RealTalkMS_jon, and subscribe to our newsletter at our website, RealTalkMS.com. RealTalk MS Episode 386 Guests: Professor Bassem Yamout, Dr. Kalina Sanders Privacy Policy

We have a special Raise the Line episode today that takes a look at some behind-the-scenes work happening at Osmosis from Elsevier to expand the reach and impact of our educational content, which is now being used by learners in nearly 200 countries. Over the past year, dozens of volunteers have been hard at work translating over 100 Osmosis videos into Arabic while simultaneously researching whether these translations increase student engagement and comprehension, and improve educational equity. Our host, Dr. Amin Azzam -- who has played an oversight role in this project -- is joined by two other key members of the team: Mohammad Kabakibi, the founder of Chain of Education, an online learning platform he developed while in school at Lebanese American University; and Dania Reina, who is an e-learning creator and a pharmacist from Brazil. “In the beginning, we had one or two volunteers, but now we have more than fifty. This is huge and this only happens because we are building this for us and to leave for other healthcare professionals who will hopefully keep it going,” says Reina. Research has shown significant learning improvement among video watchers and as a bonus, the people doing the subtitles report enhanced knowledge of the subjects they work on. These positive outcomes have spurred Kabakibi to look for other opportunities to make an impact, including helping Arabic speakers learn how to do research in English. “I believe one of the legacies that this project will carry through me will be my continuous mission in reducing barriers when it comes to healthcare and education,” he shares. Check out this inspiring episode to learn about other offshoots of the project, how this work supports lifelong learning, and why AI is not up to the task.Mentioned in this episode:Chain of EducationOsmosis Video with Arabic Translation 

We kick off 2025 on Raise the Line by sharing some good news for providers struggling to keep up with the growing number of applications for genomic testing: a new book from Elsevier Science Direct has been designed to arm you with the knowledge you need. Genomics in the Clinic: A Practical Guide to Genetic Testing, Evaluation, and Counselingdives into the use of this important tool in diagnosis and screening, indicating how individuals may respond to drug therapies, and more. “We really need to educate all healthcare providers about the practice of genetics because they're going to be involved directly or indirectly in genetic testing and conveying information about what the results mean to patients and their families,” explains co-author Dr. Ethylin Wang Jabs, enterprise chair of the Department of Clinical Genomics for Mayo Clinic. Jabs and her co-author, Dr. Antonie Kline, director of Clinical Genetics at the Harvey Institute for Human Genetics at Greater Baltimore Medical Center, chose a format that makes heavy use of case studies to help readers get a better grasp on this complicated field and they also include chapters on direct-to-consumer testing and the ethical and social implications in genomic medicine. “Any kind of potentially predictive testing can have ethical issues related to it, including insurance coverage, testing for family members, protections for minors, and more,” says Dr. Kline. Join host Caleb Furnas for an illuminating episode on an area of discussion in medicine that's growing in importance as the use of genetic testing rapidly increases.Mentioned in this episode: Genomics in the Clinic: A Practical Guide

Is investing just looking too good these days? When everything is going up including stocks, commodities and cryptocurrencies, one has to stop and think is this the top? In November US equity trading increased by 38% compared to November 2023. The last time we saw this type volume was in 2021 when meme stocks were the major craze. The CEO of Robinhood, Vlad Tenev, stated a few weeks ago that they're looking at expanding into sports betting. In my opinion that is not a far stretch from what they're doing now. Over the past year, their stock has climbed 235% and it trades under the symbol HOOD. Polling by the US conference board on the bullishness of investors revealed that consumers expectations for equities compared to their own income has never been higher. Funny thing when I was drafting this post and I tried to put in bullishness, the auto spellchecks corrected it with foolishness. I would have to agree with the spellcheck on that. Lastly, I can't help but comment on the most ridiculous thing in crypto I have seen yet. There is now a cryptocurrency and please excuse my language called Fartcoin that has a market value of over $900 million. Comparing that to something of value, that is greater than nearly 40% of all American publicly traded companies. Remember, if you are speculating, Wall Street will always have some type of crazy investment that they'll make a lot of money off of, but yet in the end, you the speculator investor will more than likely lose big if not all your investment. It may be exciting for a while, but eventually the emotional roller coaster will wear on you.   Are pharmacy benefit managers, known as PBMs, costing consumers? If you go back to the early 60s, PBMs were the heroes because they helped reduce and control spending on prescription drugs. Back then drug companies were charging high prices and the PBMs came in and negotiated contracts for large purchases of drugs so the drug companies would not have to fill an order of 20 pills. Instead, through a PBM the drug companies could fill an order of say maybe 20,000 pills and charge much less. The consumer received lower prices on drugs, the drug company made a good profit, and the PBM took a slice of the pie. The reason we receive such great prices at Costco on all items is because they buy large quantities of products and pass the savings on to the consumer. Obviously, Costco doesn't pass all the benefit to the consumer and they keep part of the cost savings as a profit. Not to mention they also charge a subscription fee to gain access to these savings. This is the same way PBMs operate, they keep part of the discount or the spread for themselves so they can make profits. What all the hoopla is about is that the PBMs don't show the discount or the spread that they are receiving. The FTC, also known as the Federal Trade Commission, already regulates PBMs to ensure compliance with antitrust and consumer protection laws. There's also concern that six PBMs control roughly 90% of the market. I personally think that is OK especially when you compare it to how many options you have for your cell phone or cell phone service. There are many other services or products where you ultimately have limited options.   Stock market falls after disappointing Fed comments It was widely anticipated the Federal Reserve would cut the Fed Funds Rate by a quarter of a point to a target range of 4.25%-4.5%. While the Fed followed through on those expectations and lowered the rate back to the level where it was in December 2022, it was the projection for 2025 that moved stocks lower. The Fed indicated it would probably only lower rates twice in 2025. This projection is based on the dot plot which is a matrix of individual members' future rate expectations. Personally, I'm not a fan of the dot plot as Fed expectations have been wildly off in the last few years and the latest dot plot cuts in half the committee's intention when the plot was last updated in September. I believe it is just too hard to predict out what inflation will be for the longer term, which then makes it difficult to get a gauge on where interest rates will be over the next few years. Given the current data I can see why the Fed wants to be patient, but the problem as we all know is data can change. If inflation does start to decelerate further next year it is absolutely possible the Fed cuts maybe four times instead of the current estimate of two cuts. The main takeaway I have from this meeting is the Fed is not on an aggressive rate cut cycle and they are going to be data dependent. Ultimately, the market did not like what Powell said and stocks fell greatly during his press conference. This led to another down day for the Dow Jones, which marked the 10th straight losing day. This is the longest losing streak since 1974 when the Dow fell 11 days straight. I do believe with the excessive valuations there will be continued volatility in the markets, but I do see this as an overreaction to the Fed comments and we still see great upside for several companies in next years market.   Should you Fund a Health Savings Account? A Health Savings Account (HSA) is an investment account that is primary used for medical expenses but also doubles as a retirement account.  Contributions to an HSA are tax deductible and can be invested.  Investment earnings in an HSA grow tax deferred and may be withdrawn tax free to cover medical expenses at any age, you do not need to wait until retirement.  You may also reimburse yourself for out-of-pocket medical expenses at any point for expenses that occurred while you had an HSA.  For example, if you paid for some medical expense in 2024 but chose not to withdraw from your HSA to cover it, you could keep those funds growing tax free and withdraw them in 2030 or any other future year.  Unlike Flexible Spending Accounts where funds must be used every year, balances in Health Savings Accounts rollover each year indefinitely, which is why they can be great retirement accounts. If you make a withdrawal that is not for medical expenses, it is taxable and comes with at 20% penalty.  At age 65 you may withdraw funds for any reason without penalty, but it is still taxable if not used for medical expenses, so you really just want to use these for medical expenses to avoid taxes and penalties.  In retirement there are typically plenty of medical expenses like Medicare premiums and elder care, so it is usually not a problem to withdraw all the funds tax free.   An HSA account must be paired with a high deductible health plan (HDHP) and in 2024 the annual maximum contribution is $4,150 for a self-only plan and $8,300 for family plans. If you are over 55 you can make an extra $1,000 catch-up contribution.  HSA accounts can be funded through payroll if your employer offers them or you can open your own account as long as you have a qualifying plan.  It is more tax advantageous to fund through payroll though because not only are contributions pre income tax, they are also pre–Social Security and Medicare tax which is an extra 7.65% savings.  Unfortunately, California does not recognize HSA accounts which means contributions are not deductible at the state level and earnings are taxable.  However, these are still extremely tax efficient and useful accounts and are not utilized enough.   Companies Discussed: Netflix, Inc. (NFLX), RH (RH), Broadcom Inc. (AVGO) & Occidental Petroleum Corporation (OXY)

    Join us for an engaging conversation with Navy CAPT(Ret) Ed Norton, the Chief of the Defense Health Agency's Pharmacy Operations Division, as we explore the intricate world of military pharmacy. With a wealth of experience in both the Navy and DHA, Ed shares his journey and the significant responsibilities he shoulders in managing the TRICARE pharmacy benefit for over 7 million users. Discover how his team collaborates with service pharmacy consultants and Military Treatment Facility representatives to ensure an informed and effective service. Ed provides insights into the expansive TRICARE Pharmacy Benefit, serving a large number of DOD eligible beneficiaries with a net government cost of around $9 billion annually, and how these operations are critical in maintaining a ready medical force through programs like the deployed prescription program. In this episode, we also shed light on the vital role of Pharmacy Benefit Managers, focusing on the partnership between the Department of Defense and Express Scripts in managing the TRICARE pharmacy benefit. Listen as we discuss how Express Scripts ensures seamless claim processing, maintains a network of pharmacies, and provides essential mail-order services to deployed service members. We address the challenges and opportunities facing the TRICARE benefit, including rising pharmacy costs and shifts away from Military Treatment Facilities. Ed highlights initiatives aimed at enhancing patient experience and cost-efficiency through improved communication and technology. This episode offers a comprehensive view of the operations that keep our service members medically ready and the strategies in place to optimize this essential benefit. Chapters: (00:05) TRICARE Pharmacy Benefit and Operations      Navy CAPT(Ret) Ed Norton discusses the TRICARE pharmacy benefit, supporting operational forces and maintaining medical readiness for 7 million users.   (08:18) TRICARE Pharmacy Benefit and Management         Express Scripts collaborates with DOD to manage TRICARE pharmacy benefit, optimizing costs and convenience for patients and taxpayers.   Take Home Messages: Understanding TRICARE's Pharmacy Benefit: The episode provides an in-depth exploration of the TRICARE pharmacy benefit, detailing its role in supporting over 7 million service members. Listeners will gain insights into how the system ensures medical readiness through programs like the deployed prescription program, highlighting the extensive responsibilities involved in managing this critical aspect of military healthcare. Role of Pharmacy Benefit Managers (PBMs): The discussion sheds light on the partnership between the Department of Defense and Express Scripts, the PBM responsible for TRICARE. The episode explains how this collaboration facilitates seamless claim processing, mail-order services, and the establishment of a robust pharmacy network, which collectively optimize costs and enhance convenience for service members. Challenges and Opportunities in Military Pharmacy: Rising pharmacy costs and the gradual shift away from Military Treatment Facilities (MTFs) are identified as significant challenges. However, these also present opportunities to enhance patient experience and cost-efficiency through improved communication and the adoption of innovative technology solutions. Enhancing Patient Experience through Technology: The episode highlights initiatives aimed at improving patient experience within military pharmacies. This includes leveraging technology like electronic health records and queue management systems to streamline operations and reduce waiting times, thereby making pharmacy services more efficient and user-friendly. Military Medicine as a Career Path: The episode emphasizes the rewarding nature of a career in military medicine, underscoring the sense of purpose and camaraderie that comes with serving America's patriots. It encourages those considering this path to appreciate the unique opportunities and meaningful impact they can have within the military healthcare system.   Episode Keywords: Military Pharmacy, TRICARE, Pharmacy Benefit, Defense Health Agency, Express Scripts, Medical Readiness, Pharmacy Operations, Military Treatment Facility, Prescription Services, Pharmacy Network, Pharmacy Costs, Technology Solutions, Patient Experience, Cost-Efficiency, Pharmacy Benefit Managers, Direct Delivery, Deployed Service Members, Contract Requirements, Civilian Pharmacy Plans, Taxpayers   Hashtags: #MilitaryMedicine #TRICAREPharmacy #EdNortonInsights #PharmacyBenefit #DefenseHealth #ExpressScripts #MilitaryReadiness #HealthcareInnovation #WarDocsPodcast #VeteransHealthcare   Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation.   Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm   WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield,demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast

Abdul and Katelyn talk about a promising bipartisan bill that could disrupt Pharmacy Benefit Managers, a miracle drug that prevents HIV--at a serious cost, and new data that show that US obesity rates may have fallen for the first time in more than a decade. Then they talk about RFK Jr's chances of being confirmed to lead HHS after news broke last week that his attorney asked the FDA to repeal approval of the polio vaccine back in 2022. Then Abdul sits down with Dr. Umair Shah, Washington State's Secretary of Health, about the role of state health departments over the next four years. We will be back with more episodes in 2025. We wish you all a restful holiday season!  This show would not be possible without the generous support of our sponsors. America Dissected invites you to check them out. This episode was brought to you by: Marguerite Casey Foundation: Sign up now to get your free Boston Review issue delivered to your door at CaseyGrants.org/State. Calm: Calm is offering an exclusive offer of 40% off a Calm Premium Subscription at calm.com/DISSECT. Lumen: If you want to stay on track with your health this holiday season, head to http://lumen.me/AD for 15% off your purchase. Reclaimed: This podcast takes you back to the very beginning when the Navajo reservation was first created. And it reveals the history of oppression and exclusion that led the Navajo to this point — and why their future is still uncertain. You can listen to “Reclaimed” wherever you get podcasts.

Brothers Inspire and Share Life Lessons Through Endurance Sports: Kyle and Brent Pease of the Kyle Pease FoundationToday, we have an especially inspiring episode in our Year of the Zebra series on rare conditions featuring Kyle Pease and his brother Brent, who recently helped each other complete the 140.6 mile Ironman World Championship in Hawaii, a challenge they also took on together in 2018. What makes their story extraordinary is that Kyle, who was born with cerebral palsy and spastic quadriplegia, participated in these races with Brent's assistance, making them the first push-assist brother duo to finish the grueling competition. With over 125 endurance races under his belt, Kyle has become a leading disability advocate, demonstrating resilience and breaking barriers through sports. “Competing really reminds me of my life. I go through many ups and downs throughout my day just as I do in this sport. You get through a lot of different challenges throughout the competition by just focusing on the idea that anything is truly possible,” he tells host Lindsey Smith. To amplify their message of inclusivity and determination, the brothers co-founded the Kyle Pease Foundation which sponsors races and other awareness building events and they deliver speeches to a variety of organizations to share the lessons they've learned. “We want to encourage people to figure out what their finish line looks like. What are the things you work for and how do you get there,” says Brent. Tune in for an uplifting conversation to learn about the Foundation's workforce inclusion program, their book, Beyond the Finish, and the “secret weapon” that makes their racing and other endeavors possible.Mentioned in this episode:Kyle Pease FoundationBeyond the Finish

David Cade, Executive Vice President and CEO, American Health Law Association, speaks with Eric Zimmerman, Partner, McDermott Will & Emery, about the potential health care priorities of a second Trump Administration. They discuss possible health care considerations in any upcoming tax bill, drug pricing and Pharmacy Benefit Manager reform, the Affordable Care Act, reproductive health, the future of the CMS Innovation Center, antitrust enforcement, and the role of private equity.New Health Law Daily Podcast Coming in January 2025 Coming in January 2025, AHLA's popular Health Law Daily email newsletter will also be available as a daily podcast, exclusively for AHLA Premium members. Listen to all the current health law news from the major media outlets on this new podcast! Subscribe Now

New proposed legislation would make it illegal for one company to own both a pharmacy and a pharmacy-benefit management company. A PBM helps health insurers manage their prescription drug benefits and negotiates prices and rebates; CVS has both pharmacies and a benefit management division, as does Cigna and UnitedHealth. But some federal lawmakers see a conflict of interest. Also: the eco-friendliness of small SUVs and the future of Nasdaq board diversity rules.

New proposed legislation would make it illegal for one company to own both a pharmacy and a pharmacy-benefit management company. A PBM helps health insurers manage their prescription drug benefits and negotiates prices and rebates; CVS has both pharmacies and a benefit management division, as does Cigna and UnitedHealth. But some federal lawmakers see a conflict of interest. Also: the eco-friendliness of small SUVs and the future of Nasdaq board diversity rules.

The use of simulation in nursing education has been growing in recent years not only because of its proven effectiveness as a training method, but because of limits on clinical training placements, and a dearth of nursing faculty. Today on Raise the Line, we're happy to welcome one of the pioneers in this area, Dr. Pamela Jeffries, the Dean of the Vanderbilt University School of Nursing which is consistently ranked among the top graduate nursing schools in the US. “Now that we've moved to competency-based education and outcomes, I feel simulation is one of the mechanisms that's going to help faculty to see our students demonstrate those competencies needed across domains,” Jeffries tells host Maria Pfrommer, director of Nursing Education at Osmosis from Elsevier. Dr. Jeffries is also known for her work improving the online learning landscape in nursing education. “Online learning is so important in nursing because if you look at our students, they're typically working part-time or even full-time and need that flexibility.” Maria and Dr. Jeffries also get into the details of Vanderbilt's graduate nursing programs and discuss the game changing potential of AI in nursing education and practice in this informative episode.Mentioned in this episode:Vanderbilt University School of Nursing

“Being a provider yourself doesn't protect you or your loved ones from illnesses and it really brings the humanity back into medicine to recognize that we're all struggling and that the  patient in front of you is processing what they hear in their own way,” says Dr. Marta Perez, and OB-GYN and mother of a child with a rare condition. As Perez shares with host Lindsey Smith, her young daughter's struggles with Smith-Magenis Syndrome – which causes an array of developmental delays and other challenges -- has made her, and her physician husband, better doctors by sharpening their understanding of the difficulty patients have navigating the healthcare system and dealing with dismissive providers. “That's been something really formative for us in how we approach patients in our own practices. We understand the stresses in medicine.” In this candid interview, Perez talks about how she and her husband juggle two demanding jobs and a child with special needs, the impediments to finding treatments for rare diseases and the emotional impact of realizing your child will not have the kind of life you hoped they would have. Don't miss an episode rich with lessons for providers and parents as our Year of the Zebra series continues. Mentioned in this episode:@Dr.MartaPerezSmith Magenis Syndrome

As 2024 ends, the ACR's Government Affairs Committee looks ahead to the 119th Congress to address key issues in rheumatology. For our second annual legislative and policy update, we're joined by Dr. Lennie McDaniel, head of ACR's Washington DC office, and Dr. Christina Downey, Chair of the Government Affairs Committee, to share insights from their ACR Convergence 2024 session. Topics include Medicare cuts, physician payments, pharmacy benefit managers (PBMs), telemedicine reimbursement changes, and how you can advocate for better outcomes with the ACR. 

This show from last year was one of the most popular episodes of the past year. And it's also extremely relevant right now, given all of the PBM (pharmacy benefit manager) goings-on, as well as ongoing litigation like the J&J lawsuit, etc. Listen to the show with Julie Selesnick (EP428) for more on that one. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. Also, Brian Reid (EP456) in the episode from a couple of weeks ago. And he talks about how Mark Cuban's way of communicating and framing some of the issues with the big PBMs and just all of the perverse incentives in the drug supply chain. He says this way of communicating is “the chef's kiss.” So, besides the insights here that follow being relevant in and of themselves, there's also some lessons just in how those issues are teed up and communicated that we all can learn from. CEOs and CFOs … hey, this show is for you. Let's start here: What do all of these numbers have in common: $140,000, $3 million, $35 million, and $3 billion? These are all actual examples of how much employers, unions, and some public entities saved on healthcare benefits for themselves and their employees. The roadmap to saving 25% on pharmacy spend and/or 15% on total cost of care in ways that improve employee health and satisfaction always begins when one thing happens. There's one vital first step. That first step is CEOs and/or CFOs or their equivalents roll up their sleeves and get involved in healthcare benefits. Why can't much happen without you, CEOs and CFOs? Here's the IRL: In 2023, the healthcare industry has been financialized. There is a whole financial layer in between your company and its healthcare benefits. And unless the C-suite is involved here and bringing their financial acumen and organizational willpower to the equation, your company and your employees are currently paying hundreds of thousands, maybe millions, of dollars too much and doing so within a business model that deeply exacerbates inequities. There are people out there who are very strategically taking wild advantage of a situation where CEOs/CFOs fear anything to do with healthcare in the title and don't do their normal level of due diligence. You think it's an accident that this whole space got so “complicated”? HR needs your help. Bottom line, if you are a CEO or CFO and you do not know everything that Mark Cuban and Ferrin Williams talk about on the pod today … wow, are you getting shellacked. Mark Cuban uses a different word. Healthcare benefits are, after all, for most companies the second biggest line-item expense after payroll. But don't despair here, because all of this information is really and truly actionable. Others out there are cutting zeros off of their spend and actually doing it in ways that are a total win for employees as well. My guest today, Mark Cuban, is a CEO, after all; and when he looked into it, it took him T-minus ten minutes to figure out just the order of magnitude that his “trusted” benefits consultants and PBM and ASOs (administrative services only) and others were extracting from his business. He pushed back. So can you. But just another reason to dig into that financial layer wrapping around your employee health benefits right now, you might get sued by your employees. Below is an ad currently being circulated on LinkedIn by class action attorneys recruiting employee plan members to sue their employers for ERISA (Employee Retirement Income Security Act of 1974) violations. It's the same attorneys, by the way, from those 401(k) class action lawsuits. I've talked to a few CEOs and CFOs who are scrambling to get ahead of that. You might want to consider doing so as well. Now, for my HR professional listeners, considering that some of what Mark Cuban says in the pod that follows is indeed a little spicy, let me just recognize that the struggle is real. There are multiple competing priorities out there in the real world, for sure. And bottom line, because of those multiple competing priorities out there in the real world, it's really vital that everybody work together up and down the organization in alignment. Lauren Vela talks a lot about these realities here in episode 406. This is a longer show than normal, but it's also like a show and a half. Mark Cuban talks not only about his work with Mark Cuban Cost Plus Drugs, which is a company that buys drugs direct from manufacturers and sells them for cost plus 15%, a dispensing fee, and shipping. It's kind of crazy how so often that price is cheaper, sometimes considerably cheaper, than the price that plan members would have paid using their insurance—and the price that the plan is currently paying the PBM. Most Relentless Health Value Tribe members (ie, regular listeners of this show) will already know that, but what is also fascinating that Mark talks about is what he's doing with his own businesses and the Mavericks on other fronts, like dealing with hospital prices. In this show, we also talk the language of indie pharmacies, fee-only benefits consultants, TPAs (third-party administrators), PBMs, and providers doing direct contracting. There are, in fact, entities out there trying to do the right thing; and Mark acknowledges that. Ferrin Williams, PharmD, MBA, who is also my guest today, is chief pharmacy officer at Scripta and an expert in pharmacy benefits. She adds some great points and some context to this conversation. Scripta is partnering with Mark Cuban Cost Plus Drugs. Scripta has a neat Med Mapper tool and also services to help employees find the lowest costs for their prescriptions. If you are a self-insured employer, for sure, check out Scripta. Here are links to other shows that you should listen to now if you are inspired to take action. I would recommend the shows with Paul Holmes (EP397); Dan Mendelson (EP385); Andreas Mang (EP419); Rob Andrews (EP415); Cora Opsahl (EP372); Lauren Vela (EP406); Peter Hayes (EP346); Gloria Sachdev, PharmD, and Chris Skisak, PhD (EP390); and Mike Thompson (EP389). Also Mark Cuban mentions in this show the beverage distributor L&F Distributors. Thanks to Ge Bai, Andreas Mang, Lauren Vela, Andrew Gordon, Andrew Williams, Cora Opsahl, Kevin Lyons, Pat Counihan, David Dierk, Connor Dierk, John Herrick, Helen Pfister, Kristin Begley, AJ Loiacono, and Joey Dizenhouse for your help preparing for this interview. Also mentioned in this episode are Mark Cuban Cost Plus Drug Company; Scripta Insights; Julie Selesnick; Brian Reid; Paul Holmes; Dan Mendelson; Rob Andrews; Peter Hayes; Gloria Sachdev, PharmD; Chris Skisak, PhD; Mike Thompson; and Scott Conard, MD. You can learn more at Mark Cuban Cost Plus Drug Company and Scripta Insights. You can also connect with Scripta and Ferrin on LinkedIn.   Mark Cuban has been a natural businessman since the age of 12. Selling garbage bags door to door, the seed was planted early on for what would eventually become long-term success. After graduating from Indiana University—where he briefly owned the most popular bar in town—Mark moved to Dallas. After a dispute with an employer who wanted him to clean instead of closing an important sale, Mark created MicroSolutions, a computer consulting service. He went on to later sell MicroSolutions in 1990 to CompuServe. In 1995, Mark and longtime friend Todd Wagner came up with an internet-based solution to not being able to listen to Hoosiers basketball games out in Texas. That solution was Broadcast.com—streaming audio over the internet. In just four short years, Broadcast.com (then Audionet) would be sold to Yahoo! Since his acquisition of the Dallas Mavericks in 2000, Mark has overseen the Mavs competing in the NBA Finals for the first time in franchise history in 2006—and becoming NBA World Champions in 2011. Mark first appeared as a “Shark” on the ABC show Shark Tank in 2011, becoming the first ever to live Tweet a TV show. He has been a star on the hit show ever since and is an investor in an ever-growing portfolio of small businesses. Mark is the best-selling author of How to Win at the Sport of Business. He holds multiple patents, including a virtual reality solution for vestibular-induced dizziness and a method for counting objects on the ground from a drone. He is the executive producer of movies that have been nominated for seven Academy Awards: Good Night and Good Luck and Enron: The Smartest Guys in the Room. Mark established Sharesleuth, a research and investigation Web site to uncover fraud in financial markets, and endowed the Electronic Frontier Foundation's Mark Cuban Chair to Eliminate Stupid Patents, an effort to fight patent trolls. Mark gives back to the communities that promoted his success through the Mark Cuban Foundation. The Foundation's AI Bootcamps Initiative hosts free Introduction to AI Bootcamps for low-income high schoolers, starting in Dallas. Mark also saved and annually funds the Dallas Saint Patrick's Day Parade, the largest parade in Dallas and a city institution. In January 2022, he started Mark Cuban Cost Plus Drug Company as an effort to disrupt the drug industry and to help end ridiculous drug prices because every American should have access to safe, affordable medicines. Ferrin Williams, PharmD, MBA, is chief pharmacy officer of Scripta. With 15+ years' experience in the pharmacy industry, Ferrin brings a unique perspective to Scripta that spans the retail pharmacy, pharmacy benefit manager (PBM), and broker/consulting sectors. Her expertise ranges from pharmacy operations and services to innovative clinical programs, pharmacy audit, alternative payer funding, and specialty drugs. As chief pharmacy officer, Ferrin leads the company's clinical strategies organization responsible for devising innovative cost-containment strategies for prescription drugs, ensuring Scripta clients, members, and their providers are provided with best-in-class clinical insights and tools. Ferrin earned her bachelor's, Doctor of Pharmacy, and MBA degrees from the University of Oklahoma.   06:29 What was Mark Cuban's own journey as a self-insured employer with Cost Plus Drug Company? 07:44 What did Mark find when he decided to go through and look through his company's benefit program? 09:12 “When you think it through, you start to realize that money is being spent primarily by your sickest employees.” —Mark 10:02 How do you get CEOs and CFOs of self-insured employers to realize that their sickest employees are the ones subsidizing their checks? 13:00 What is the role of insurance in healthcare? 14:30 “If you can't convince them, confuse them and hide it.” —Mark 15:24 The reality behind getting a rebate check. 16:21 Why are rebates going away, and why isn't that changing PBM earnings? 19:05 How do you get CEOs and CFOs to dig into their benefits plan? 20:59 Does morally abhorrent move the needle? 21:33 “What we're trying to do is just simplify the [healthcare] industry.” —Mark 24:19 What's been changing in consumer behavior? 25:04 “Transparency is a huge part of building that trust.” —Ferrin 25:19 Why CEOs and CFOs really have the power to change healthcare. 32:29 What are Cost Plus Drugs' plans to expand? 39:21 Where is the future of the prescription drug market going? 42:09 What will happen to the prescription drug market in 10 to 20 years? 48:40 The wake-up call self-insured employers should be acknowledging now. 52:02 Where is the real change in the healthcare industry going to come from?   You can learn more at Mark Cuban Cost Plus Drug Company and Scripta Insights. You can also connect with Scripta and Ferrin on LinkedIn.   @mcuban and Ferrin Williams provide advice for #CEOs and #CFOs of #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast #digitalhealth #valuebasedcare #healthcareoutcomes   Recent past interviews: Click a guest's name for their latest RHV episode! Rob Andrews (Encore! EP415), Brian Reid, Dr Beau Raymond, Brendan Keeler, Claire Brockbank, Cora Opsahl, Dan Nardi, Dr Spencer Dorn (EP451), Marilyn Bartlett, Dr Marty Makary  

This episode of Raise the Line is special for a couple of reasons. Our guest, Toh Hong Keng recently graduated from medical school at the age of seventy, making him one of the oldest medical students in the world; and Shiv Gaglani is taking a break from his 3rd year of medical school -- which he is completing at the age of 35 -- to make a rare appearance hosting the show so he can compare notes with Toh about being a non-traditional med student and to learn from his inspiring example. Toh is a retired tech sales executive who earned his medical degree this summer from Southwestern University PHINMA in the Philippines after a long career in the Asia-Pacific region. As he tells Shiv, Toh brushed aside the opinions of acquaintances that pursuing a medical degree in his late sixties was a little crazy. “I'm a firm believer that at this age, we should be able to do what we like to do, not what people think we should be doing.” Tune in to find out what sparked his interest in getting the degree, what his biggest challenges were, how his classmates interacted with him, what he considers highlights of the experience, and what he plans to do next.  You'll also learn about the concept of “sayang” which Toh relied on when he was facing doubts along this very difficult, but rewarding journey. Mentioned in this episode:CNN Article About TohSouthwestern University PHINMA School of Medicine

A troubling disconnect between medical expertise and insurance mandates is putting patients' health at risk. Policies like step therapy and prior authorization are forcing individuals into treatments not recommended by their doctors—often with devastating consequences. In this episode, we hear from a patient who endured months of suffering due to her insurer's 'fail-first' requirements. We also talk with a doctor navigating this impossible system and a biotech leader fighting to ensure innovative treatments reach the patients who need them most. Follow us on LinkedIn, X, Facebook and Instagram. Visit us at https://www.bio.org/

Leaning into the ancient wisdom that ‘practice makes perfect' nursing educators are increasingly embracing approaches such as simulation and competency based education that provide students with low-risk opportunities to practice skills. You might even say that the  ‘see one, do one, teach one' framework has evolved into ‘see one, do one, debrief, get assessed and do it again.' But while research shows these hands-on methods lead to increased patient safety and better clinical outcomes, they can be challenging to implement as we'll learn on this episode from April Rowe Neal, PhD, RN, the graduate nursing simulation educator at Winona State University College of Nursing & Health Sciences. “It can be hard for a lot of faculty because it's not necessarily how we've all been trained, right? You have to take more of that ‘guide on the side' role rather than having all of your lecture notes perfectly typed to deliver to your students,” she explains to new Raise the Line host Kelsey LaFayette, DNP,  Senior Content Manager at Osmosis from Elsevier. On the plus side, Rowe Neal thinks these methods build a partnership between the learner and the teacher. Find out why that happens, learn how her program uses scaffolding to set students up for success and get Rowe Neal's take on the role of mindfulness for medical learners and providers in this insightful conversation.Mentioned in this episode:Winona State University College of Nursing & Health Sciences

Pharmacy closures nationwide are leaving some communities at risk, including in the Kansas City area. Experts say pharmacy benefit managers are what's driving drugstores out of business.

2024 is the year today's Raise the Line guest, Michelle Hughes, is supposed to die. That's according to the diagnosis she received three years ago from an oncologist who told her she had a rare, incurable form of cancer that had already caused innumerable tumors throughout her body.   As a mother of three – with her youngest child being just a few weeks old at the time of her diagnosis – this was obviously devastating news.  But fortunately, the optimism and encouragement of a second oncologist allowed for a new path forward. “It changed my entire world when that one doctor had hope,” she tells host Lindsey Smith.Fueled by the advice of her new doctor “to just live your life” Michelle embraced a healthy lifestyle that includes distance running, including a recently completed triathlon. She has also embraced the role of empowering others to face their challenges through “My Journey to Just Live” an organization she created that keeps her busy doing a blog, social media posts, speaking engagements fundraisers and other activities. Join us for a special edition of our Year of the Zebra series focused on rare diseases to learn about Michelle's challenging journey to motherhood, being a parent to three young children, and living with terminal cancer. “I remind my children and myself that cancer doesn't define me. I'm so much more than that.”For information on the November 16th online premiere of a documentary about Michelle's story, visit My Journey to Just Live