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This is Haley Reitker with the Becker's Payer
Podcast. And today, we are recording live at
the Becker's third annual spring payer issues roundtable.
Today, I am joined by Eric Cannon, who
is the chief pharmacy officer at SelectHealth.
Hello, Eric. Thank you so much for having
this discussion with me today. Can you go
ahead and introduce yourself and share a little
bit about your background?
Yeah. You bet. Thank you, for having me.
It's great to be here. I'm a pharmacist
by background and training.
I've spent,
twenty eight years now with SelectHealth
and love every minute of it. It's great
being part of the Intermountain system and being
able to do the right thing for our
clients and our patients.
Well, thank you so much for that brief
introduction.
Now to get things started,
balancing affordability and quality is a constant challenge
for health plans. How is your organization innovating
to manage the cost of care while maintaining
or improving member outcomes?
You know, taking care of our members and
ensuring they have access to quality care
is our top priority.
It's one of our major commitments,
and it guides just about everything we do.
Our philosophy has always been if if we
do the right thing for our patients and
our members from a clinical standpoint,
the cost will follow or we will see
cost efficiency.
As the cost of therapies becomes more and
more expensive,
maintaining that position is becoming more and more
difficult.
What we know though is we've demonstrated that
through quality care,
we can improve
patient outcomes. We can improve cost. That doesn't
always mean we adopt the most expensive or
the latest therapy,
but what it does mean is we follow
the evidence, and that drives great outcomes for
our patients.
Well, I'd love to dive deeper into that
with the quality of care. So in an
ever evolving regulatory landscape, what best practices or
tools does your organization rely on to keep
quality of care at the forefront?
You know, twenty seven years ago, we established
our own PBM, Scripius,
and we did that because
we didn't see any what we believe to
be ethical options in the market.
We built Scripius to provide greater transparency.
We share data. We run all our own
operations. We own our own contracts.
So our clients know exactly what they're going
to pay,
for a prescription drug.
This has given us a solid framework to
build the organization
on, and it puts us in a situation
where we're consistently
doing the right thing
for our members. I I think as you
look at
regulation, as that regulatory
environment continues to evolve, evolve may not be
the right word. It may be forced upon
us. Yeah.
But many of those changes that we're seeing
proposed today,
those are things that
we already do as an organization. So we
continue to work with
regulators and legislators
as they draft and develop policy.
We believe
through greater transparency,
that's the right way for us to evolve
the market and go forward. Thank you so
much for sharing. Cost transparency
is so, so important, especially in today.
I'd like to pivot the conversation a little
bit. So net promoter score is a powerful
indicator of member loyalty and satisfaction.
How are you using NPS to drive meaningful
improvements across your health plan?
You know, NPS has become
such a part of what we do.
We're constantly trying to leverage that so that
we can enhance and provide a better overall
experience for our members.
As we've followed Net Promoter Score, one of
the things we found is that
the single biggest dissatisfier for our members is
they don't like being surprised when they get
to the pharmacy. And and let me give
you a great example.
With our Medicare membership,
every year, they get a transition fill. Well,
when people would get a transition fill, we
would send out a typical
CMS standard letter to say, you just got
a transition fill.
But people didn't fully understand that. They didn't
know exactly what they were supposed to do.
They took the letter to their doctor. The
doctor didn't know what they were supposed to
do. So we've started following those up with
a personal phone call to each one of
those members. They were gonna call us anyway.
So we reach out to the member. We
explain, hey. You just got a transition, Phil.
Here's what you need to do. Here are
the different options,
and here's the process, and we're happy to
help you walk through that.
Had we not been focused on
NPS,
we would not have really had that opportunity
to improve that single process for those Medicare
members.
Alright. And finally, looking ahead, what do you
see as the biggest opportunity for payers to
lead the charge in transforming care delivery and
driving better outcomes for all stakeholders? And how
can leaders take a step in this direction
now?
Pushing for greater transparency within the various
facets of health care, I think,
remains one of those essential opportunities.
The more we can increase visibility
into costs and policies
and decision making processes, stakeholders
can come together
and facilitate
a more equitable and informed environment for all
of us to take care of the patients.
As we take steps in those directions, I
think as leaders,
we need to be fostering collaboration, and and
that's fostering collaboration with people maybe we haven't
typically
interacted with. That's sitting down with the administrators
of the hospitals and really looking at billing
practices. And how do we make sure patients
go to the optimal side of care and
not the cheapest side of care?
How do we work together on all of
that? I think as we continue to increase
that level of transparency, we continue to demystify
health care, and we make it better for
everybody.
Well, Eric, thank you so much for joining
me today. Again, this is Haley Recker with
the Becker's Payer Podcast recorded live at the
Becker's third annual spring payer issuers roundtable. Eric,
have a great rest of your day. Hey.
Thank you.