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Evernorth brings the power of wonder and relentless

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innovation to create world class pharmacy, care, and

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benefit solutions.

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Barriers to care can lead to gaps in

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care, which can drive up the total cost

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of care. Our capabilities work seamlessly together to

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create innovative pharmacy care and benefit solutions for

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today and tomorrow.

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Our connected health services make the treatment, prediction,

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and prevention of health care's most complex conditions

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easier and more accessible as we drive organizations

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and people forward.

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This is Haley Reitker with the Becker's Payer

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Podcast. And today, we are recording live at

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the Becker's third annual spring payer issues roundtable.

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Today, I am joined by Eric Cannon, who

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is the chief pharmacy officer at SelectHealth.

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Hello, Eric. Thank you so much for having

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this discussion with me today. Can you go

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ahead and introduce yourself and share a little

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bit about your background?

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Yeah. You bet. Thank you, for having me.

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It's great to be here. I'm a pharmacist

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by background and training.

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I've spent,

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twenty eight years now with SelectHealth

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and love every minute of it. It's great

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being part of the Intermountain system and being

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able to do the right thing for our

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clients and our patients.

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Well, thank you so much for that brief

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introduction.

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Now to get things started,

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balancing affordability and quality is a constant challenge

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for health plans. How is your organization innovating

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to manage the cost of care while maintaining

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or improving member outcomes?

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You know, taking care of our members and

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ensuring they have access to quality care

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is our top priority.

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It's one of our major commitments,

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and it guides just about everything we do.

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Our philosophy has always been if if we

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do the right thing for our patients and

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our members from a clinical standpoint,

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the cost will follow or we will see

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cost efficiency.

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As the cost of therapies becomes more and

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more expensive,

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maintaining that position is becoming more and more

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difficult.

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What we know though is we've demonstrated that

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through quality care,

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we can improve

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patient outcomes. We can improve cost. That doesn't

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always mean we adopt the most expensive or

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the latest therapy,

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but what it does mean is we follow

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the evidence, and that drives great outcomes for

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our patients.

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Well, I'd love to dive deeper into that

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with the quality of care. So in an

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ever evolving regulatory landscape, what best practices or

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tools does your organization rely on to keep

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quality of care at the forefront?

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You know, twenty seven years ago, we established

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our own PBM, Scripius,

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and we did that because

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we didn't see any what we believe to

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be ethical options in the market.

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We built Scripius to provide greater transparency.

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We share data. We run all our own

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operations. We own our own contracts.

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So our clients know exactly what they're going

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to pay,

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for a prescription drug.

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This has given us a solid framework to

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build the organization

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on, and it puts us in a situation

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where we're consistently

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doing the right thing

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for our members. I I think as you

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look at

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regulation, as that regulatory

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environment continues to evolve, evolve may not be

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the right word. It may be forced upon

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us. Yeah.

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But many of those changes that we're seeing

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proposed today,

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those are things that

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we already do as an organization. So we

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continue to work with

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regulators and legislators

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as they draft and develop policy.

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We believe

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through greater transparency,

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that's the right way for us to evolve

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the market and go forward. Thank you so

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much for sharing. Cost transparency

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is so, so important, especially in today.

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I'd like to pivot the conversation a little

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bit. So net promoter score is a powerful

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indicator of member loyalty and satisfaction.

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How are you using NPS to drive meaningful

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improvements across your health plan?

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You know, NPS has become

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such a part of what we do.

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We're constantly trying to leverage that so that

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we can enhance and provide a better overall

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experience for our members.

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As we've followed Net Promoter Score, one of

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the things we found is that

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the single biggest dissatisfier for our members is

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they don't like being surprised when they get

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to the pharmacy. And and let me give

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you a great example.

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With our Medicare membership,

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every year, they get a transition fill. Well,

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when people would get a transition fill, we

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would send out a typical

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CMS standard letter to say, you just got

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a transition fill.

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But people didn't fully understand that. They didn't

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know exactly what they were supposed to do.

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They took the letter to their doctor. The

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doctor didn't know what they were supposed to

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do. So we've started following those up with

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a personal phone call to each one of

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those members. They were gonna call us anyway.

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So we reach out to the member. We

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explain, hey. You just got a transition, Phil.

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Here's what you need to do. Here are

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the different options,

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and here's the process, and we're happy to

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help you walk through that.

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Had we not been focused on

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NPS,

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we would not have really had that opportunity

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to improve that single process for those Medicare

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members.

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Alright. And finally, looking ahead, what do you

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see as the biggest opportunity for payers to

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lead the charge in transforming care delivery and

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driving better outcomes for all stakeholders? And how

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can leaders take a step in this direction

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now?

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Pushing for greater transparency within the various

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facets of health care, I think,

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remains one of those essential opportunities.

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The more we can increase visibility

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into costs and policies

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and decision making processes, stakeholders

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can come together

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and facilitate

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a more equitable and informed environment for all

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of us to take care of the patients.

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As we take steps in those directions, I

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think as leaders,

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we need to be fostering collaboration, and and

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that's fostering collaboration with people maybe we haven't

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typically

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interacted with. That's sitting down with the administrators

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of the hospitals and really looking at billing

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practices. And how do we make sure patients

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go to the optimal side of care and

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not the cheapest side of care?

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How do we work together on all of

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that? I think as we continue to increase

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that level of transparency, we continue to demystify

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health care, and we make it better for

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everybody.

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Well, Eric, thank you so much for joining

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me today. Again, this is Haley Recker with

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the Becker's Payer Podcast recorded live at the

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Becker's third annual spring payer issuers roundtable. Eric,

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have a great rest of your day. Hey.

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Thank you.