))
Episode 13: A Refreshing Look at Pharmacy Benefits (Part 2)
Manage episode 313694752 series 3282256
Content provided by Cristy Gupton. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Cristy Gupton or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
00:00 Intro
00:40 Vinay Patel of Self-Insured Pharmacy Networks
01:25 In last week's episode
02:38 A day in the life of a community pharmacist
03:32 Pharmacists in a big box format want to cater to patients just like community pharmacists do
03:53 We're replicating the same model on the pharmacy side as DPC has done on the medical side
04:41 Care coordination needs to happen all throughout the local care team (healthcare supply chain)
05:41 Community pharmacist is just that--part of the community
07:00 More tools, more attention to detail, more customization
07:38 Less overspending, overtreatment, example = mail order
07:58 Smaller is better, especially if you're trying hard not to overspend
12:00 Is mail order even all it's cracked up to be?
14:30 Those dealing with healthcare challenges could benefit by having another member of the local care team to help "tag team" with the physician
18:24 When you have a chronic disease you need high-touch support and accountability
19:00 Getting back to the basics might not be a bad thing
20:00 We drifted away from relationship-based primary care but we're coming back to it
20:32 www.sipharmacynetwork.com, Self-Insured Pharmacy Networks based in Raleigh, NC
21:00 vinay.patel@sipharmacynetwork.com
21:41 No one definition of "specialty drug". The definition your PBM gives it is in your contract
22:15 Get an actual list of what specialty drugs are on your formulary
22:26 Make sure you ask lots of questions
22:47 There shouldn't be any generic drugs in the specialty category
23:37 Allocate much more time to the PBM contract
25:00 Spend more time to the upfront education about the prescription drug benefit and what goes into that design
27:00 Crawl, walk, run strategy
28:30 Employers need a co-fiduciary to be their partner
30:00 Carriers glossed over Rx like there was "nothing to see here"
31:00 Rockford, IL story
32:00 You MUST read your PBM contract
33:43 This is people's lives we are dealing with
34:00 Municipality resources are deficient today because of the drainage into the healthcare system
35:00 Thank you, www.custombenefits.work, #letsfixhealthcare
32 episodes
Share
