Evernorth brings the power of wonder and relentless
innovation to create world class pharmacy care and
benefit solutions. Our connected health services make the
treatment, prediction, and prevention of health care's most
complex conditions
easier and more accessible as we drive organizations
and people forward. Ever North Home Based Care
provides value based care that helps patients with
multiple chronic conditions
and social determinant of health barriers get the
care they need and the personalized experience they
deserve. We serve patients who struggle to navigate
the health care system by bringing high quality
primary
and preventative care services to the home. By
providing clinical care and support services that provide
whole person care, we improve health equity, access,
and outcomes for the populations we serve.
Hello, and welcome to the Becker's Health Care
podcast.
I'm joined today by Eric Cannon, chief pharmacy
officer and general manager at SelectHealth and Scripius.
Can you start by telling us a little
bit about yourself and your organization?
Yeah. You bet. I'm a pharmacist by background
and training.
SelectHealth
is the payer arm of Intermountain Healthcare,
and Scripius is the PBM subsidiary
of SelectHealth.
So I started my career. I've been in
this role now since
1997,
and we created
the backbone
of the PBM, which is Scripius
today in 1998.
Okay. So from improving member experience and expanding
value based care to controlling costs,
payer executives have ambitious goals for the rest
of 2024 and the year ahead. In your
role, what would you say is your top
priority, and how are you planning to get
there?
Yeah. Right now,
our our top priority is additional growth
within Scripius. And I think
a lot of that's driven by how we
take care of our members. A lot of
that's driven by how we take care of
our customers.
And and what is that experience we want
people to have, both
for for the member themselves and and for
the client or the payer or, you know,
the employer that may whichever it may be.
So at an industry level, how would you
describe the biggest barriers to effectively serving and
engaging members?
And, what opportunities do you see for large
scale improvements, and how are you applying them
in your current strategies?
You know, it's a fascinating question. I think,
you know, there's there's several barriers in in
what I do
within the PBM industry. The lack of transparency
is massive. Mhmm. And I think
we've we've tried to move in a direction
where we've always owned all the paper.
So we contract directly with the manufacturers.
We can show people exactly what the contract
is, unlike
most of our competitors where those contracts are
actually held
offshore in,
you know, Europe. Mhmm. So I think that's
the first piece is how do we how
do we bring transparency? How do we allow
transparency
to help drive costs down by letting people
see the full picture? The second is that
member experience piece. And I think when we
talk about barriers and member experience, especially when
we're talking about pharmacy,
we have to acknowledge that there's a lot
wrong
today in the retail pharmacy space. I think
we see Walgreens and CVS
taking drastic steps, closing stores, trying to
improve their financial picture. At the same time,
that experience that members have at the pharmacy
is not great. We saw a decrease this
year in, rating of the drug plan. And
as we really drilled into that, it wasn't
anything that specifically we were doing.
It had everything to do with the member's
experience of the pharmacy, the inability to talk
to a pharmacist, the need to stand in
great big lines,
not feeling
like like you're important.
All of those things have had a negative
impact on members.
So keeping in mind today's dynamic health care
landscape,
what's one piece of advice you'd share with
other leaders in the industry to help grow
their businesses while keeping members top of mind?
It's an interesting question. And then, you know,
I remember talking to an executive at a
health plan,
4 or 5 years ago and
made made the comment that it was super
important
to focus on the member the member experience.
And he was adamant that you could not
improve member experience
and also decrease costs.
I I think I disagree with that. I
I if we look at at our business
today, we've actually, as a result of having
a negative 20% trend in pharmacy,
been able to reduce
what consumers will pay on the individual exchange
for their insurance this year.
So with the election last night, I think
we really saw how important the economy is
to people. And so every step that we
take, I think, to reduce what they have
to pay is a step towards improving the
experience they have. Mhmm. And and then that
that experience, you can't you can't have a
good experience without coordination between
your your
health care delivery partners.
So what role is technology playing in your
organization's growth strategies? And can you share a
couple examples?
Yeah. You bet. I I think,
a, we're we're in a situation where
it's harder and harder to to hire frontline
employees, and and it's even harder to retain
them once you've hired them. Mhmm. So how
do we look at AI? How do we
look at the digital tools that we need
to have in place that actually
put us in a situation where we don't
have to add employees to improve our customer
service. I I think that's the first one.
The second one is how do we put
the power of information in the hands of
our our members, our consumers?
And, you know, we're in the process right
now of rolling out a tool that'll allow
members to have their physician send their prescription
to their wallet.
Once that prescription gets to their wallet,
they can then look at all the pharmacy
alternatives that they have, what they'll pay at
the different pharmacies,
what those options are. Is it mail?
Do they have to drive down the street?
And then they can shop and pick where
they wanna go for the lowest cost.
On top of that, then they're able to
see what coupons or discounts or other things
may be available in the market, and they
can stack that on top of that.
So really, our goal is to say, you
know, we're moving towards e commerce.
We see that happening more and more. You
look at the pharmacies that are growing. It's
Mark Cuban's Cost Plus. It's Amazon. Mhmm. People
really want that ecommerce experience. So how do
we engage that member with the digital tools
they need to make those decisions?
So how is technology,
supporting value based care or member focused initiative
at your organization? And, you know, what excites
you most here and why?
Well,
we we talked about putting Mhmm. Information in
front of the member. Right. Right. I I
think it's it's also crucial that I'm putting
information in front of the physician. Mhmm. And
so how do I coordinate with those medical
directors,
those medical officers that may
be over those physicians in their clinics? And
then how do we make sure that we've
put the digital tools out there in terms
of electronic prior authorization, real time benefit check?
Are we taking the steps to make sure
that it's easily accessible within the EMR? I
think we we've had an experience with one
client who's on Cerner,
and the physicians won't use it because it
is so cumbersome to actually find the real
time benefit check within the system. And so
how do how do we make sure that
all of those pieces are in place? It
has to be easy.
Well, Eric, thank you so much again for
joining us today on the show. But before
I let you go, is there any final
thoughts you'd like to leave with our listeners?
Yeah. I think I think the one thing
that we've really learned is as we've brought
on clients, as we improve transparency,
we're seeing improvements in in the cost profile.
We're seeing improvements in that experience that the
members actually have. And so, you know, the
model that we've tried to build upon, which
is total and complete transparency,
is really helping to drive and improve the
financials and and drive and improve that that
member experience.
Awesome. Well, thank you again for joining us
today, Eric, and I hope you have a
great rest of your day. Hey. Thank you.