The-Shift-Shapers-Podcast-(Rough-Comp-2)

Mark Blum has taken a very different path to get to the healthcare universe – starting as a labor organizer and negotiator who quickly found healthcare to be the most frequent stumbling stone in negotiations. The determination to find a way to resolve that issue has brought him to some interesting destinations and some surprising conclusions along the way. He is Executive Director of America’s Agenda, a non-profit healthcare delivery innovation center, and also serves as President of SolidaritUS Health.

What You’ll Learn From this Episode:

  • How his beginnings in labor influenced the questions and answers he found going forward.
  • What worked in Maine and in Vermont, and how that informs newer challenges.
  • What happened when the ACA meteor landed on healthcare.
  • What are “labor-owned” plans and what impact could they have?
  • How he created an eBay type environment for one state to solicit bids for pharmacy plans and what that saved.

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-smalliHeartRadio-small

The-Shift-Shapers-Podcast-(Rough-Comp-2)

Specialty drugs represent an ever-growing driver of our overall enormous drug spend. Pramod John, our guest on this episode, is CEO of Vivio Health, which is singularly focused on using outcomes revealed by data and analytics to bend the hockey-stick curve of this spending trend.

What You’ll Learn From this Episode:

  • Why do Americans have the highest drug costs?
  • Exploding the myth that Americans’ costs are highest because we pay for all of the R&D while the rest of the world benefits.
  • Can Amazon, Aetna/CVS, etc. solve this problem?
  • How can we be efficient and effective when there are five times more pharmacies than McDonald’s?
  • Are PBMs part of the solution or part of the problem?

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-smalliHeartRadio-small

Is a PBM a gatekeeper and whose interests are they serving?

Renzo Luzzatti is an expert on how and why pharmacy costs are growing at an exponential rate and driving an ever-more significant portion of claims spend. He explains that there are multiple vantage points to consider if benefit advisors and fiduciaries are to gain a good overall understanding of the problem and its possible solutions.

We explore the rebates shell game and learn how advisors can arm themselves to make better recommendations to prospects and clients. The conversation also spotlights the starting line for this problem – the physician’s prescription pad and discusses who, if anyone, is educating the physician.

What You’ll Learn From this Episode:

  • What is driving pharmacy spend to such high levels.
  • Whether PBMs have an inherent conflict of interest.
  • The current role of the PBM and what that role should be.
  • Who’s educating physicians about pharmacy costs, choices, and efficacy.
  • The meaning of “specialty pharmaceuticals” and why they are being approved at a faster rate.
  • Potential solutions for fully-insured plans.
  • What advisors need to know.

Featured on the Show:

Listen to the Full Interview:

This Episode is Sponsored by:

Enjoy The Show?

Subscribe-with-iTunes-smallSubscribe-with-Stitcher-smalliHeartRadio-small