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What Your PBM Doesn’t Want You To Know - Delivering Savings and Better Care with Financial and Performance Transparency

Event Date:5/9/2019

Event Overview

Thursday, May 09, 2019
11:00 AM CT – 12:00 PM CT (60 minutes)
Vendor Spotlight Host: Truveris

This vendor spotlight is hosted on our ReadyTalk platform

 

Health plan sponsors contract with their PBM to provide low medication prices and operational efficiency. Yet, the financial incentives of most PBMs lie with dispensing medication rather than with managing your benefits. Further, PBMs can’t truly benchmark because they don’t have visibility into the claims managed by other PBMs. Truveris does.

There are reasons that one plan performs at an overall pharmacy spend of $70 PMPM while another is at $100 PMPM. It takes a strategy that is driven by analytics that make things transparent and establish clear benchmarks.

In this webinar, pharmacy benefit experts Rahul Singal, MD and Ryan Hanes, MBA will demonstrate how to create transparency throughout every stage of your PBM contract life-cycle, as well as align your internal management team to focus on a few key metrics and benchmarks. 

Learn how to navigate even the most obscure elements of your PBM contract including:

  • Managing high-cost generics –  
    How to analyze your claims data to identify better solutions for managing high cost generics based on your unique member population
  • Recognizing the impact of your contractual guarantees –
    How the guarantees listed at the beginning of your contract are often offset by caveats buried at the end – many which drive dispensing volume to the PBM’s preferred channels, increasing their profits
  • Understanding your formulary strategy– 
    How to analyze your formulary strategy to ensure you are maximizing your PBM’s performance and pursuing the lowest-cost options
  • Preventing specialty leakage –
    How to identify when your specialty dispensing is noncompliant, under-reimbursed, overutilized and/or being inappropriately dispensed and what to do once you find it

     

Notice to Participants:
Please note that this webinar is a Vendor Spotlight and will be a capabilities-focused presentation. While this vendor is not under contract with the Health Plan Alliance, we believe this webinar will provide you the opportunity to learn more about this vendor and the programs and services it provides. Offering this webinar does not imply that the Health Plan Alliance endorses this vendor. The webinar is merely for informational purposes only. Should you wish to share feedback and/or have questions about this vendor, please contact Jaime González, the Alliance’s Chief Business Development Officer, at jaime.gonzalez@healthplanalliance.org or 972-830-6355.

Documents
Attendees

Below is a list of all delegates registered to date for this event

  • Mike Abdo
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Pharmacy at CommunityCare
  • Olamide Akanbi
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Regulatory Coordinator at Paramount Health Care
  • Abiola Aluko
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Compliance Analyst at FirstCarolinaCare Insurance Company
  • Shawn Barger
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Pharmacy at AvMed
  • Craig Bogner
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Pharmacist at Paramount Health Care
  • Bill Bradish
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Investigator at Presbyterian Health Plan
  • Elizabeth Brusig
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Pharmacy Specialist, Managed Care at Sentara Health Plans (Optima)
  • Michelle Burnham
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • RN, Medical Coding Auditor at Neighborhood Health Plan of Rhode Island
  • Alisa Cocozza
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Associate Director, Finance at MetroPlus Health Plan
  • Patrick Cory
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Pharmacy Program Director at Quartz Health Solutions
  • Kathy Coslett
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • SIU Investigator at Geisinger Health Plan
  • Xuan Cung
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • SUPV Pharmacist at Valley Health Plan
  • Christina Domingo
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Pharmacy Technician, CPhT at Aspire Health Plan
  • Jason Edenburn
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Claims Manager at Health Alliance Medical Plans
  • Jaime Gonzalez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Chief Business Development Officer at Health Plan Alliance
  • Shane Greene
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Pharmacy Services at Care N' Care Insurance Company, Inc.
  • Valarie Hathaway
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Claims Project Analyst at Health Alliance Plan (HAP)
  • Alan Heaton
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Pharmacy Benefits at PreferredOne
  • James Hiveley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Vice President, Chief Financial Officer & Treasurer at Quartz Health Solutions
  • Jonni Holybee
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Pharmacy Liaison at Prominence Health Plan
  • Jennifer Hunt
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Actuarial Services at Paramount Health Care
  • Henry Johnson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Executive Director - Pharmacy at Indiana University Health Plans
  • Christine Lounsbery
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Population Health Services Operations at Avera Health Plans (DAKOTACARE)
  • Greta Matus
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • FWA Special Investigator at Health Alliance Medical Plans
  • Tamara Migut
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Managed Care Pharmacist at Health Alliance Medical Plans
  • Jonathan Moody
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Legislative Affairs at Quartz Health Solutions
  • LaToya Morgan
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Finance Project Specialist at Paramount Health Care
  • Daniel Morrissey
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Assistant Coordinator at Paramount Health Care
  • Pavel Pechenov
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Program Manager, Care Improvement at Community Health Plan of Washington
  • Charles Perez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Pharmacy Services at CommunityCare
  • David Piasecki
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medicare Part-D Compliance Consultant at Indiana University Health Plans
  • Stefanie Pike
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Pharmacy Program Manager at Community Health Options
  • Jean Rao
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Pharmacy Manager at Chinese Community Health Plan
  • Yusuf Rashid
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Vice President Pharmacy and Vendor Relationship Management at Community Health Plan of Washington
  • Tim Riley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Chief Information Officer/VP of Information Services at Network Health
  • Annie Shieh
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Compliance Counsel at Central Health Plan of California
  • Brian Smolich
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Pharmacy Director at Health Alliance Medical Plans
  • Susan Sotak
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Pharmacy Audit and PBM Oversight Manager at Presbyterian Health Plan
  • Casey Stockman
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP, Specialty Pharmacy at Neighborhood Health Plan of Rhode Island
  • Tiffanie Swartz
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Pharmacy at SummaCare
  • Teodor Todhe
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Quality of Care Manager at MetroPlus Health Plan
  • Christopher Zapart
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Investigator at Geisinger Health Plan
  • Ryan Haynes
  • SPEAKER
  • Sr. Clinical Director, Account Management at Truveris, Inc.
  • Rahul Singal
  • SPEAKER
  • Advisory Board Member, Truveris at Truveris, Inc.
  • Tyler Koch
  • SPONSOR
  • Marketing Director at Truveris, Inc.
  • Sherman Sanchez
  • SPONSOR
  • SVP of Sales and Business Development at Truveris, Inc.
Speakers