Latest / Becker’s Healthcare Podcast / The Connected Healthcare Economy: Insights on Growth, Scale and Collaboration

Transcript

The Connected Healthcare Economy: Insights on Growth, Scale and Collaboration · Becker’s Healthcare Podcast

• 0:00
  - Hello, everyone. This is Erica Spicer Mason with
• 0:02
  - Becker's Healthcare. Thank you so much for tuning
• 0:04
  - in to the Becker's Healthcare podcast series.
• 0:08
  - Today, we're going to talk about the connected
• 0:10
  - healthcare economy.
• 0:11
  - So we'll go through insights on growth, scale,
• 0:14
  - and collaboration.
• 0:16
  - And joining me for this conversation, we have
• 0:18
  - two leaders from CoverMyMeds.
• 0:20
  - We have Matt Hare, vice president of network
• 0:23
  - growth and client success,
• 0:24
  - and Bill Cicconetter,
• 0:26
  - vice president of network sales.
• 0:29
  - Matt,
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  - Bill, it's so great to have you with
• 0:31
  - us today. Thank you so much for joining
• 0:33
  - Becker's.
• 0:34
  - Thank you for having us. This is great.
• 0:36
  - Appreciate it.
• 0:38
  - Yeah. So glad to have you with us.
• 0:39
  - And just to get us started, wondering if
• 0:41
  - you can each just tell us a little
• 0:43
  - bit about yourselves and your work at CoverMyMeds.
• 0:46
  - Bill, do you wanna tee us up?
• 0:48
  - Sure. Yeah. Again, you said Bill Cicconetter. I
• 0:51
  - am the vice president of network sales here
• 0:53
  - at CoverMyMeds.
• 0:54
  - That means my role focuses on building and
• 0:56
  - strengthening and connections across the health care ecosystem,
• 0:59
  - particularly with health systems,
• 1:02
  - providers, payers, and pharmacies.
• 1:04
  - Big part of my work is looking at
• 1:05
  - how we can improve connectivity,
• 1:07
  - across the stakeholders to reduce friction in the
• 1:09
  - patient journey, ultimately making it easier for patients
• 1:12
  - to access the medications that they need.
• 1:15
  - Wonderful. Thanks so much. And, Matt?
• 1:17
  - Yeah. Absolutely.
• 1:19
  - Thanks for having us. Matt Hare. I lead
• 1:21
  - our provider
• 1:22
  - growth and client success teams at CoverMyMeds.
• 1:25
  - So really responsible for,
• 1:28
  - ensuring that our solutions,
• 1:30
  - get into the hands of our customers
• 1:32
  - and then, importantly,
• 1:33
  - that they're able to leverage those tools, and
• 1:36
  - we're working to help them optimize their workflows.
• 1:40
  - Fantastic. Well, thank you both for getting us
• 1:43
  - started. And
• 1:44
  - I'm looking forward to kind of digging deeper
• 1:46
  - into this concept of connectivity and where that
• 1:49
  - fits in with pharmacy.
• 1:51
  - The the term connectivity gets used pretty broadly
• 1:54
  - in health care, and it really can mean
• 1:56
  - anything from data exchange to workflow integration to
• 1:59
  - partnership strategy.
• 2:01
  - So I'm wondering if you could both just
• 2:02
  - kind of set the scene for us. When
• 2:04
  - you talk to health system leaders and executives
• 2:06
  - about connectivity right now, what are they actually
• 2:09
  - describing as the problem they're trying to solve?
• 2:12
  - Yeah. I think connectivity, it it really focuses
• 2:14
  - on moving data between systems. Right? It isn't
• 2:18
  - just about an API. It isn't about a
• 2:20
  - FHIR connection, DaVinci FHIR connection. It's truly about
• 2:23
  - helping the right stakeholder at the right time,
• 2:26
  - make the right action, and reduce friction for
• 2:28
  - patient advancement.
• 2:30
  - Connectivity is the infrastructure
• 2:31
  - that turns fragmented
• 2:33
  - access activities into coordinated patient journeys.
• 2:36
  - It enables providers, pharmacies,
• 2:38
  - payers, biopharma to work from a more connected
• 2:40
  - view of what's needed next. And I know
• 2:42
  - Matt has a lot of thoughts here too.
• 2:44
  - Yeah. I think Bill hit the nail on
• 2:46
  - the head with
• 2:48
  - giving,
• 2:49
  - access to the right step at the right
• 2:51
  - next time. And so, really, what we hear
• 2:53
  - from customers is just a greater need for
• 2:56
  - clarity.
• 2:57
  - What's the next step that I need to
• 2:58
  - take in order to get, medication for my
• 3:01
  - for my patient? So,
• 3:03
  - fewer disconnected experiences
• 3:05
  - and just ultimately a more consistent way to
• 3:07
  - navigate
• 3:08
  - access work, so really from end to end.
• 3:10
  - So whether it's a prior authorization
• 3:13
  - or affordability
• 3:14
  - options, making sure that all of that is
• 3:16
  - housed in one single workflow,
• 3:18
  - and everyone's working from a consistent,
• 3:20
  - process.
• 3:21
  - Mhmm. Yeah. Well, I appreciate you both setting
• 3:24
  - that foundation for the conversation today and definitely
• 3:27
  - can see the value prop here in connectivity
• 3:29
  - from the medication standpoint.
• 3:32
  - I'm curious where a lack of connection tends
• 3:35
  - to show up first. Is it in operations?
• 3:38
  - Is it in patient access?
• 3:40
  - Maybe somewhere else. But curious if you can
• 3:42
  - elaborate on whether there's a point where an
• 3:44
  - organization tends to realize that its current approach
• 3:46
  - isn't really working.
• 3:48
  - Yeah. Absolutely. So I would definitely say that
• 3:51
  - operations are typically where we hear about it
• 3:53
  - first.
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  - Doesn't mean that's where it starts. So, and
• 3:56
  - it doesn't stay there. Really, it shows up
• 3:58
  - in in different ways, but I think what
• 4:00
  - we hear the most is it really results
• 4:03
  - in staff working across multiple portals, different systems,
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  - individual workarounds that they've found in order to
• 4:09
  - do their work, just to understand what's needed
• 4:11
  - next for patients. And so that results in
• 4:14
  - care teams,
• 4:15
  - pretty pretty consistently losing confidence when... Whether it's
• 4:19
  - status or ownership of the next step in
• 4:21
  - the process or next steps aren't clear, and
• 4:24
  - patients feel that ultimately as delays and uncertainty
• 4:27
  - and and to them getting,
• 4:29
  - additional
• 4:31
  - therapy or medication.
• 4:33
  - One of the things that we've heard from
• 4:34
  - some of our our customers and users are
• 4:37
  - they might be working in upwards of a
• 4:39
  - dozen different portals. So logging into different portals,
• 4:43
  - different different logins for those portals. And so
• 4:46
  - that really tends to be
• 4:48
  - where we we see that pain felt the
• 4:50
  - most.
• 4:51
  - So starting in operations where we where we
• 4:53
  - hear about it first, but, really, then growth
• 4:56
  - tends to expose the issue.
• 4:58
  - A system can manage,
• 5:00
  - fragmented workarounds for a while, but as volume
• 5:03
  - increases, as new clinics or sites come on
• 5:06
  - board or
• 5:07
  - benefit,
• 5:08
  - requirements change, those cracks become pretty visible and
• 5:12
  - harder to work around. That's often the moment
• 5:14
  - that leaders realize
• 5:16
  - what we're doing isn't built to scale, and
• 5:18
  - we need to focus on on connectivity.
• 5:21
  - Our focus really today is connectivity, but what
• 5:23
  - come up... Customers are really looking for is
• 5:25
  - confidence. Confidence that the right information is available.
• 5:28
  - The next stakeholder knows what to do, and
• 5:30
  - the patients keep moving forward
• 5:32
  - all with the right partner by their side.
• 5:35
  - That's right. And at scale, one off processes
• 5:37
  - become an enterprise constraint.
• 5:40
  - Every portal, every manual handoff, every custom workflow
• 5:43
  - consumes capacity,
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  - and teams that are already stretched thin can't
• 5:47
  - quite handle that. Right? We're putting them in
• 5:49
  - a tough situation that's tough to succeed for
• 5:51
  - your patients and be a true advocate.
• 5:53
  - So the question is whether the organization can
• 5:55
  - continue to grow, expand services,
• 5:58
  - and manage increasing therapy complexity without continuously adding
• 6:01
  - more process, as Matt mentioned.
• 6:04
  - That's where access infrastructure matters. The organizations that
• 6:07
  - scale most effectively aren't necessarily adding more technology.
• 6:10
  - They're reducing friction by creating more visibility,
• 6:13
  - coordination, and consistency across the system.
• 6:16
  - Mhmm.
• 6:18
  - Yeah. And,
• 6:19
  - you know, Bill,
• 6:20
  - when you say that, it reminds me of
• 6:22
  - this shift that we're seeing where
• 6:24
  - organizations
• 6:25
  - seem to be framing connectivity as a growth
• 6:28
  - and a business decision rather than a technology
• 6:30
  - one to your point.
• 6:32
  - So what's driving that shift, and what changes
• 6:35
  - when a leadership team starts to think about
• 6:37
  - it in that way?
• 6:39
  - Yeah. Historically, I remember these conversations living only
• 6:43
  - with IT.
• 6:44
  - Truly, through my experience at McKesson and CoverMyMeds,
• 6:46
  - that is where we started.
• 6:48
  - But today, they're showing up in executive strategy
• 6:51
  - discussions because leaders are realizing that fragmentation has
• 6:54
  - a real business consequence.
• 6:56
  - Every disconnected workflow, every manual handoff and siloed
• 6:59
  - process consumes resources
• 7:01
  - that could otherwise support growth, innovation, or just
• 7:04
  - straight patient care.
• 7:06
  - As health systems expand services, acquire new sites,
• 7:09
  - adopt more specialized therapies,
• 7:11
  - navigate increasing reimbursement complexity,
• 7:13
  - they can't afford to scale through workarounds alone.
• 7:16
  - So connectivity becomes a question of operational capacity
• 7:19
  - and organizational resilience.
• 7:21
  - That's why we're seeing a shift in the
• 7:23
  - mindset. The conversation isn't any longer
• 7:25
  - how do we connect these systems. It's how
• 7:27
  - do we create an operating model that can
• 7:29
  - grow without adding any friction.
• 7:31
  - The organizations that are succeeding view connectivity as
• 7:34
  - infrastructure. It's the first step. When leadership teams
• 7:38
  - think about connectivity this way, they start measuring
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  - its impact on growth, efficiency,
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  - workforce utilization, and patient outcomes,
• 7:45
  - not simply technology adoption. Matt has a ton
• 7:48
  - of experience helping connect those dots.
• 7:50
  - Yeah. And I would say from a customer
• 7:52
  - perspective,
• 7:53
  - implementations are are a very important step, but
• 7:56
  - it's really the first step. And, ultimately,
• 7:58
  - the real work starts when you start to
• 8:01
  - ask care teams, are they using and benefiting
• 8:04
  - from the solutions that that are adopted? And
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  - so a successful connection is really measured by,
• 8:09
  - do the teams trust it? Are they gonna
• 8:11
  - incorporate it into their work and how their
• 8:13
  - work gets done?
• 8:14
  - We consistently hear that adoption happens when workflows
• 8:18
  - fit more naturally into the existing operations of
• 8:20
  - a of a team or a health system
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  - when the value is pretty obvious and visible
• 8:25
  - and when organizations have a partner that's helping
• 8:28
  - them optimize that over time.
• 8:30
  - It's it's especially important, I would say, as
• 8:32
  - health systems face workforce constraints and increasing access
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  - complexity.
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  - We're getting ready to get into reverification or
• 8:40
  - blizzard season as we call it, in January,
• 8:43
  - and that's a real strain on workforce at
• 8:46
  - these health systems. And so having solutions and
• 8:49
  - systems and processes in place are really important.
• 8:52
  - Teams don't have capacity for tools that just
• 8:54
  - ultimately create more work for them. They need
• 8:57
  - solutions that give them that clarity and help
• 8:59
  - staff focus. Bill and I are gonna say
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  - this a lot.
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  - Focus on the patient care.
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  - Mhmm.
• 9:06
  - Yeah. And, Matt, I'd love if you could
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  - build on this idea a little bit more.
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  - You mentioned growing complexity that we're seeing at
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  - at hospitals and health systems.
• 9:15
  - So for those that are facing more specialized
• 9:18
  - therapies,
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  - more complex access requirements,
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  - What does a connected approach really look like
• 9:24
  - in practice across
• 9:25
  - data workflows and also stakeholders?
• 9:29
  - Yeah. Absolutely. I would say a couple of
• 9:31
  - different things. You mentioned the stakeholder piece. When
• 9:34
  - you have more complex therapies, more complex diagnoses,
• 9:38
  - ultimately, there's gonna be more people involved in
• 9:40
  - the care of that patient. And so when
• 9:42
  - we talk about disconnectedness,
• 9:44
  - you really need to help eliminate that by
• 9:46
  - having tools in place that are available to
• 9:49
  - all of the stakeholders in that process. I
• 9:52
  - think the other thing that's probably worth mentioning
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  - is,
• 9:55
  - we believe strongly in harnessing
• 9:58
  - the investment that health systems have made in
• 10:00
  - their EHR.
• 10:01
  - Information's available... Readily available. How can we help
• 10:05
  - them access that information more quickly
• 10:07
  - and have tools that help support them getting
• 10:10
  - patients on therapy?
• 10:12
  - Mhmm. Yep. Great points. Bill, anything that you'd
• 10:15
  - add from that standpoint?
• 10:18
  - No. Of course. Matt's absolutely right here. It's
• 10:20
  - deepening our knowledge on patient journeys. It's having
• 10:23
  - a passion truly driven to advance patient experience.
• 10:26
  - When we engaged Nielsen on this, they told
• 10:28
  - us some staggering statistics. Around eighty five percent
• 10:31
  - of specialty patients reported at least one barrier
• 10:33
  - to care. Fifty percent of specialty patients experienced
• 10:37
  - coverage or utilization management friction.
• 10:39
  - Those numbers should be zero. There should be
• 10:41
  - no friction in this process, and that's what
• 10:43
  - we're really focused on trying to figure out.
• 10:45
  - Health system models should feel routine.
• 10:48
  - Complex specialty needs should all feel the same
• 10:51
  - and similar to providers, and patients shouldn't feel
• 10:53
  - the barrier at all.
• 10:55
  - Mhmm. Yeah. But I appreciate you sharing that
• 10:57
  - Nielsen data too. It's,
• 10:59
  - definitely something for for listeners to consider, and
• 11:02
  - I appreciate the point too around
• 11:04
  - the fact that there shouldn't be friction at
• 11:06
  - all. And that's really what what I know
• 11:08
  - you all and leaders are aiming for.
• 11:11
  - And I wanna also make sure that we
• 11:13
  - touch on kind of the timeliness of this
• 11:15
  - conversation
• 11:16
  - too, especially in light of benefits reverification
• 11:19
  - season. I know that time puts
• 11:21
  - real pressure on pharmacies as well as providers
• 11:25
  - and, of course, patients too.
• 11:27
  - So what should organizations be thinking about now
• 11:30
  - to minimize that friction, that disruption, and and
• 11:33
  - what do you think separates groups that get
• 11:35
  - through it well from those that struggle?
• 11:37
  - Yeah. I would say benefits reverification season, it
• 11:41
  - it puts pressure on every single
• 11:43
  - stakeholder in the access journey all at the
• 11:45
  - same time. So it's not even as if
• 11:47
  - it's
• 11:48
  - sequenced. It's all at once. And so,
• 11:50
  - whether it's coverage changes, utilization management requirements that
• 11:54
  - shift,
• 11:55
  - formularies
• 11:56
  - evolve,
• 11:57
  - and patients often just need guidance on what
• 11:59
  - does that change mean for them in their
• 12:01
  - care. We've seen that the organizations
• 12:04
  - that that navigate that season most successfully
• 12:06
  - aren't waiting until January when the time is
• 12:09
  - there to start to react and plan for
• 12:11
  - it. They create clarity before the pressure peaks,
• 12:15
  - establishing ownership, aligning teams around those common processes
• 12:19
  - that we've mentioned, and make sure that that
• 12:21
  - stakeholders have visibility into where patients might need
• 12:24
  - support and with the right partner by their
• 12:27
  - by their side.
• 12:28
  - That partnership really matters during those high pressure
• 12:31
  - periods.
• 12:32
  - You need visibility,
• 12:34
  - expertise,
• 12:34
  - and then, again, ultimately, confidence that everyone is
• 12:37
  - working from the same playbook.
• 12:39
  - The goal really is to create a more
• 12:41
  - seamless experience
• 12:42
  - for patients even when that complexity
• 12:45
  - increases behind the scenes. They don't see that.
• 12:47
  - They don't they don't know it. They don't
• 12:49
  - need to feel it. And so we're trying
• 12:50
  - to to help really bring that seamless experience
• 12:53
  - to reality.
• 12:54
  - Matt, the benefits reverification season, I mean, you're
• 12:57
  - hitting it perfectly. It's the clearest example of
• 12:59
  - why access and infrastructure matters.
• 13:02
  - The coverage changes aren't unexpected. Everyone feels them
• 13:05
  - coming. The question ends up, do we think
• 13:08
  - the operation
• 13:09
  - of the organization
• 13:10
  - can absorb that predictable pressure?
• 13:13
  - The organizations that perform well here have invested
• 13:15
  - in the infrastructure to help stakeholders anticipate those
• 13:18
  - barriers, coordinate action, adopt changing requirements
• 13:21
  - without recreating a process every single year. The
• 13:24
  - event itself, it's seasonal. The lesson is very
• 13:27
  - structural.
• 13:28
  - Benefits, reverification
• 13:29
  - exposes whether an organization has built an access
• 13:32
  - model designed to scale and evolve as health
• 13:34
  - care continues to change with a partner that
• 13:36
  - makes sense.
• 13:38
  - Yeah. Yeah. Great points. And just building on
• 13:41
  - that, is there
• 13:42
  - a particular capability or partnership approach that you've
• 13:45
  - seen make a real difference heading into this
• 13:48
  - window and and really reducing those friction points?
• 13:52
  - Yeah. I think so. It's the right question
• 13:54
  - to be asking, but we've said it multiple
• 13:57
  - times here today,
• 13:58
  - feeling a bit like a record here broken.
• 14:00
  - But I would say that health care doesn't
• 14:03
  - have a shortage of point solutions.
• 14:05
  - There are hundreds of opportunities and options. What
• 14:08
  - organizations need are partnerships that help them operate
• 14:10
  - more effectively across broader ecosystems,
• 14:13
  - not individual point solutions.
• 14:15
  - Strongest partnerships create connections between providers, pharmacies, payer,
• 14:19
  - biopharma, and technology,
• 14:21
  - helping each stakeholder
• 14:23
  - for... Feel more informed and get a view
• 14:25
  - of what needs to happen next. At the
• 14:27
  - enterprise level, scale matters. Leaders are looking for
• 14:29
  - partners with established networks, proven connectivity,
• 14:32
  - and the ability to support diverse use cases
• 14:35
  - across service lines, care settings, and benefit structures.
• 14:38
  - That's why I'm really proud to work for
• 14:40
  - CoverMyMeds. I've been fortunate to work for McKesson
• 14:43
  - for over twelve years, CoverMyMeds just over a
• 14:45
  - year now, but the benefit here is that
• 14:47
  - we're literally removing those barriers and those layers
• 14:50
  - in health care that make it harder for
• 14:52
  - every patient. So having that as our mission
• 14:54
  - is is truly a a great journey to
• 14:56
  - be on.
• 14:58
  - Yeah. I would just add, I... Bill hit
• 15:00
  - the nail on the head again. He's good
• 15:01
  - at that. The strong... Strongest partners, I would
• 15:04
  - say, really listen closely to customers, understand the
• 15:07
  - goals of their organizations, their teams,
• 15:10
  - and then help translate
• 15:12
  - technology capabilities that can that can, increase operational
• 15:16
  - value. And so we we can have all
• 15:18
  - of the tools, but making sure that it's
• 15:20
  - fitting into the goals and the objectives of
• 15:22
  - our partners is is something that's that's really
• 15:24
  - important.
• 15:25
  - I would also say that hearing consistently from
• 15:28
  - cut... Customers that they want a partner who
• 15:30
  - helps them optimize over time. You're not just
• 15:34
  - trying
• 15:34
  - to find a solver, a solution for an
• 15:36
  - immediate,
• 15:38
  - problem or challenge that you're facing,
• 15:40
  - but you're you're really trying to challenge the
• 15:42
  - status quo. And that's especially important as access
• 15:45
  - requirements,
• 15:46
  - payer policies, therapy complexity continue to change.
• 15:50
  - I think one of the things I love
• 15:52
  - the most about my role at Cover My
• 15:54
  - Meds is that I love when a customer
• 15:56
  - calls and will bring up a problem or
• 15:58
  - a challenge that they're facing and asking, can
• 16:00
  - you help us solve this, or do you
• 16:02
  - have something that can help us? And so
• 16:04
  - really helping customers do more than solve that
• 16:06
  - that just the challenge of the day. They
• 16:08
  - help them build capabilities that that they'll need
• 16:11
  - for years to come.
• 16:13
  - Yeah. Well, I've appreciated everything that you both
• 16:16
  - have shared about, you know, the value of
• 16:18
  - partnerships here and and really reducing
• 16:21
  - difficulties and barriers and simply,
• 16:24
  - you know, having patients get access to their
• 16:27
  - medications that they need.
• 16:29
  - And it sounds like to both of your
• 16:31
  - points, partnerships play such a key role here.
• 16:34
  - But I'm curious for the listeners who are
• 16:36
  - are hearing our conversation and they're wondering about
• 16:39
  - that next step they should take or that
• 16:41
  - next capability that you think would be most
• 16:43
  - useful for them to build now to support
• 16:46
  - that connected journey,
• 16:48
  - what would it be? And, you know, open
• 16:50
  - to any other final thoughts that both of
• 16:52
  - you might have on this.
• 16:54
  - Yeah. I think picking the right partner matters.
• 16:56
  - Right? And and understanding that connectivity across the
• 16:59
  - entire ecosystem is what's gonna separate,
• 17:02
  - us as as as a partner. And, ultimately,
• 17:05
  - picking those partners will advance the organization and
• 17:08
  - truly health care for the patient. That's what
• 17:10
  - matters. Right? Is is the patient getting the
• 17:12
  - medication they need? So finding those right partners
• 17:15
  - is is the biggest thing.
• 17:17
  - If there is one thing I leave the
• 17:19
  - listeners with today, it is that access is
• 17:21
  - becoming a defining operational capability
• 17:24
  - for health care organizations.
• 17:25
  - The leaders who invest in scalable infrastructure and
• 17:28
  - strong partnerships today will be better positioned for
• 17:31
  - whatever comes next.
• 17:32
  - Yeah. And I would say from a customer
• 17:34
  - perspective, success comes from continuous collaboration.
• 17:38
  - The strongest organizations, the strongest partners that we
• 17:41
  - have aren't standing still. And again, they're they're
• 17:43
  - not accepting of the the status quo.
• 17:46
  - They're listening. They're learning from some of their
• 17:48
  - peers in the industry and constantly looking for
• 17:51
  - ways to make the patient journey simpler and
• 17:53
  - more connected. I think one of the things
• 17:55
  - that I try to show up with every
• 17:56
  - day is that there's a patient at the
• 17:59
  - end of every prior auth or RTBP connection
• 18:02
  - that that we have, and how can we
• 18:04
  - continue to service
• 18:07
  - the teams that are that are supporting those
• 18:09
  - patients directly. And that's really the driving force
• 18:12
  - for the work that we do.
• 18:13
  - Yeah.
• 18:14
  - Well, it's been such a pleasure talking to
• 18:17
  - you both today, and the passion that you
• 18:19
  - both have for this work really came through
• 18:21
  - in our conversation. So I wanna thank you
• 18:23
  - both for all the insights that you've shared,
• 18:26
  - some actionable next steps for our listeners,
• 18:28
  - and just thank you again for your time,
• 18:30
  - Matt and Bill.
• 18:31
  - Thank you.
• 18:33
  - And, of course, we'd also like to thank
• 18:34
  - our podcast sponsor, Cover My Meds.
• 18:37
  - Listeners, be sure to tune in to more
• 18:39
  - podcasts from Becker's by visiting our podcast page
• 18:42
  - at beckershospitalreview.com.