This Week Health

March 8, 2022: Today, we bring you another #InterviewInAction from the ViVE 2022 conference.

Snezana Mahon shares new announcements from Transcarent, including Rush Medical's agreement to provide Transcarent's new and different health and care experience to RUSH employees and their families.

#ViVE2022

Transcript

Today and interview and action from the Vive event down here in Miami. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health, a set of channels dedicated to keeping health it staff, current and engaged. We want to thank our show sponsors who are investing in developing the next generation of health leaders, Gordian dynamics, Quill health tau site nuance, Canon medical, and current health.

Check them out at this week. health.com/today. Onto our interview.

All right, here we are at 5 20 22, and, uh, we have a special guest with us today. Snezana man with, uh, with transparent chief operating officer for transparent, a lot of really exciting stuff going on right now to transparent. Look forward to this conversation. We've talked to Glenn a couple of times. I'm looking forward to, uh, um, not talking about strategy so much as just the, I mean, you're at the brass tacks of making things.

Absolutely. Absolutely. What's your background? How'd you get to trench? So I'm a pharmacist by training and I spent about seven years with Walgreens and then about 14 years with express scripts. And about five months ago, I joined, uh, transparent where Glenn convinced me to leave the big PBM world and tried to transform healthcare at transparent.

So with all this stuff, With all of the stuff I knew about the payer and the PBM world yet in St. Louis, I am based in St. Louis still in St. Louis and wasn't St. Louis the entire time. Well, wow. Well, we'll have to talk about that after the interview. Cause I lived there for 40 years and you know, people are complaining about the, uh, the humidity down here, but, um, the most human place I've ever lived in St.

Louis, we have a lot of humidity there. Um, so some really exciting stuff coming out of trans carrot. I don't know where I want to start. I don't know if I want to talk about, I mean, the insulin. The thing with Civica is really exciting. W w what do you want to talk about? Yeah, let's start with the insulin thing.

I mean, we have transparent are ultimately focused on delivering very comprehensive, complete care experiences for the consumer, and also super focused on the affordability and sustainability of the benefit for our employers. So when you think about the civic canoes and our partnership with Civica to bring more affordable medications to the consumer, 8 million Americans are dependent on insulin and prior to the civic, The average consumer is spending over $150 on their insulin vials.

And now we're able to bring that to members that less than $30 a vial, that is huge. So both from a consumer standpoint and the employer standpoint, this is good news, and we're going to continue to see opportunities like this in the future. I mean, that in and of itself is amazing the number of people that suffer from diabetes and need that medication.

But it, but that deal is that more, that's about a broader. Of medications as well as correct. So right now Civico offers a lot of generic, uh, products that are available and insulin was the next foray into trying to help a greater consumer set both in terms of consumers that don't have any insurance consumers that have insurance through their employers or health plans.

And we're probably going to see a whole lot more from companies like Civica that are delivering some of those lower cost medications to the consumer directly. So it's, that's interesting. Yeah. Uh, you know, I just had a conversation last week and I was, so I interviewed mark Cuban is the mark Cuban drug cost plus drug company.

And this seems to be an area that PBM space seems to be an area where people are looking at it going there's too many middlemen. There's too many, um, components pulling money out of there. And it's not serving the employer's real well. It's not serving the, the patients and the consumers. Obviously we have.

You know, the costs leading to what they are. And then if we have bankruptcies as a result of, of cost of medications. So, you know, you're somebody who really understands the PBM space, what what's it going to take to transform? Yeah, I think there's a couple of things we have to do. The first is bringing transparency to the consumer today.

We will never be able to move into a true value-based care ecosystem without having a baseline of transparency. And unfortunately, the pharmacy space is one that's very opaque and there's very little cost transparency, both to the employer and the consumer most important. So the first step is giving the consumer the ability to see lower costs.

And to know that you can get this medication at this particular location, just by simply switching a drug or switching where you get your drug. It's a huge opportunity. So companies like the cost plus opportunities, Walmart, Amazon, that are giving members. A lot of those lower cost alternatives are certainly transforming that.

Second is bringing transparency to the employers and that's why you're starting to see a shift and a lot of the transparent PBMs that are emerging in the marketplace where rebates are fully past. You're only paying for the services that are being delivered. And so we're starting to see a huge shift in the way care is being delivered in the pharmacy space, both from a cost and a care stage.

And we're probably going to see a whole lot more innovation in that space as well. So Civica Walmart, we talked to Glenn about the Walmart deal. Are there others that have been signed? I know there's others in the works I'm sure. Absolutely. So, uh, transparent has been working with a lot of health systems.

You may have seen, uh, some of our recent partnerships with rush health system in Chicago. We are very much looking to transform the way their care is being delivered to their employees, um, within the rush health system. And we're super excited about. Delivering consumer centric experiences that are personalized, that are seamless in their lunch toodle while ultimately giving the consumer the ultimate upper hand and giving them the ability to get the care on their terms at the right time, right place within seconds, day or night.

And so we're really excited that might seem counterintuitive to some people that might sit there and go a health system has to go to trans carrot for that experience, but having been. At a health system that doesn't exist anymore. We merged with another one. So I can talk about this. Our employees, weren't happy with our, uh, how we handled healthcare.

Even though we were a significant healthcare organization, they trusted the doctors, they appreciated their primary care physician, but the overall knitting it all together with transparency, like you're talking about, and they would still end up with these bills and they'd be like, is this really what we're doing to our patients?

And the answer was, yes. Yeah. That's what we were doing. One in three Americans are skipping care because they're afraid of the medical bills. More consumers are afraid of the medical bills than they are. The actual disease that they've been diagnosed with, which is a problem. 18 million Americans can't afford at least one or more of their chronic medications.

And so, and the experience is broken. It's totally fragmented. You have the medical benefits, the pharmacy benefits, the behavioral benefits, all of these point solutions that have emerged in the marketplace. Consumers are confused. Okay. And they're spending over 50% of their time trying to understand where to get the care, how to get the right care.

And so why these health systems are coming to transparent is they want to enable their consumers to be more productive. Think about it, less absenteeism, presenteeism, being able to be on their job, especially with the shortages of the healthcare workers that we're seeing. And so how do we enable their healthcare workers to be as present as available for their work, their organizations, as well as their families and giving them this amazing.

Comprehensive longitudinal care experience that they have not had yet. And when we talk to some of our members actually rush members, too, they tell us I didn't even realize this type of a healthcare experience even existed before. And so it's awesome. We were talking to Glen, he was talking about, uh, you know, we're committed to getting somebody on the phone within 60 seconds.

Okay, well, that's a big one right there. I mean, it's, uh, you know, somebody on the other line to say, look, I'm trying to figure out this or that they walk you through it. It's pretty amazing. So rush is, are there, I mean, that's the recent news. Are there other. Yep. Absolutely. We're working with dozens of health systems right now, evaluating when they want to go live.

And most of them will be going live later, um, at the end of Q1 and early Q2. So more news to, so that's health systems as clients, but then you have health systems you're partnering with. On the delivery and the direct care delivery side. What does that look like? So when you think about today, you have a lot of the virtual health, digital health companies out there that most consumers are interested in, but we're finding is consumers actually want a hybrid experience.

They want both local care and virtual care. And so what transparent is doing is we're bridging that integration of local and virtual in a fully coordinated mechanism. So when we partner with our health system partners, how do I offer tele-health capabilities at a local primary care? Just like, I may be able to give them a 62nd weighed opportunity at 2:00 AM in the morning in a digital virtual experience.

And having those two experiences, speaking to one another and connecting is what we're developing. So giving that consumer choice, you can get your care delivered in a local setting, or you can get your care delivered in a virtual world from an acute care setting. And it's your choice. And that is where we're bringing local and virtual care in a fully integrated system.

What about specialty care? Yeah, so specialty. Extremely focused on that as well, all the way from everyday care to complex care. So when you think about cancer care, MSK care, surgery, care, behavioral care, we are operating in all of those segments and we'll continue to expand in those categories over the next 12 months, where we will be able to service our clients with over 90% of total healthcare spending.

Uh, I would imagine, I mean, this is just me, but I would imagine that, um, if you go in and talk to an employer right now and say, Hey, here's what we have to offer. Um, you're going to have to hold Glenn back from selling too much. I mean, there's, there's an awful lot of demand out there. Absolutely. And most of our employers that we speak with they're exactly stating that they're overwhelmed with managing the administrative burden of the various disparate point solutions that are in the marketplace.

They're not getting the financial benefit, the ROI on the solutions that they've bought today, nor are their members necessarily getting better, higher quality or the clinical outcomes. And that's exactly what. And the most innovative thing about trans Karen is we go fully at risk. So unlike many of the other solutions in the marketplace, we're full risk.

We don't make any money until we save our, save our clients money. And that's ultimately why they're so interested in us, this challenges, some of those difficulties or, yeah. Oh, absolutely. Right. I mean, when I think back to 15 years ago, when I entered the pharmacy PBM space, prior to that point, we were taught two things in pharmacy school.

You can work behind the counter at a retail pharmacy, or you can work in a hospital basement. There was not much out there about here's who you can do, managed care. You can go into pharmacy benefits, management, pharmaceutical management. So entering the bent of the business side of pharmacy was challenging because there's not a lot of women in that space.

And I fortunately had the opportunity who had a lot of mentors and sponsorship, um, in the organization that allowed me and gave me the opportunities to progress. And I've now made it a personal mission of mine to allow other young pharmacists who are in the healthcare space to see the world together.

And to be able to make an impact. So as a COO, you are you're negotiating these steals. Oh, absolutely. Yeah. So how did you go from where you were at to there? I mean, that's a different skillset. Um, for me, fortunately also had the opportunities to gain some of that experience at express scripts, by working with some of the largest health plans employers in the country, uh, negotiating deals working with, with them in terms of finalist meetings, presentations, and actually just one of the mechanisms how I met.

About six years ago where Glenn was running, Lavango negotiate with, I got to negotiate with Glenn. Yes. I was his toughest negotiator. He didn't like it most days. And he actually said to me about four years ago, he said one of these days, if I ever build another company, you're going to be working on my side of the table.

Cause I don't know that I can handle your again in my next adventure. So anyway, that's how Glenn called me last year and said, Hey, look, I need you. We're building this incredible company. And I would love to have you build something incredible and transform health. It is incredible. Hey, I want to thank you for your time.

Thank you so much for your time. Thank you.

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