Relentless Health Value

TJ is a designer at heart and a pharmacist by training. He started his career at his family's long-term care pharmacy in 2004 and has worked at Target pharmacy, a local community pharmacy, and Massive Health (acquired by Jawbone). He holds a doctor of pharmacy (PharmD) degree from Massachusetts College of Pharmacy and Health Sciences. In 2015, Forbes named TJ to its 30 under 30 List in Healthcare. In 2018, PillPack was acquired by Amazon. 02:20 TJ talks about his origin story with PillPack. 04:16 TJ explains what PillPack is and how it works as a full-service pharmacy. 06:57 One of the biggest challenges is getting across to patients that there is a better option to approaching their health. 10:06 How the customer experience is different between PillPack and a retail pharmacy, and how PillPack is working toward eliminating the frustration that comes with a normal retail pharmacy. 11:13 PillPack's average customer age is 49. 12:42 How PillPack addresses the issue of customer loyalty and the personalized experience that might be offered by retail pharmacies. 15:01 Providers and prescribers often spend somewhere around 30% of their time prescribing medication, when a more efficient solution can be to implement a start and end order. 20:16 The illogic behind using expirations on prescriptions to entice patients to remain accountable at doctor visits. 22:47 How PillPack steps in to be the medication coordinator for individuals. 26:32 The complicated issue of nonadherence and what this means. 27:57 How PillPack reminds the patient about being proactive about refilling prescriptions. 33:29 How patients pay to use PillPack. (Hint: It's the same cost as going to a traditional pharmacy.)

When not hosting the show, Stacey is co-president of Aventria Health Group, a marketing agency and consultancy. Aventria specializes in helping pharmaceutical, employer, pharmacy, and health system clients improve patient outcomes by creating and leveraging collaborations with other health care organizations. For more than 20 years, Stacey has innovated better-coordinated health solutions benefiting all stakeholders and, most of all, the patient. Dave is a 30-year veteran of managed-markets marketing. After working in consumer marketing with AT&T and health care publishing with Elsevier, Dave made the move to medical advertising and communications at KI Lipton, Inc. Subsequently, he became a cofounder of Pinnacle Health Communications. Dave is an accomplished strategist, providing innovative customer marketing, access, quality, and health intervention solutions for large clients and has directed the development of numerous industry-leading campaigns in primary care and specialty markets. He has supported clients in disease areas that include oncology (Bristol Myers Squibb [BMS], Novartis, Eisai), virology (BMS, Merck & Co.), pharmacy (American Pharmacists Association, Merck, Novartis), and blood disorders (Novo Nordisk), to name a few. Dave has helped more than 15 clients achieve top rankings in their respective categories. He is also an active member of the Pharmacy Quality Alliance. 00:30 Collaborating with "large organized customer groups" aka IDNs and health care stakeholders. 01:36 Pharmaceutical companies working with IDNs. 04:58 "Historically, Pharma trained ... their representatives on the brand; secondly ... on [their] selling skills." 05:17 "What they don't do well ... is training them on understanding customer objectives and needs." 05:56 "What a customer wants to buy is impact." 07:57 "It's basically Pharma meeting on a level playing field with peers." 08:42 The more stakeholders take on risk, the more they will demand seeing outcomes from Pharma. 09:09 "Pharma can't ... prove its value in the absence of having collaborative relationships." 09:30 One of the most important roles that Pharma can play. 10:42 The barrier with market share. 13:13 Enabling a brand to be successful. 13:39 Solving the customer's problems. 13:50 Creating a near-term and a long-term plan. 16:00 How Pharma can be a collaborative partner throughout the entire patient journey. 16:58 Pharma's barrier in not striving for the ideal. 22:39 Barriers in pharma collaboration with IDNs. 24:28 "Consider these plans a living document." 24:45 "It's a commitment to invest the time, invest the energy." 27:24 "The much more valuable brands are [the ones] that build upon their successes." 29:44 "How can we work together to find a solution that is approvable?" 31:03 How Aventria might be able to help mitigate some of these challenges.

Dave Dierk, my co-president at Aventria Health Group, and I talk about the pharmaceutical industry and its ability to collaborate with "large organized customer groups." This is pharmaceutical code for integrated delivery networks (IDNs) or any large health care stakeholder. Also, "our clients" refers to Aventria's pharmaceutical clients. Just one other term, when we talk about "unbranded" programs, or "value above the brand," this means things that don't directly talk about the pharmaceutical product.

Maya Dusenbery is a journalist, editor, and the author of Doing Harm: The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick. She is editorial director of Feministing.com and has previously been a fellow at Mother Jones magazine and a columnist at Pacific Standard. Her work has appeared in publications like Slate, Cosmopolitan.com, HuffPost, TheAtlantic.com, Popular Science, and Teen Vogue, among others.

Population health management is typically an endeavor carried out with a big extensive patient encounter. It's fairly unlikely that a patient will be able to tackle 20 identified interventions at one time. Also, it's suboptimal for the patient to have multiple members of the care team working on various interventions. Today I speak with Virginia Gurley, MD, MPH, who sets us straight on all these points and more. Dr. Gurley is the senior vice president and chief medical officer at AxisPoint Health.

Virginia Gurley, MD, MPH, is the senior vice president and chief medical officer at AxisPoint Health, responsible for leading all clinical content development and analytics activities for the company, as well as providing strategic clinical oversight for delivery of population health management services. Dr. Gurley brings with her more than 30 years of experience in preventive medicine, clinical programs and systems design, analytics, and health education. Prior to this role, Dr. Gurley held leadership positions at managed care organizations and care management vendors, including Healthways, Blue Cross Blue Shield of Michigan, McKesson, and Henry Ford Health System. Dr. Gurley earned her MD from the University of California at Davis School of Medicine and completed her residency training at George Washington University and Johns Hopkins University, where she also completed her MPH in epidemiology.

Do we as an industry typically know what matters to our patients and how their lives affect their health and their health affects their lives? If we do, then three good things happen: patients feel better and their outcomes are better, provider experience goes up, and health organizations do better—readmits go down and margins go up. Listening to patients makes radical common sense, as Greg Makoul from PatientWisdom puts it.

Gregory Makoul, PhD, MS Greg is founder and CEO of PatientWisdom, Inc. He is internationally recognized for expertise in physician-patient communication and shared decision making as well as a radical commonsense, person-centered approach to health care innovation. He started PatientWisdom because professional and personal experience made it clear that listening to patients—individually and at scale—is the real key to improving health and care.

As a broad stroke, value-based arrangements produce better patient outcomes than fee for service. Health care businesses are rational actors when it comes to the economics of their business models. Today I speak with Frazer Buntin, president of value-based services at Evolent Health and a noted expert in how to actually achieve value-based incentives and make CFOs happy, because CFOs need to be happy for patient outcomes to improve meaningfully at the system level and at the national level.