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Relentless Health Value

Relentless Health Value

Health & Fitness:Medicine

EP435: Optimized Pharmacy Benefits Are Required if You Want to Do or Buy Value-Based Care, With Dan Mendelson

EP435: Optimized Pharmacy Benefits Are Required if You Want to Do or Buy Value-Based Care, With Dan Mendelson

2024-05-02
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Optimizing Pharmacy Benefits in Value-Based Care: A Conversation with Dan Mendelson

In Episode 435 of 'Relentless Health Value,' Stacey Richter hosts Dan Mendelson from Morgan Health to discuss the importance of integrating pharmacy benefits into the broader context of value-based care. The conversation stems from a LinkedIn post by Mendelson outlining five key considerations for optimizing pharmacy benefits. Topics include the total cost of care, the need for value-based decision-making in pharmacy benefits, the integration of clinical teams in formulary development, and the critical role of patient engagement. The episode also explores how employers can better manage healthcare costs by aligning incentives and navigating the complexities of the pharmaceutical landscape. Key advice for various healthcare stakeholders, including pharma companies, hospitals, and primary care doctors, is also provided.

To read the full article and show notes with links mentioned as well as a full transcript, click here.

Love the show? Please consider signing up for our weekly newsletter. We'll send you an article covering the latest episode with show notes, mentioned links and a transcribed intro. Join the RHV Tribe.

00:00 Introduction

00:28 The Intersection of Pharmacy Benefits and Value-Based Care

00:57 The Critical Role of Pharmacy in Healthcare Outcomes

03:16 Exploring Pharmacy Benefits Optimization with Dan Mendelson

03:39 Morgan Health's Mission and Healthcare Innovation

04:46 The Conversation with Dan Mendelson: Deep Dive into Pharmacy Benefits

06:13 Strategies for Optimizing Pharmacy Benefits in Value-Based Care

11:19 The Future of Pharmacy Benefits and Employer Concerns

12:40 Advice for Pharma Companies in a Value-Based Healthcare System

16:13 Innovative Approaches to Managing Pharmacy Benefits

16:56 Engaging Patients in Pharmacy Benefit Decisions

18:06 Experimental Drug Tiers and Formulary Design

21:49 The Importance of Value-Based Contracting for Pharma

31:23 Lightning Round: Advice for Various Healthcare Stakeholders

34:47 Closing Thoughts and Invitation to Engage Further

 

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EP281: COVID-19—Badly Managed Health System Supply Chains Steal From Patients and the Providers Who Let This Happen, With Rob Austin From Guidehouse
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EP280: COVID-19—Will Currently-in-Use Technology Advancements Wind Up Disrupting Traditional Models of Health Care Delivery and Reimbursement? With Yauheni Solad, MD, and Rahul Dubey
2020-06-11
EP279: COVID-19—How Did Health Systems Get Addicted to the Inflated Prices They Charge Employers and Some Patients? With Peter Hayes, President and CEO of the Healthcare Purchaser Alliance of Maine
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EP276: COVID-19—Advice for Self-insured Employers and That Prediction of a 4% to 40% Premium Increase in the Fully Insured Market, With Brian Scott From Point6 Healthcare
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EP275: COVID-19—Will Self-insured Employer Costs Ultimately Go Up? The Why and How to Protect Your Company From Predatory Health Care Pricing, With Brian Scott, From Point6 Healthcare
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EP274: COVID-19—What Telehealth Means After the Pandemic, With Jonathan Thierman, MD, PhD, From LifeBridge Health System
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EP273: COVID-19—At What Level Will Telehealth Survive After the End of the Pandemic? With Jonathan Thierman, MD, PhD, From LifeBridge Health System
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EP272: COVID-19—Why This Pandemic Is a Game Changer for PCPs and the Employers and Plans Who Pay Them, With Guy Culpepper, MD
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EP271: COVID-19—A Surprise Billing Defense Strategy for Patients AND Employers in the Middle of a Pandemic, With Al Lewis, Rachel Miner, David Contorno, and Doug Aldeen
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EP270: COVID-19—How to Save Primary Care Practices With the Marshall Plan for Prospective Payment Models, With Dave Chase, Cofounder and CEO of Health Rosetta
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EP269: COVID-19—Prepping for the Next Wave: What Payers and Providers Should Be Doing Right Now to Get Ready, With Eric Bricker, MD, From AHealthcareZ
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AEE11: COVID-19 Billing, With Doug Aldeen and Al Lewis
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EP268: COVID-19—After June: Action Steps for Hospitals, Payers, Employers, and Pharma, With Marty Makary, MD, MPH
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EP267: COVID-19—From Now Until June: Action Steps for Hospitals, Payers, Employers, Pharma, With Marty Makary, MD, MPH
2020-03-30
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