POPULARITY
Guests:Robin Arnicar, president, NADONATJ Griffin, chief clinical officer, Pharmerica
For a full transcript of this episode, click here. This conversation I am having with Dan Mendelson, my guest today, all started with a post that he had written on LinkedIn considering how pharmacy benefits can or should be optimized within the broader context of value-based care. Total cost of care, value-based medical care, and pharmacy benefits—these worlds have to collide. There is just so much intertwined into all of this, which is why I pretty much immediately invited him to come back on the pod to discuss in greater detail. A few years ago, I heard a doctor say that practicing medicine without considering pharmacy is like getting to the 90 yard line, putting down the ball, and walking off the field. And, yeah … when a patient gets to a certain point in a whole lot of disease progressions, optimal medical therapy includes pharmacy. It's a thing. Adherence is a thing. In fact, I saw a stat the other day that patients not taking their meds costs an estimated $3874 PEPY (per employee per year). Also, half of all hospital admits are caused by nonadherence. Those two stats, by the way, are from a post on LinkedIn by Brian Bellware, who was recapping a video from Eric Bricker, MD. But also, as Barbara Wachsman (EP430) said on the show, half, I think she said, of all ER visits are due to patients not taking their meds right. Olivia Webb (EP337) was on the pod, if you want to go back and listen to that one, talking about how she spends hours every month trying to figure out how to navigate access issues to manage to get her Crohn's disease drug. So, yeah … one underlying reason why a lot of this stuff happens is that pharmacy benefits are purchased and siloed a lot of times. In fact, I have yet to see, really, any mainstream contract wherein a PBM (pharmacy benefit manager) is held accountable in any way for downstream medical costs, which may be incurred because of suboptimal pharmacy benefit design, right? And there are so many examples of bad downstream medical impacts. I really like how Mark Fendrick, MD, put it in episode 308. He said benefits, including pharmacy benefits, are like peanut butter and jelly relative to enabling high-quality care. You gotta have both working in concert, like CMS or a plan sponsor just paid a ton of money to get a patient an organ transplant, and then the patient can't afford their transplant meds, which aren't on formulary and are really expensive, and therefore there's organ rejection. This happens. Or a patient with uncontrolled diabetes with a huge co-pay for insulin. Doctor says, “Hey, you gotta take your insulin.” Patient says, “Can't afford it.” Right? This makes no sense, and it's shockingly common. I'm thinking right now of that young man who died in the Midwest because he could not get his asthma inhaler. It wasn't on formulary. So, here's the game plan. I talk with Dan about the five kind of vital considerations he had brought up in that aforementioned LinkedIn post when considering how pharmacy benefits can or should be optimized within the broader context of value-based care. Dan's advice for the pharma industry is woven in here as much as his advice for EBCs (employee benefit consultants) and employers. I am sure that most of our listeners are going to be very familiar with Dan Mendelson, my guest today, and his work; but the quick background here is that he runs Morgan Health. The mission over there at Morgan Health is to drive innovation in employer-sponsored healthcare, and they do that by investing and working with their portfolio companies in the context of the 300,000 or so employees over at JPMorgan Chase. At the same time, Morgan Health also engages in policy discussions because, as Dan says, no one employer is going to control public policy. As a footnote here, I just will say that I actively seek out opportunities to listen to Dan Mendelson's thoughts. He has spoken a lot and really eloquently and with great insight about setting up the economic models for healthcare, not sick care. Recently, actually, he was on a panel at the Milken conference along with Natalie Davis; Yele Aluko, MD, MBA; and Henry Ting, MD. There are definitely insights to be gleaned. Also mentioned in this episode are Brian Bellware, CIC, CHVP; Eric Bricker, MD; Barbara Wachsman; Olivia Webb; Mark Fendrick, MD; Natalie Davis; Yele Aluko, MD, MBA, FACC, FSCAI; Henry Ting, MD; Ashok Subramanian; Rik Renard; Nina Lathia, RPh, MSc, PhD; Don Berwick, MD; Kenny Cole, MD; Steve Pearson, MD, MSc; Sarah Emond; Alex Sommers, MD, ABEM, DipABLM; and Jodilyn Owen. You can learn more at the Morgan Health Web site and follow Dan on LinkedIn. Dan Mendelson is the chief executive officer of Morgan Health at JPMorgan Chase & Co. He oversees a business unit at JPMorgan Chase focused on accelerating the delivery of new care models that improve the quality, equity, and affordability of employer-sponsored healthcare. Mendelson was previously founder and CEO of Avalere Health, a healthcare advisory company based in Washington, DC. He also served as operating partner at Welsh Carson, a private equity firm. Before founding Avalere, Mendelson served as associate director for health at the Office of Management and Budget in the Clinton White House. Mendelson currently serves on the boards of Vera Whole Health and Champions Oncology (CSBR). He is also an adjunct professor at the Georgetown University McDonough School of Business. He previously served on the boards of Coventry Healthcare, HMS Holdings, Pharmerica, Partners in Primary Care, Centrexion, and Audacious Inquiry. Mendelson holds a Bachelor of Arts degree from Oberlin College and a Master of Public Policy (MPP) from the Kennedy School of Government at Harvard University. 04:50 How do we connect the dots between value-based care and pharmacy benefits? 07:43 Where do things need to go for employers in terms of drug spend integration? 08:42 How do we think about having a value-based component in the decision-making process? 09:44 How do we enable the necessary information to make proper decisions? 10:56 EP206 with Ashok Subramanian. 11:21 “Many payviders just haven't gotten to pharmacy yet; they need to.” 14:14 Why do pharmaceutical companies need to be prepared to contract on the basis of value? 16:46 EP426 with Nina Lathia, RPh, MSc, PhD. 17:36 EP431 with Kenny Cole, MD. 18:07 Why is it important to “let the market work”? 21:04 Why do we have cost sharing, and when does it not make sense to have that as a co-pay? 23:59 Why are evidence requirements good for everyone? 28:45 Why is pooling of risk important? 29:49 How do you pool risk without going to an insurance company? 32:03 What is Dan's advice to hospitals? 33:30 “In a value-based world, buy and bill does not make sense.” 33:36 What is Dan's advice to primary care doctors? 33:54 What is Dan's advice to entrepreneurs and innovators? You can learn more at the Morgan Health Web site and follow Dan on LinkedIn. @dnmendelson discusses #pharmacybenefits on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation Recent past interviews: Click a guest's name for their latest RHV episode! Dr Benjamin Schwartz, Justin Leader, Dr Scott Conard (Encore! EP391), Jerry Durham (Encore! EP297), Kate Wolin, Dr Kenny Cole, Barbara Wachsman, Luke Slindee, Julie Selesnick, Rik Renard
In Episode 8 of FrameworkFocus, Dr. Mark Fulton interviews TJ Griffin, Chief Clinical Officer at PharMerica, in a fast-paced exploration of the LTC pharmacy landscape in 2024. PharMerica is a national leader in pharmacy services, serving our partners in over 3,100 long-term care, senior living, IDD/behavioral health, home infusion, specialty pharmacy, and hospital management programs. In this conversation, the pair dive into the workforce challenges faced by LTC pharmacies. Griffin explores the advancements in pharmacy practice, including an expanded scope and additional opportunities for pharmacies. Host: Dr. Mark Fulton & Guest: TJ Griffin, Chief Clinical Officer, Pharmerica
There are two big reasons why I decided to encore this show with Dan Mendelson from Morgan Health at this exact moment in time. 1. It's a great show (one of our most popular shows in the last year, actually) with lots of keen insights for self-insured employers—and by self-insured employers, I mean HR folks, of course, but also CEOs and CFOs. That was foreshadowing for my second reason. 2. It's gonna be an employer CEO/CFO triple play here on Relentless Health Value. Next week on the pod, my guest is Mark Cuban, along with Ferrin Williams from Scripta. And Mark Cuban, spoiler alert, has his own message for CEOs and CFOs of self-insured employers. Then the week after that, we hear from Andreas Mang from Blackstone who shares, among other things, what happens when some company gets bought by Blackstone and that CEO shows up for a meeting with Andreas and that CEO happens to know nothing about their vast, inefficient, and wildly wasteful healthcare spend. And with that, here is your encore. For a physician practice to transform itself from an FFS (fee-for-service) machine cranking out volume but not necessarily health or care, the office has to have a high enough percentage of their patients in value-based arrangements to make it actually feasible to transform. It is only when they hit a tipping point of enough patients in risk-based contracts that they can afford to be accountable for their results. At that point, yeah, everybody wins—doctors, patients, actually the entire community wins because when a local practice transforms, all of their patients tend to benefit at some level from the new processes and procedures and standardizations and pop health systems that get put in place. So, let's move forward with this with all haste, shall we? Why aren't we? What's the problem here? Well, there are lots of problems, don't get me wrong. But a big one is self-insured employers on the whole are not offering any sort of accountable care arrangements to the providers in their community. This is 150 million patient lives we're talking about here—a huge chunk of many providers' patient panels. Self-insured employers have a really big opportunity to level up the care in their whole community due to the spillover effect when a provider practice transforms itself because it has enough patients to do so. But these employers are stuck. They are paralyzed. They are doing the same thing this year that they've done last year, and therefore their whole community is equally stuck in a smorgasbord of suboptimal FFS goings-on. So, offering accountable care contracts is one thing (a very big consequential thing) that is also one of the five things self-insured employers can do to improve employee health that I talk about in this healthcare podcast with Dan Mendelson. Dan Mendelson, my guest today, also wrote a Forbes article listing out these five things. Here are all five things that Dan mentions in one handy list: 1. Expand availability of accountable care models to improve the care experience, quality, and affordability at a local level. For a deep dive on this, listen to the show with Dave Chase (EP374). 2. Invest in the data access needed to assess health outcomes. For a deep dive on this, listen to the show with Cora Opsahl (EP372). 3. Align employees' health benefits with pop health outcomes. For a deep dive on this, listen to the show with Mark Fendrick, MD (Encore! EP308). 4. Prioritize care models that can meet employees wherever they are. For a deep dive on the DEI (diversity, equity, and inclusion) aspect of this, listen to the show with Monica Lypson, MD, MHPE (EP322). 5. Make care navigation a central part of the benefits package and experience. My guest today, Dan Mendelson, is CEO of Morgan Health at JPMorgan Chase. He previously founded Avalere Health. Before that, Dan served as associate director for health at the Office of Management and Budget. Besides exploring the why and the what for each of the five things employers should do right now, I also wanted to find out from Dan what's going on at Morgan Health and how they are looking to help self-insured employers who want to do these five things actually do them. You can learn more at the Morgan Health Web site. Dan Mendelson is the chief executive officer of Morgan Health at JPMorgan Chase & Co. He oversees a business unit at JPMorgan Chase focused on accelerating the delivery of new care models that improve the quality, equity, and affordability of employer-sponsored healthcare. Mendelson was previously founder and CEO of Avalere Health, a healthcare advisory company based in Washington, DC. He also served as operating partner at Welsh Carson, a private equity firm. Before founding Avalere, Mendelson served as associate director for health at the Office of Management and Budget in the Clinton White House. Mendelson currently serves on the boards of Vera Whole Health and Champions Oncology (CSBR). He is also an adjunct professor at the Georgetown University McDonough School of Business. He previously served on the boards of Coventry Healthcare, HMS Holdings, Pharmerica, Partners in Primary Care, Centrexion, and Audacious Inquiry. Mendelson holds a Bachelor of Arts degree from Oberlin College and a Master of Public Policy (MPP) from the Kennedy School of Government at Harvard University. 05:01 Why did Dan direct his article about health benefits at CEOs? 06:03 What does an accountable care model mean to a self-insured employer? 07:58 “This alignment of value will never work … if the 150 million Americans … getting their health insurance through their employer are not also aligned in the same way.” 11:28 “We're offering them a higher level of service.” 11:40 “Everything that we do is intended to be scalable and not just for us.” 12:09 “We have an obligation to do better for our employees.” 14:52 “Employers need to understand, the only way to get outstanding care is locally.” 17:28 Encore! EP206 with Ashok Subramanian and EP358 with Wayne Jenkins, MD. 18:18 Why is getting quantitative metric data important? 18:50 Encore! EP308 with Mark Fendrick, MD. 20:58 “This is a much broader vision of accountable care than … primary care.” 22:48 “Until everything is aligned, the employer is just not going to be providing an optimal product.” 23:39 “There are substantial issues with … health equity, and employers are paying for the care of 150 million Americans in this country.” 25:23 Is digital health access important for creating meaningful relationships between patients and providers? 29:50 What is the myth that employers need to tackle? 30:18 Why is care navigation important for employees? 31:44 EP334 with Sunita Desai, PhD. You can learn more at the Morgan Health Web site. @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast Recent past interviews: Click a guest's name for their latest RHV episode! Josh Berlin, Dr Adam Brown, Rob Andrews, Justina Lehman, Dr Will Shrank, Dr Carly Eckert (Encore! EP361), Dr Robert Pearl, Larry Bauer (Summer Shorts 8), Secretary Dr David Shulkin and Erin Mistry, Keith Passwater and JR Clark (Summer Shorts 7)
Episode 15 of the Spoonful of Sugar podcast, recorded live at the AHCA/NCAL Conference earlier this month, features AHCA/NCAL President and CEO Mark Parkinson, along with John O'Connor from McKnight's Long Term Care News, and TJ Griffin, Chief Clinical Officer at PharMerica. Hear them discuss the current landscape and challenges facing the long-term care sector, the shift toward patient-centered care, and how technology can enhance care and residents' well-being.
TJ Griffin is SVP of LTC Operations and Chief Pharmacy Officer at PharMerica. TJ is a seasoned healthcare executive with 30 years in long-term care and retail pharmacy management. In his current role, he helps deliver on the PharMerica promise of Care, Commitment and Collaboration by maintaining the highest quality standards in the industry through innovative pharmacy operations and clinical excellence. During his 20 years at PharMerica, TJ has held several positions, starting as Pharmacy Director, then serving as Regional Pharmacy Director and Vice President of Operations, experiences that have helped shape the company's Community Focus, National Expertise. TJ is also very active with the American Society of Consultant Pharmacists, serving as co-Chair of their DEA Task Force, and Vice-Chairman of the ASCP Foundation. He was a long-term care pharmacy representative on Operation Warp Speed.
An Open Letter To Administrators: DONs and administrators work toward the same goal. But it often seems they are miles apart, especially when it comes to ensuring nurses receive the tools and support they need. In this engaging and lively discussion, nurses will speak out about ways to improve the dynamic. pharmerica.com nadona.org
Amazon has new echo devices, but that's not helping their drone deliveries, Zelda is a thing, and people still use pagers. That and so much more this episode. Enjoy and tech better! Watch on YouTube! Followup: Todd asked if there are shows on Twitter Long form video on Twitter (00:55) New Apple announcements (03:25) Free Telly from the Pluto TV people (06:15) Amazon has new echo devices (10:30) Logitech partners with iFixit for self-repairs (13:10) The HP ink issue gets worse (14:50) Amazon has only made 100 drone deliveries (15:45) OpenAI launches official iOS app (18:15) You can't parody Wes Anderson because he is a parody of himself (20:20) Dave's Pro Tip of the Week: Manage location services on iOS (21:00) Takes: Legend of Zelda: Tears of the Kingdom sells 10M copies in 3 days (26:00) AT&T tries to block Starlink/T-Mobile plan for satellite-to-phone service (29:30) Google will soon let Pixel phones double as dash cams (31:55) People are still using pagers (34:15) Re-Victimization from Police-Auctioned Cell Phones (36:40) Ransomware gang steals data of 5.8 million PharMerica patients (39:30) Bonus Odd Take: Phil Grishayev discovers locations of famous movies and recreates their scenes (40:10) Picks of the Week: Dave: Unifi Dream Router (43:25) Nate: YouTube Premium - YouTube adding 30-second unskippable ads (48:30) Find us elsewhere: https://notpicks.com https://www.notnerd.com https://www.youtube.com/c/Notnerd https://ratethispodcast.com/notnerd https://www.tiktok.com/@notnerdpod https://www.twitter.com/n0tnerd/ https://www.instagram.com/n0tnerd https://www.facebook.com/n0tnerd/ info@Notnerd.com Call or text 608.618.NERD(6373) If you would like to help support Notnerd financially, mentally, or physically, don't hesitate to get in touch with us via any of the methods above. Consider any product/app links to be affiliate links.
Names, dates of birth, Social Security numbers, medication lists and health insurance information were exposed in the breach
The Cybercrime Magazine Podcast brings you daily cybercrime news that airs each day on WCYB Digital Radio, the first and only 7x24x365 Internet radio station devoted to cybersecurity. Our host keeps you on the cutting edge of cyber with a rundown of the latest cyberattacks, hacks, data breaches, and more. Don't miss an episode! Airs every half-hour on WCYB and every day on our podcast. Listen to today's news at https://soundcloud.com/cybercrimemagazine/sets/cybercrime-daily-news
The EU actually approved the Microsoft Activision acquisition so… what now? The IRS might finally allow us to file our taxes online for free. The EU passes the first crypto regulatory regime, but questions are being asked of their forthcoming digital Euro experiment. And an interesting raise allows us to take our first look at the Open Source vs. Centralized debate when it comes to AI.Sponsors:Collective.comLinks:E.U. Approves Microsoft's $69 Billion Deal for Activision (NYTimes)IRS tests free e-filing system that could compete with tax-prep giants (Washington Post)Windows 11 users can now link their iPhones and use iMessage from a PC (The Verge)Ransomware gang steals data of 5.8 million PharMerica patients (BleepingComputer)Twitter makes its first acquisition with a recruiting startup (Axios)EU's Crypto Legal Framework Inches Towards Law With Finance Ministers' Sign-Off (CoinDesk)The digital euro: a solution seeking a problem? (Financial Times)AI startup Together raises funding for open-source AI and cloud platform (VentureBeat)See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
In today's podcast we cover four crucial cyber and technology topics, including: 1. airBaltic leaks passenger flight details 2. PharMerica has data stolen, likely by Money Message ransomware 3. Former ByteDance employee alleges Chinese abuse of TikTok 4. Former Ubiquiti employee gets 6 years in prison for attempted extortion I'd love feedback, feel free to send your comments and feedback to | cyberandtechwithmike@gmail.com
At Viviant Healthcare of Murfreesboro, located in rural TN, 25% of residents are short stay. When they leave, Lisa Lugo, Director of Social Services, worries. Lacking transportation makes it hard for many to fill prescriptions. Some in need of pain medications can't get an appointment with a pain clinic for days. Others return home and don't follow up with their healthcare providers. Without support, residents may experience health mishaps that land them back in the hospital. To avoid these complications, Lugo opted to take part in a pilot program for Continue Care, a suite of services from PharMerica designed to help keep patients healthy at home. It worked: the rehospitalization rate for Viviant during the pilot was 10%, a significant improvement over the average rate among SNFs of 23%-31%. And residents weren't the only ones who benefitted. By eliminating manual processes and calls or faxes to the pharmacy to get prescriptions filled, Continue Care saves a lot of staff time and frustration and frees caregivers up to spend more time with residents. Plus, with a three on/three off schedule, there's no risk of orders falling through the cracks between shifts. Hear firsthand from Lugo when she joins hosts John O'Connor and TJ Griffin along with PharMerica's Bill Deane, whose team operationalized the program, to discuss her facility's previous processes that prompted her to adopt Continue Care and the positive impacts it has had on outcomes and her team alike.
CMS plans to increase psychotropic drugs oversight – to include targeted audits. These stepped up efforts follow the latest updates to the State Operations Manual surveyors started using October 24, which include unnecessary psychotropic use, misdiagnosis related to antipsychotics, and gradual dose reductions of these medications. Nursing facilities are not yet required to have a psychotropic stewardship program. But adopting one can preempt regulatory action while promoting the appropriate use of these medications to improve outcomes, reduce adverse events, and drive a higher Five-Star rating. Listen as hosts TJ Griffin and John O'Connor discuss the importance of implementing a psychotropic stewardship program to prevent headaches, problems, and costs down the line – and get a leg up if CMS decides to mandate such an initiative.
Kurt interviews Zack Barlow, Director of Marketing Operations and Product Marketing at PharMerica. In his role, Zack oversees branding and content teams, and supports the sales team in their lead generation efforts. Zack and Kurt discuss innovating solutions for complex problems, root cause analysis, and how personalized communication is key.
Staffing shortages and high turnover rates are constant challenges across the sector. Unfortunately, COVID-19 has only made things worse. Nursing facilities have lost nearly a quarter million employees during the current pandemic. Given the direct correlation between staffing levels and adverse outcomes -- including increased mortality, hospitalizations, and ED visits -- how can facilities improve the safety and quality of care when workers can't be had? Back by popular demand, we'll discuss ways nursing homes can maximize staff efficiency by putting first things first. Among the issues our provider panel will address: Streamlining workflows and optimizing processesSystematic and consistent use of operating protocolsTraining and development to boost capabilities and versatilitySupport that can ease staff burdens like feedback, variety, and growth, because when employees are satisfied, work is completed faster and with better results You will walk away with proven methods to enhance operational efficiencies while improving outcomes.
If you listened to the show with Dan O'Neill (EP359), you would know this already. But let me tell you: If you're a provider, even a provider very confident in your office's ability to confer better patient health, you will still have a super hard time getting off the fee-for-service (FFS) hamster wheel. Why? Because it's hard to find payer contracts out there which will reward you (the provider) for actually taking care of your patients and to be accountable for the value of healthcare that you deliver. This is a tangled web we weave because, despite some payers offering risk-based contracts, a lot of times there's some IPA (independent physician association) or other “holder of the actual payer contract” who does not pass along these contract terms. These IPAs or health systems even sometimes just keep paying docs or provider offices FFS even if they themselves have a risk-based or capitated or value-based-of-any-kind agreement. If I actually kept track of the issues raised in the emails I receive from docs, there's one thing that I would likely find amongst the most frequently cited points of consternation: Physicians or practices or CINs (clinically integrated networks) or ACOs (accountable care organizations) want contracts where they can do right by patients. These are the good docs. These are the ones burned out and suffering from moral injury because physicians, PAs (physician assistants), nurses, clinicians who actually follow up and coordinate care and spend time making accurate diagnoses instead of cramming in more procedures … these are the clinicians who want to do the right thing and are also the ones who are getting dinged on performance reports and paid less. Bottom line here, for a physician practice to transform itself from an FFS machine cranking out volume but not necessarily health or care, the office has to have a high enough percentage of their patients in value-based arrangements to make it actually feasible to transform. It is only when they hit a tipping point of enough volume, enough patients in risk-based contracts that they can afford to be accountable for their results. At that point, yeah, everybody wins—doctors, patients, actually the entire community wins because when a local practice transforms, all of their patients tend to benefit at some level from the new processes and procedures and standardizations and pop health systems that get put in place. So, let's move forward with this with all haste, shall we? Why aren't we? What's the problem here? Well, there are lots of problems, don't get me wrong. But a big one is self-insured employers on the whole are not offering any sort of accountable care arrangements to the providers in their community. This is 150 million patient lives we're talking about here—a huge chunk of many providers' patient panels. Self-insured employers have a really big opportunity to level up the care in their whole community due to the spillover effect when a provider practice transforms itself because it has enough patients to do so. But these employers are stuck. They are paralyzed. They are doing the same thing this year that they've done last year, and therefore their whole community is equally stuck in a smorgasbord of suboptimal FFS goings-on. So, offering accountable care contracts is one thing (a very big consequential thing) that is also one of the five things self-insured employers can do to improve employee health that I talk about in this healthcare podcast with Dan Mendelson. Dan Mendelson, my guest today, also wrote a Forbes article listing out these five things. Here are all five things that Dan mentions in one handy list: Expand availability of accountable care models to improve the care experience, quality, and affordability at a local level. For a deep dive on this, listen to the show with Dave Chase (EP374). Invest in the data access needed to assess health outcomes. For a deep dive on this, listen to the show with Cora Opsahl (EP372). Align employees' health benefits with pop health outcomes. For a deep dive on this, listen to the show with Mark Fendrick, MD (Encore! EP308). Prioritize care models that can meet employees wherever they are. For a deep dive on the DEI (diversity, equity, and inclusion) aspect of this, listen to the show with Monica Lypson, MD, MHPE (EP322). Make care navigation a central part of the benefits package and experience. I am looking for an expert to take a deep dive on care navigation who does not work for a care navigation company. Hit me up if you know someone (again, who does not work for a care navigation company). My guest today, Dan Mendelson, is CEO of Morgan Health at JPMorgan Chase. He previously founded Avalere Health. Before that, Dan served as associate director for health at the Office of Management and Budget. Besides exploring the why and the what for each of the five things employers should do right now, I also wanted to find out from Dan what's going on at Morgan Health and how they are looking to help self-insured employers who want to do these five things actually do them. You can learn more at the Morgan Health Web site. Dan Mendelson is the chief executive officer of Morgan Health at JPMorgan Chase & Co. He oversees a business unit at JPMorgan Chase focused on accelerating the delivery of new care models that improve the quality, equity, and affordability of employer-sponsored healthcare. Mendelson was previously founder and CEO of Avalere Health, a healthcare advisory company based in Washington, DC. He also served as operating partner at Welsh Carson, a private equity firm. Before founding Avalere, Mendelson served as associate director for health at the Office of Management and Budget in the Clinton White House. Mendelson currently serves on the boards of Vera Whole Health and Champions Oncology (CSBR). He is also an adjunct professor at the Georgetown University McDonough School of Business. He previously served on the boards of Coventry Healthcare, HMS Holdings, Pharmerica, Partners in Primary Care, Centrexion, and Audacious Inquiry. Mendelson holds a Bachelor of Arts degree from Oberlin College and a Master of Public Policy (MPP) from the Kennedy School of Government at Harvard University. 05:53 Why did Dan direct his article about health benefits at CEOs? 06:56 What does an accountable care model mean to a self-insured employer? 08:50 “This alignment of value will never work … if the 150 million Americans … getting their health insurance through their employer are not also aligned in the same way.” 12:21 “We're offering them a higher level of service.” 12:32 “Everything that we do is intended to be scalable and not just for us.” 13:01 “We have an obligation to do better for our employees.” 15:44 “Employers need to understand, the only way to get outstanding care is locally.” 18:21 Encore! EP206 with Ashok Subramanian and EP358 with Wayne Jenkins, MD. 19:10 Why is getting quantitative metric data important? 19:42 Encore! EP308 with Mark Fendrick, MD. 21:50 “This is a much broader vision of accountable care than … primary care.” 23:41 “Until everything is aligned, the employer is just not going to be providing an optimal product.” 24:32 “There are substantial issues with … health equity, and employers are paying for the care of 150 million Americans in this country.” 26:15 Is digital health access important for creating meaningful relationships between patients and providers? 30:43 What is the myth that employers need to tackle? 31:10 Why is care navigation important for employees? 32:37 EP334 with Sunita Desai, PhD. You can learn more at the Morgan Health Web site. @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast Why did Dan direct his article about health benefits at CEOs? @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast What does an accountable care model mean to a self-insured employer? @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast “This alignment of value will never work if the 150 million Americans getting their health insurance through their employer are not aligned in the same way.” @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast “We're offering them a higher level of service.” @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast “Everything that we do is intended to be scalable and not just for us.” @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast “We have an obligation to do better for our employees.” @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast “Employers need to understand, the only way to get outstanding care is locally.” @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast Why is getting quantitative metric data important? @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast “This is a much broader vision of accountable care than … primary care.” @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast “Until everything is aligned, the employer is just not going to be providing an optimal product.” @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast “There are substantial issues with … health equity, and employers are paying for the care of 150 million Americans in this country.” @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast Is digital health access important for creating meaningful relationships between patients and providers? @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast What is the myth that employers need to tackle? @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast Why is care navigation important for employees? @dnmendelson of @JPMorgan discusses #selfinsuredemployers on our #healthcarepodcast. #healthcare #podcast Recent past interviews: Click a guest's name for their latest RHV episode! Wendell Potter, Brian Klepper (Encore! EP335), Dr Aaron Mitchell (EP382), Karen Root, Mark Miller, AJ Loiacono, Josh LaRosa, Stacey Richter (INBW35), Rebecca Etz (Encore! EP295), Olivia Webb (Encore! EP337), Mike Baldzicki, Lisa Bari, Betsy Seals (EP375), Dave Chase, Cora Opsahl (EP373), Cora Opsahl (EP372), Dr Mark Fendrick (Encore! EP308), Erik Davis and Autumn Yongchu (EP371), Erik Davis and Autumn Yongchu (EP370), Keith Hartman, Dr Aaron Mitchell (Encore! EP282), Stacey Richter (INBW34), Ashleigh Gunter, Doug Hetherington, Dr Kevin Schulman, Scott Haas, David Muhlestein
Staffing shortages and high turnover rates are constant challenges across the sector. Unfortunately, COVID-19 has only made things worse. Nursing facilities have lost nearly a quarter million employees during the current pandemic. Given the direct correlation between staffing levels and adverse outcomes -- including increased mortality, hospitalizations and ED visits -- how can facilities improve the safety and quality of care when workers can't be had? Back by popular demand, we'll discuss ways nursing homes can maximize staff efficiency by putting first things first. Among the issues our provider panel will address: Streamlining workflows and optimizing processesSystematic and consistent use of operating protocolsTraining and development to boost capabilities and versatilitySupport that can ease staff burdens like feedback, variety, and growth, because when employees are satisfied, work is completed faster and with better results You will walk away with proven methods to enhance operational efficiencies while improving outcomes. pharmerica.com
Thanks to COVID-19 and rapidly rising inflation, operators must now pay more than ever for virtually everything. In episode 2 of this two-part Spoonful of Sugar podcast, industry legend Robert G. Kramer will address how and why operators must grow to succeed. He'll address influencers that support growth and expansion moving forward -- and how facilities can take advantage to improve care, occupancy and the bottom line.
For the past two years, operators have had to deal with higher costs brought on by COVID-19. Now comes the highest inflation rates seen in more than four decades. In episode 1 of this two part-Spoonful of Sugar podcast, you will hear from industry legend Robert G. Kramer as he talks through the impact of higher operating costs in this sector. He'll dig into the diverse new pressures operators are coping with, and will discuss why the new normal promises to be very different indeed.
MDS coordinators are usually responsible for two core duties: monitoring care quality and maximizing payments. But as staffing challenges worsen and regulations increase, more MDS coordinators are taking on a third responsibility: walking the floor. Is this a reasonable job extension? Or an unfair demand? Moreover, might facilities that adopt this practice be leaving money on the table? In this Spoonful of Sugar podcast, two of the nation's foremost nursing experts will address the pros and cons of this emerging trend.
From staffing and regulatory issues to the many challenges DONs face in long-term care, NADONA, McKnight's and PharMerica surveyed nurses to find out their biggest concerns in 2022. We'll address them all during our live podcast event. In this podcast, we will discuss the topics nurses told us are their top challenges, including important trends that are, or will be, affecting you, your facilities, and your residents. We know keeping educated about and on top of these issues is a constant challenge for DONs and Nurse Leaders. That's why we're here for you with solutions to the top concerns you face daily. You have a voice with us!
In this episode, we'll hear from Mark Parkinson firsthand on growth opportunities and strategies your organization can embrace. These insights will help providers not just survive, but thrive in the years ahead.
In this episode, we'll hear from Mark Parkinson firsthand on his specific request to have Congress take additional steps to ensure the safety and protection of America's most vulnerable. You will walk away with a better understanding of how these measures would help invest in the frontline caregivers our nation's seniors need, so they continue to have access to high quality, long-term care. Read the full letter.
In this episode, we'll explore the influencers that support this transitional care model and how facilities can take steps to capitalize on the growth of care at home to impact their census, financial penalties, and outcomes. This is the third installment of the Spoonful of Sugar podcast. Please click here to tune into its first and second installments.
The workforce crisis in long-term care is not a new phenomenon, but one that has been decades in the making. Regulations make it difficult for facilities to stay efficient without investing in resources to manage the overload of daily administrative work. Long-term staffing plans are certainly worth considering, but ultimately freeing up staff from administrative tasks and introducing operational efficiencies that allow them to spend more time with patients is in everyone's best interest – the facility's, the staff's, and the patients'. Many administrative tasks in long-term care are repetitive and tedious, which leave care teams overworked and with less time to spend on patients. However, with minimal investment, hundreds of hours can be saved while delivering better patient outcomes, lower operational costs, and faster revenue recognition. In this episode, we'll examine trends, challenges, and opportunities facing long-term care leaders in skilled nursing. You will walk away with proven methods to enhance operational efficiencies while improving outcomes.
This episode explores how skilled nursing facilities can leverage their partners and vendors to offset these challenges with innovative solutions that can drive better care and outcomes.
Dan Mendelson is CEO of Morgan Health at JPMorgan Chase & Co. He was previously Founder and CEO of Avalere Health, a healthcare advisory company based in Washington DC. Dan also served as Operating Partner at Welsh Carson, a private equity firm. Before founding Avalere, Dan served as associate director for Health at the Office of Management and Budget in the Clinton White House. Dan currently serves on the board of Champions Oncology (CSBR) and is an adjunct professor at the Georgetown University McDonough School of Business. He previously served on the boards of Coventry Healthcare, HMS Holdings, Pharmerica, Partners in Primary Care, Centrexion, and Audacious Inquiry. He holds a BA from Oberlin College, and an MPP from the Kennedy School of Government at Harvard University. The Caring Economy made it onto FeedSpots Top 30 CSR Podcasts Don't forget to check out my book that inspired this podcast series, The Caring Economy: How to Win With Corporate Social Responsibility (CSR). --- Support this podcast: https://anchor.fm/toby-usnik/support
Stephen Creasy, the Director of Clinical Services at PharMerica, joins us to talk about how PharMerica approached pandemic response at their long-term care facilities, the potential of pharmacogenetics and precision medicine in long-term care settings, and the importance of embracing new technologies to improve patient care. Show Notes: 2:15 Stephen's past experience and why he joined Pharmerica 5:40 Key takeaways working at Pharmerica / What is long-term care? 7:07 Pandemic response 9:10 Vaccine rollout 12:00 Application of pharmacogenetics in prescribing 16:24 How the vaccine rollout can inform the best approaches to future novel programs 18:10 Potential for pharmacogenetics in long term care settings 20:40 Challenges for precision medicine in long term care 22:34 Importance of embracing new technologies Find Stephen Creasy on LinkedIn
Listen NowHealth care insurance plans and policy makers are constantly working toward improving cost management. Recently two techniques to do so have reemerged in this effort: narrow networks and reference pricing, techniques that have enjoyed success in the past. Likely the largest (de facto) user of narrow networks is the integrated health plan Kaiser and CalPERS (the California Public Employees's Retirement System) has saved millions in its use of reference pricing. What are these practices, to what extent are they successful in saving money (and improving health care quality) both for payers and patients and what are the real and/or potential downside risks associated with these practices. During this 21-minute interview Dan Mendelson defines these two cost savings techniques, i.e., how do they work or why they are attractive to plans, do they improve health care quality both within and beyond the ACA insurance marketplaces and how or why these techniques might not be in the best interests of patients (and possibly providers as well). Dan Mendelson is CEO of Avalere Health, a DC-based health care research and policy consulting firm. Dan leads the organization's operations and engages in strategic advisory work for major clients in life sciences, managed care and in many provider segments. Prior to founding Avalere in 2000, Dan served as Associate Director for Health at the White House Office of Management and Budget. Dan also presently serves on the board of two public companies: HMS Holdings; and, Champions Oncology. He previously served on the boards of Coventry Healthcare and Pharmerica. Dan is also on the faculty at the Wharton School of Business at the U. of Penn. He holds a BA in Economics and Viola Performance from Oberlin College and a MPP from the Harvard Kennedy School of Goverment. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com