Meritain Health® - In the Booth

Meritain Health Pharmacy Solutions

April 01, 2022 Meritain Health Season 3 Episode 5
Meritain Health® - In the Booth
Meritain Health Pharmacy Solutions
Show Notes Transcript

Join our host, Bridgette Cassety, as she speaks with Jeremy Wisniewski, head of Meritain Health  Pharmacy Solutions to discuss the benefits of Meritain Health Pharmacy Solutions.

Speaker 1 (00:07):

Welcome back for another edition of in the booth. I'm Bridgette Cassety and I'm head of our broker engagement here at Marta health. And today I'm so pleased to be joined by Jeremy Wisniewski. And Jeremy's been with me before, and he is head of our Meritain pharmacy solutions at Meade. And it's always a pleasure to have Jeremy with me since there's always a lot to talk about when it comes to pharmacy. And certainly Jeremy has a lot of passion around the space. So we always get a lot of questions from our brokers and consultants and customers. So grabbing a few minutes of Jeremy's time to get together and have a conversation is always a great use of time. So Jeremy, I, I thought we would just go ahead and get right into it since time always tries by when we get together. And the first thing I'd really like to touch on with Meritain pharmacy solutions is how it's evolved. Really. This evolution has been transformative in a lot of ways, and I've heard being part of, bit of many conversations with our customers recently. That certainly that is evident. So I thought if you could make, just kick off our conversation date and talk a little bit of how you would describe this transformative journey that Meritain pharmacy solutions has been on.

Speaker 2 (01:12):

Awesome. Well, thanks for, for having me to start off with yeah. You know, we've been, we have been trying to evolve and the reason that we're trying to evolve is because that's is happening in the marketplace, right? Pharmacy is a, a space that, you know, is not the same from day to day. Each day there's going to be, you know, new things that are coming new drugs that are coming into the market that present new challenges for our, our members, for our clients, for our brokers who are trying to solve for essentially everyone to trying to solve for the same thing, which is, you know, how do we make sure that we're taking care of our members, their health aid them along a healthcare journey, but at the same time, ensuring that we're keeping costs down. And one of the things that we realize was that's not the same for every single group.

Speaker 2 (02:02):

That's not the same from you know, year to year from vendor to vendor, from, you know, person to person. And it's easy to create kind of a, a one size fits all. But when you create that kind of one size fits all, it's kind of like one size fits, maybe one person it's not gonna fit everybody. Right. And you can't push everybody into that, that same kind of narrow channel. So we need, need to make sure that we're in touch with what's happening in the marketplace and respond to it, be on the front end of what's happening in the marketplace and continue to make sure that we're evolving because you know, Meritain is one of the hallmarks of Meritain has always been our ability to be flexible and to partner with our, our downstream partners, right? Again, our brokers, our clients, and even our individual members.

Speaker 2 (02:50):

And that's one of the big things that is, is hallmark of Meritain pharmacy solutions is wanting to make sure that we are partnering with our, again, our, who we see as our downstream clients, which are our, our brokers, our clients, and our members doing all that we can to make sure that we're delivering the best possible outcomes for them. And if you're going to do that, you can't, again, you can't just do what you did yesterday, right? Because this, this space has changes so rapidly that if you do that, that same thing that you were doing yesterday, you're gonna miss where the marketplace has gone. Now that's where we've decided that we needed to continue to evolve, continue to, to leverage the various partnerships that we have continue to leverage the strength that we have through our parent company CVS health to bring those the right solutions at the right times and put them in the right places for our customers.

Speaker 2 (03:50):

And the other thing that we've done is we've made a significant investment in our, our overall team. We've more than doubled the size of our team in the last couple of years. And, and that was done purposely because we wanted to be able to deliver that true kind of concierge level of service. Right? So in order to do that, in order to build these partnerships that we're talking about, we knew that it was going to take people to build those relationships, but not just any people, the right people. And that's where I say we have a fantastic, that we've built so that we're able to deliver on that service.

Speaker 1 (04:25):

So Jeremy, when you talk the word that sort of comes to mind that formulates is around optimization, right? Being the optimizer when it comes to pharmacy solutions. And, you know, as you stated, our ability to think innovatively, or as I like to say, you know, looking ahead to what's next, right. You know, we're, what's next for, for pharmacy that we can leverage here at Meritain health. And, and I know that when I'm out in the field and I talk to folks around pharmacy, a word that I hear a lot around is I want choice, right? That's what, what people want. That's what people expect and they oftentimes think is missing. So can you talk a little bit about Meritain pharmacy solutions and how we solve for choice that the market is certainly in, in need of, and, and certainly desires from us?

Speaker 2 (05:06):

No, absolutely. Absolutely. We, what we wanted to do was we have a, a mission so to speak, and that mission is to, to reimagine how we're delivering service to our clients. And if you're going to, to reimagine, essentially what we're saying is, Hey, we need to listen. We need to listen to what is it that our customers need and want in terms of a pharmacy solution. So it's easy for folks to say you know, we're gonna do this particular type of model or that particular type of model. And what I mean is you kind of get into the nuance a little bit. You'll you start to have some, some of the buzz words that you hear within the PBM space. You have a traditional model, you have rebates, you have, you know, admin credits, you have past, you have transparent, you have all these different things, right?

Speaker 2 (05:53):

And at the end of the day, each of those can deliver value to clients. The real question, and this is where you get back to this idea of partnership. And that optimization is, is partnering with our clients to make sure that we are hearing where they see value or what value they're specifically looking for. And then behind the scenes, what Meritain pharmacy solutions does is we've gone out and we've created this whole ecosystem of the best in class vendors to address specifically what people are looking for. Right? Sometimes people are looking for specialty, carve out. Sometimes people are looking for pass through. Sometimes people are looking for, you know, X, Y, Z, whatever those specific things are. We wanna make sure that we're able to pull that together for them, do the vetting for them, so that, you know, when they come to our ecosystem, they know that all the, all the solutions that are in place have already been vetted and they can begin to choose what's right for them and in for their particular situation.

Speaker 1 (06:57):

So Jeremy, you talk a lot about choices and options that our customers have. Could you maybe give us an example of why that's important?

Speaker 2 (07:05):

Let me give you a really simple example. And, and it's a bit silly, but hopefully it fits. I give the example sometimes of this idea of, you know a fruit cart. And if I have fruit cart and I am selling apples, I might have the greatest apples and the best apples in that are out there on the market. But if you come to me Bridgette and you're looking for a banana, you don't wanna hear me say, you know what? Bananas are terrible. You want, you want an apple, let me talk to you and tell you about this amazing apple that I have and show you all the great, wonderful things about apples. And let me tell you the three things that I don't like about bananas and the three reasons why I think apples are better. If you think about what happens a lot of time to consumers in this space, that's what they have to navigate every single day, because each PBM is doing their model a little differently and they're saying, Hey, we sell bananas.

Speaker 2 (08:02):

We only sell apples. And there's a lot of this push pull of trying to understand what's what, what Meritain pharmacy solutions has done is we said, we've realized, Hey, we are not a true PBM, right? We sit in the place of the TPA, but part of Meritain, and that gives us an opportunity that nobody else has. And not just through leveraging the assets that we have through Aetna, not just through leveraging the assets that we have through CVS health, but also by utilizing our position, that flexibility and that independence that we still have in the marketplace to go out and to build out that ecosystem that we were talking about. So bringing it back to that analogy, that means when somebody comes to our fruit cart, we're not trying to sell them an apple instead, we're stocking apples and bananas and every other kind of fruit so that when the person comes to us and they say, Hey, I, I wanna purchase a banana. We don't instantly put them on a defensive by saying, Hey, well, we don't, we don't sell bananas. And let me tell you the three reasons why we don't sell bananas. No we're meeting them where they're at, and we're, we're gonna have the opportunity to be able to to deliver on what folks are specifically looking for, giving them what they're the you that they're out looking for in the way that they're looking for it.

Speaker 1 (09:19):

Yeah. And I think Jeremy you're right. So when I, when I hear you speak about the fruit card, it sounds more like a buffet than and, and that's what we're trying to offer to our customers. And we think about choice and flexibility is, and you said, you said these words, you said, meet people where they're at, or I wrote down when you were speaking, I wrote down no wrong door. Matter where you wanna come in, we can meet you where you're at. We wanna accomplish the same thing, which is, you know, you wanna get your serving your fruit. It doesn't matter how you get it. But we're here to serve and, and, and do that. So I think that's a great way of, of thinking about this shift and the evolution at Maryam pharmacy solutions. And, you know, with that, Jeremy, here's another question that might be on our listeners minds and, you know, how do we accomplish that? And, and examples are a great way to do that. So when you think about this differentiation and you think about Meritain pharmacy solutions versus let's say going direct to another vendor, you know, what is sort of the secret sauce that's in it for, for people when they choose to, to join us on that journey of Meritain pharmacy solutions?

Speaker 2 (10:15):

Well, I can't tell you the she sauce, or it won't be a secret anymore. No, I'm just kidding. No, that's a great question because it's the, the obvious next question, right? Like, Hey, you guys pulled together this ecosystem that you're talking about with all the big different vendors. Well, if these vendors are great, well, why don't I just go to them directly? Fantastic question. And the reason that you don't is because they specific things that we are, we have considered, and that we have brought together when we built out that ecosystem, the easiest one, and the most apparent one is obviously the idea of integration. Having, being able to have things fully integrated between your medical and your pharmacy, huge, huge benefits. There, lots of cost savings that can be accomplished lots of cost savings and be accomplished just through something as basic as a medical to pharmacy interchange.

Speaker 2 (11:02):

And we had a recent savings that was done by care, which I'll talk about in a, in a second done by our care team where we were able to move a drug from the medical side to the pharmacy side, because of that integration, because we're seeing the old sides of the fence, right? We're not just looking at, but pharmacy in a vacuum, we see the entire picture of what's happening. And we dug in and we, we ended up working with our, our sister company, American health holding through some of their med management with the nurses who were engaged with this particular member. And we were able to move that drug over to the pharmacy side, saving client 1.9 million. And that was just a move. There's a couple of other strategies that we're able to employ now under the pharmacy side to further save even more money.

Speaker 2 (11:51):

Right? So that's just a, a quick example. And I talked about and, or touched on this care program. This care program is something that Meritain pharmacy solutions has built ourselves in house. A great way to think about it is we, you think of all the different things that you're hearing about in the marketplace, people who do patient assistance, or people who are doing copay optimization or people who are trying to do, you know, what we just talked about moving thing from, from the medical side to the pharmacy side, trying to do dose optimizations and clinical studies and all these different things. And you have to piece together these three or four different vendors. Each of those vendors comes with a its own unique fee structure in order to access it. But most importantly, in order to activate all these vendors, you're sending your data out to all these different places, right?

Speaker 2 (12:38):

You're disaggregating your solution to go to all these different points, to try to save some money. And what we realized was that has a negative impact on the overall cost of care. And even more importantly, it can have a very negative impact on the member and their healthcare journey, right? Cause now this member is trying to navigate this really complicated ecosystem of where do I go to do these things with our care program, we built all of those components in to our offering and we don't do it at any additional costs, right? There's no connection fees that need to be paid. There's no farming stuff out or whatnot. It's something that was developed in house. It's led by our clinical pharmacist. And they're the ones who are doing all of these, the same types of things that you hear about in the marketplace.

Speaker 2 (13:30):

But again, we're doing it at, without costs and without the, the disaggregate, without taking away that integration. On top of that, we have a fantastic business development team. We have service team, we have an account team. We have you know, RX smart savings program that we put into place. We have RX savings plus through CVS, all these are things that you can only get from Mary Kay pharmacy, the solutions. And these are the things that we just inherently do servicing the account, having a clinical team that's, you know, again, beyond just a care team, a clinical team, that's looking at the various programs that you have in place or don't have in place as a client to make recommendations. And I think that's one of the biggest things that that folks particularly in this market, when you start talking about the middle market where, you know, we, we really have our kind of bread and butter, so to speak of where we serve in service, you have a lot of folks who don't have the opportunity to engage with pharmacy consultants, to help, you know, understand where they should or what they should, or what they shouldn't do or what they need to stay away from.

Speaker 2 (14:40):

And that's what our team does, because again, we are not the PBM. So why are you coming to Meritain it's for that ecosystem? It's for the expertise it's for that partnership and that guidance, because our mission again, is to make sure that we're truly delivering on our promise to lower that total cost of care. So in doing that, we're going to be there every step of the way to try to shepherd again, our clients and their members through that healthcare journey.

Speaker 1 (15:10):

And Jeremy, you know, when I hear you talk, what, what sort of came to mind is, you know, that personal touch partnership, when you talk about an example of differentiation, is that, you know, is that really that personal touch, which comes from, from people that we've invested in for the future to, to really manage pharmacy for our consultants and brokers and our plan sponsors. And really when I think about our convers today, and I know you and I could, could talk for hours about this. But when I think about Meritain pharmacy solutions and sort of answering the, you know, what's next, what I wrote down was optimizing innovation through choice and flexibility. And, and it sounds like that everything we're doing is really to drive that forward, because as you said, we're in the, we wanna reduce our total cost of care for our plan sponsors for our member, because part of our everyday mission is, as you stated, we are advocates for healthier living here at Meritain health, and certainly pharmacy solutions, innovative pharmacy solutions that optimize savings is where it starts. So Jeremy, I just so wanna thank you for your time today and your perspective. It's always great to talk to you and I sure our listeners appreciate your perspective. So to everyone that joins us today, thank you for joining. And we look forward to you coming again for another addition of, in the booth till next time stay well.