Moving to Value Alliance
Moving to Value Alliance
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PBM Problems (Part 4): Challenges & Solutions for Independent Pharmacies w/ National Community Ph...
Pharmacists are one of the most trusted professions, yet more and more pharmacies are closing. A recent survey (benjaminjolley.substack.com/p/2275-pharmacies-have-closed-so-far?publication_id=72487&post_id=148814481&isFreemail=true&r=21b848&triedRedirect=true&) found 2275 pharmacies have closed so far this year, and every day independent pharmacies are shuttering their doors - often leaving “pharmacy deserts” in their wake.
Vertically-consolidated Pharmacy Benefit Managers (PBMs) have made it practically impossible for local pharmacies to survive, and we’re all paying the price.
But independent pharmacists are speaking out and pushing back - and they’ve secured wins!
General Counsel for the National Community Pharmacists Association (NCPA) Matt Seiler joins MTVA to discuss the current state of community pharmacy, how “shareholder capitalism” got us here, and what comes next. NCPA (ncpa.org/about) is the voice for independent pharmacy, representing the interests of nearly 19,000 community pharmacies across the country.
Despite the challenges facing his industry, Matt is optimistic that desperately-needed PBM reform is on the horizon.
“If there’s one thing that’s brought the political parties together in our country, it’s the dislike for pharmacy benefit managers.”
Listen to learn more about the unique role community pharmacists play in the health system, why PBM consolidation is particularly acute at the local level, and how NCPA has helped secure bipartisan support for reining in PBMs.
Check out the other episodes in our “PBM Problems” series:
Part 1 w/ ERISA Attorney Paul Holmes (www.movingtovalue.org/podcast/episode/ee7684d9/pbm-problems-part-1-who-do-brokers-and-consultants-really-work-for-risks-for-plan-sponsors-with-erisa-attorney-paul-holmes)
Part 2 w/ Mutual Rx CEO Roy Wilkinson (www.movingtovalue.org/podcast/episode/dd2356a4/pbm-problems-part-2-transparency-and-disrupting-the-status-quo-with-mutual-rx-ceo-roy-wilkinson)
Part 3 w/ Luke Slindee, PharmD (www.movingtovalue.org/podcast/episode/273a1f16/pbm-problems-part-3-monopoly-power-in-prescription-drug-markets-with-luke-slindee)
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We’re excited to welcome like-minded organizations and individuals to join the MTVA Membership program!
As a 501(c)(3) nonprofit, we rely on support from our grassroots network to advance our mission of creating a value-based health system with high-quality patient outcomes at a reasonable cost. We’re proud to offer two membership models, Ally Member and Trade Member. Tax-deductible membership contributions help us enrich the healthcare environment with quality content - including this podcast - and robust platforms to fuel discussion, collaboration, and advocacy that lead to ground-breaking solutions.
For more information and to join us, visit our website ⁠www.movingtovalue.org/trademember⁠ (www.movingtovalue.org/trademember) .
All episodes of MTVA Unscripted can be found⁠ ⁠here⁠⁠ (www.movingtovalue.org/podcast) .
Переглядів: 6

Відео

Retail Health Failures: Misaligned Incentives and Misunderstanding Primary Care w/ Brian Klepper
Переглядів 82 місяці тому
Many successful companies have ventured into the healthcare space and failed. Why can’t businesses that are household names make it work in our industry? Where do retail investments in health care go wrong? What is missing from their approach to primary care? Health care reform legend Brian Klepper joins MTVA to explain the pitfalls companies make and why they can’t seem to nail down a sustaina...
PBM Problems (Part 3): Monopoly Power in Prescription Drug Markets w/ Luke Slindee
Переглядів 42 місяці тому
We all know the cost of prescription drugs in the U.S. is a problem. How did we get here and what can we do about it? This week, MTVA Board Members Dr. John Rodis and Dr. Steven Schutzer are joined by MTVA Executive Director Laura Wadsten for an engaging discussion with Senior Pharmacy Consultant ⁠Luke Slindee⁠ (www.linkedin.com/in/luke-slindee-pharm-d-034946160/) , PharmD. Luke is a second-gen...
PBM Problems (Part 2): Transparency and Disrupting the Status Quo w/ Mutual Rx CEO Roy Wilkinson
Переглядів 13 місяці тому
“There’s a reason that over the last 45 years, the PBM model has been the darling of Wall Street: because it makes a heck of a lot of money for its investors.” - Roy Wilkinson PBMs are in the hot seat: Last week, the House Committee on Oversight and Accountability pressed (oversight.house.gov/release/hearing-wrap-up-pharmacy-benefit-managers-push-anticompetitive-drug-pricing-tactics-to-line-the...
Fighting for Independence: Private Equity Ownership of Physicians w/ Association for Independent ...
Переглядів 43 місяці тому
Rollups, takeovers and buyouts. Oh my! With increasing fear about private equity in health care, the MTVA Board is joined by Dr. Marco Fernandez and Jack Dillon of the Association for Independent Medicine to discuss their perspectives on private equity and best practices for maintaining or reclaiming an independent practice. The Association for Independent Medicine (AIM) (www.associationforinde...
From ERISA to CAA: How Has Employer’s Fiduciary Responsibility Changed Over Time?
Переглядів 84 місяці тому
Though ERISA is often thought of as an issue for retirement plans, the law has always applied to employer-sponsored health benefit plans. The Consolidated Appropriations Act of 2021 (CAA) sought to put a spotlight on the issue by clarifying responsibilities of health benefit plan fiduciaries and the third-party service providers they contract with. Yet, 3 years after its passage, many plan spon...
Market Forces Created Our Dysfunctional Health System. Now We Must Harness Them to Drive Change w...
Переглядів 94 місяці тому
“We have to cherish the opportunity in front of us. We’re at a point that public awareness of the current system failure is unprecedented.” American health care is in crisis, but this expert says there’s reason for hope. MTVA spoke with renowned scholar Ge Bai, PhD, CPA about the dynamics underlying problems in our system, and how middlemen keep taking a bigger piece of the pie. She makes the c...
PBM Problems (Part 1): Who do Brokers and Consultants Really Work for? Risks for Plan Sponsors w/...
Переглядів 75 місяців тому
This episode is a must-listen for all plan sponsors and employers! “In American business you don’t expect your major vendors to be profit-gouging you, and you don’t expect these major consulting firms to be taking their side instead of yours.” - Paul Holmes As Pharmacy Benefit Managers (PBMs) face mounting scrutiny from policymakers and the public, health plan fiduciaries can’t ignore the money...
Transforming Healthcare: The Impact of Purpose-Driven Approaches - A Conversation with Dr. Scott ...
Переглядів 56 місяців тому
Join MTVA for a conversation with Dr. Scott Conard, MD, as we delve into the transformative power of purpose-driven healthcare. From fee-for-service models to data-driven initiatives, we explore improving healthcare outcomes, challenges in elder care, and the importance of a social model of care. Discover how autonomy, mastery, and purpose shape healthcare success and the need for a shift towar...
How One Health System Has Embraced Value-Based Care: Mount Sinai's Population Health Journey
Переглядів 57 місяців тому
In this episode, the MTVA team delves into the challenges and obstacles faced by a leading healthcare system in its transition into a patient-centered care model. Joined by Mount Sinai Health System's CMO and Senior VP of Population Health, Dr. Arshad Rahim, we discuss the complexities of aligning financial incentives with outcomes-based care principles, leveraging data-driven insights to drive...
Wake-up Call: The Johnson & Johnson Prescription Pricing Scandal
Переглядів 18 місяців тому
The gig is up. Wake up and smell the coffee. It’s finally happened. After years of speculating what an employee complaint against an employer for breach of fiduciary duty would look like, it has arrived. And this one doesn’t disappoint. Johnson & Johnson is being sued by its employees, alleging that their health plan overpaid for prescription drugs, costing workers money. This suit touches on A...
The Role of the Primary Care Provider in Disease Prevention and Management in a Value-Based World
Переглядів 119 місяців тому
We know that more than 50% of all health care spending (around $4T per year in the US) is spent on only 5% of the population, mostly on those with multiple chronic conditions. Most are entirely preventable, reversible or can be delayed by many years. Healthcare industry leaders and value-based-healthcare champions Dr. Garry Welch (Silver Fern Healthcare), Dr. John Rodis (Arista Health), Dr. Ken...
MTVA Friday Forum: Payment Reform is Working ... and these disruptors are taking advantage of it.
Переглядів 292 роки тому
How payment reform is tied to success for these healthcare disruptors: - Dan Blumenthal, M.D., MBA - CEO, Novocardia - Ian Chiang, Partner, Flare - Sam Holliday, CEO, Oshi Health
MTVA Friday Forum: Payment Reform is Working - and these disruptors are taking advantage of it.
Переглядів 32 роки тому
How payment reform is tied to success for these healthcare disruptors: - Dan Blumenthal, M.D., MBA - CEO, Novocardia - Ian Chiang, Partner, Flare - Sam Holliday, CEO, Oshi Health
What Matters Most in the Move to Value Movement, a Discussion with Christin Deacon
Переглядів 932 роки тому
What Matters Most in the Move to Value Movement:  What Do Employers Need to Do to Radically Change and Improve Access, Quality, and Outcomes for Health Consumers? Guest: Christin Deacon, Health Care Leader, and Public Sector Entrepreneur at 4C Health Solutions Join us for a discussion with Christin Deacon about provider and health system care transformation, and what employers and health cons...
MTVA End of Year Update - December 3, 2021
Переглядів 222 роки тому
MTVA End of Year Update - December 3, 2021