Episode S02 E38: Integrating Pharmaceutical, Medical Benefits to Lower Drug Spending

Pharmacy benefits managers (PBMs) offer one method of delivering pharmaceutical benefits to members, but Highmark Inc. and payers like it have developed an alternative that they argue may boost member engagement and improve drug spending. Sarah Marche, senior vice president of Pharmacy Services at Highmark Inc, discusses how Highmark has implemented integrated benefits and the outcomes that the payer saw as a result of greater drug price transparency.

Episode S02 E37: Emphasizing Patient Experience in Value-Based Care to Improve Collaboration

While views on the definition of "value" in value-based care may vary, healthcare professionals can rally around prioritizing patient experience in value-based care. LeChauncy Woodard, MD, director of Humana Integrated Health System Sciences Institute and professor at the University of Houston, and Tray Cockerell, a strategic relationship executive at Humana, explain how value is perceived today and how the industry can unify around patient-centered, value-based care.

Episode S02 E36: Making Progress toward Physical, Behavioral Healthcare Integration

Healthcare industry leaders have emphasized the need for physical, behavioral healthcare integration, but what actions do payers and healthcare organizations need to take to meaningfully move in the right direction? Brett Hart, Centene’s Chief Behavioral Health Officer, and Indira Paharia, Centene’s Chief Operating Officer for Behavioral Health, discuss barriers to integration and how to best leverage telehealth and value-based care to empower primary care services and achieve integration.

Episode S02 E35: Progressing from COVID Cost-Sharing Waivers to Less Low-Value Spending

Payers eliminated cost-sharing for coronavirus treatment when the pandemic hit the US in March 2020. Now they have the opportunity to use those waivers as a model for reducing low-value care spending and investing in high-value care across the industry. Mark Fendrick, director of the University of Michigan Center for Value-Based Insurance Design and professor of the division of general medicine, department of internal medicine and department of health management and policy at The University of Michigan, shares how payers can make that transition.