Capital Rx Chief Growth Officer Kristin Begley, PharmD, joins Validation Institute CEO & President Benny DiCecca for an engaging discussion about the pressure on payers - particularly employers and other health plan sponsors - to rein in the total cost of care, the benefits of a modern technology stock for pharmacy benefit administration (PBA), and how to push vendors for accountability on spend. Kristin said that stakeholders' new fiduciary responsibilities under the Consolidated Appropriations Act magnify the importance of working with an aligned PBM or medical partner.
Kristin and Benny also covered the importance of drug mix and evaluating costs down to the drug level during RFPs, why "technology should be invisible," how our adjudication platform, JUDI®, is designed to give health systems and health plans the ability to manage their pharmacy programs efficiently, the importance of per member per month (PMPM) guarantees, the importance of involving pharmacists in virtual care, and the move to value-based care and paying providers for better outcomes.
Watch below or visit Validation Institute for more information!
"Employees are under a lot of stress - the economy, inflation, mental health, financial wellbeing... these are all priorities for employers."
"It's really important to push vendors to have accountability on spend."
"Technology should be invisible. The two things that help our clients - and us - are 1) in the pharmacy space, technology hasn't been innovated in decades - we're operationally more efficient because we built JUDI after Medicare [Part D] regulations were put in place, for example; and 2) we have one seamless experience and the flexibility to allow people into the system - it's not a patchwork... the other adjudication platforms aren't built for value-based care."
What matters most to the health plan member and consumer, and what needs to be addressed to help improve their experience?
"We need to see regulation. We're starting to see it, particularly on drug pricing; [buying your prescription drugs] should be simple like buying something over the counter."
Contact us for more information about Capital Rx's aligned PBM and PBA solutions!