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May 1: Today on the Conference channel, it’s an Interview in Action live from ViVe 2023 with Snezana Mahon, Chief Operating Officer at Transcarent. How does the acquisition of 98point6 enable Transcarent to offer a better care experience for its members? What solutions has Transcarent developed in the pharmacy space to improve transparency and accessibility for consumers? How does Transcarent partner with health systems, and what are some examples of recent partnerships they have formed?

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Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong

Welcome to this week, health 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. Today we have an interview in action from the 2023 Spring conferences, vibe in Nashville and hymns in Chicago.

Special thanks to our cDW, Rubrik, Sectra and Trellix for choosing to invest in our mission to develop the next generation of health leaders.

You can check them out on our website this week, health.com, now onto this interview.

Here we are from the Vibe Conference in Nashville, and we are joined by Za Mayhan, with Man with Transparent. I was so worried about your first name. I got your last name wrong. No, it's all right. It's awful. We caught up last year.

Yeah, we did.

First, I was just remembering last March in Miami, you and I were talking so incredible.

Yeah, it was, it was fantastic. There was a lot of stuff going on at that point, but the pace really hasn't slowed down. For transparent what's, what's new? What are you guys working?

Yeah, I mean, we are extremely busy here at trans.

Karen, you may have seen a couple of weeks ago, we announced our intent to acquire 98.6, so our part of 98.6 technology platform, the provider ecosystem as well as the customer base. So we are going to be extremely busy over the next coming weeks and months with

that.

well,

First of all, let's remind people what transparent is all about and what you guys are doing.

Yeah, Yeah. So transparent is building a new. Care experience for the consumers, and we're working predominantly with self-insured employers, large self-insured employers, mid-market, self-insured employers, delivering a better health and care experience for their members. And we offer a number of longitudinal care experiences.

Everything from everyday care, pharmacy care, surgery, care, oncology care. And so we're offering a breadth of experience. It's focusing on 90% of healthcare spending. And so when you think about this acquisition, it gives us that on-ramp that entryway into that healthcare ecosystem, being there for the consumer 24 by seven day and night, and offering them telehealth services and that entry into the other care experiences that transparent

and for the employer themselves.

There's an experience aspect of it. Yes. Because we all hate going to that benefits meeting and Yes. Saying, Hey, you're gonna get less benefits and whatever. And you're actually elevating that experience and driving the cost down as well.

A hundred percent. So when you think about what the average self-insured employer is dealing with today, most.

To them, if they're a national employer, they have multiple medical carriers, they have one PBM and they have 15 point solutions. So for the employer, it's highly administratively burdensome to manage all of those benefits, and they're very costly to their employees. It is a very confusing experience on where to go.

Do I go here for this point? Solution that point solution. When do I go to my medical plan? What do I do about my pharmacy Benefit? Transparent is looking to streamline all of that and make it very easy. Transparent is the single platform for all things care. That's all you have to remember, right? As a consumer, you go to transparent as that employee of that employer and you get all of those services in a single place.

And because we're able to deliver this longitudinal experience, the cost to the. Significantly less, and it doesn't cost anything to the employee because now the employer is able to offer all of these services at no cost to their employee.

You know?

I

love it. And, if you could just continue to remind Glen Yeah.

That transparent isn't done until I can offer it to my employees and I'm only a six person company.

Yes, Yes. We are absolutely working on that.

So we go back to 98.6, what does this add in terms of what. To take to those employers.

Yeah. So today transparent with the telehealth abilities to fully integrate, we today offer a telehealth service for members with chat with the provider.

But what this is enabling us is having full control right before not being able to have full control of the provider group of the plat. Form the AI technology, 98.6 now enables us to be more front center with the member. I can manage the providers, I can give them protocols and how to enable and engage with the members longitudinally, not just as a singular acute telehealth episode, but really looking at what does that telehealth episode lead next?

Do you need a prescription? How do I help you get that script? Do you now need to get a virtual physical therapy visit as a recommendation? Whatever that chief. Was in that acute telehealth visit. So really connecting those dots and enabling that longitudinal experience, not just being a singular episode, but really being able to be there for the member day in and day out.

So last year we talked about drug pricing. Yes, we did. Specifically, I think we talked about insulin. Yes. Yes. Has there been progress? I mean, that's a huge Yeah. Announcement of itself. Yes. But has there been progress in that area?

Absolutely. We continue to invest. Pharmacy. And since you and I last spoke, we've done several other things in the pharmacy space.

The first one is we launched the industry's first pharmacy marketplace that is comprehensive across the pharmacy benefit cash coupon. So now the consumer or the member of an employer is able to. To go into the transparent pharmacy marketplace and see today, am I better off getting this drug at this price, at this pharmacy on my benefit cash or coupon?

And we're proactively allowing those triggers to fire. So instead of you having to go look them up, let's say on Google or GoodRx or other places we're doing that. Searching for you and you as the consumer just simply need to click and you're able to get that medication delivered to you. And now going back to the telehealth piece, imagine now enabling that provider in our ecosystem to see that same information.

So at the time of prescribing, the physician is making the best decision along with the patient, simultaneously on, I want this drug at this price, . So that's one of the key investments. transcarent has made, and we also continue to invest more broadly in the full pharmacy experience. One area we're working on right now is specialty.

As you know, specialty costs are through the roof, right? Employers are really trying to manage that spend, and we're investing in a specialty center of excellence network similar to what we have done in the surgery space, where now we can open. The aperture for the consumer to be able to see what is the lowest cost specialty pharmacy that can deliver the highest quality care for me, versus just being forced to go to a singular specialty pharmacy.

So we continue to expand our capabilities in the pharmacy space.

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  📍 all right, we'll get back to  our show in just a minute. We're excited. We have a great webinar for you in May on May 4th at one o'clock Eastern Time. It is part of our leadership series on modern data strategies in healthcare. In this webinar, we're going to explore data driven approaches to healthcare and how they can improve patient outcomes, increase efficiency and reduce cost, which are also critical at this time.

In this juncture in healthcare, our expert speakers will explore data governance, analytics, strateg. anything that can help healthcare providers gain actionable insights from healthcare data. We would love to have you there and we're excited about it. You can register on our website.

Just hit the leadership series, modern Data Strategies. It's gonna be in the top right hand corner of our website this week, health.com. you can discover how we are going to use data to be more efficient, effective in the modern healthcare system. we would love to have you join us again.

Hit the website this week, health.com. Top right hand corner. Sign up today. Hope to see you there. Now back to the show,

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I'm hitting so many top things here, so, yeah. What about msk?

Yeah, musculoskeletal, gosh, I mean, every single employer that you speak with, that is one of their top three pain points when you look at musculoskeletal care. Surgery spending ] continues to be through the roof, especially since Covid the last two years we have seen.

Sort of this delay in care, and now you're starting to see more and more of that surgery tsunami that was building up where people were delaying care and now they're coming back. Right? When you think about orthopedic spine care, bariatric surgical procedures are also on the rise pretty significantly, and employers are seeking centers of excellence like the one that Transparent Surgery Care is offering to deliver that expansive care and.

Stopping there in terms of supporting just the surgical episode, there's the pre and the post, right? Right. You have that longitudinal musculo because you're, you're about the experience. We're, about the full experience, so not everybody should be getting a surgery. In fact, 30% of surgeries in the US today are completely unnecessary, so you have to get them the proper, we have to be there upfront in the ecosystem to be able to flag and identify that patient to say, do you need a surgical recommendation first?

Because you shouldn't go under the knife unless you have had. Board certified, surgeon, that is authorizing and agreeing that you should have a surgical procedure if you do not need a surgical procedure. We have virtual physical therapy as a first stop gap for that member to try before they go into that surgery.

We also offer specialized expert medical opinions for members in this musculoskeletal space to make a decision should you get surgery or not get surgery. And then post-surgery, you gotta stay with the member to ensure that they're, well, how do you follow up with them? With their pharmaceutical regimen, with their post-surgical physical therapy regimen.

And so really being there for them. And that's what all transparent is about, is building most experiences pre, during, and post.

I think this is my exit question. Yeah. And it's about the provider space. So a lot of my, listeners are gonna be from the provider space. Mm-hmm. They're hearing this and they're saying, okay, where do we fit Uhhuh?

How do we partner? You alluded to it earlier, I just want to talk about it more overtly, like how do you partner with the health systems and who have you partnered

with?

Yeah, absolutely Transparent. Loves our health systems across America and we continue to, Span. We have partners over 200 different health systems today that we partner across the nation and we continue to expand the type of centers of excellence and partnerships that we have.

Wow. I know we started in surgery Center of Excellence. We're expanding into Cancer Center of Excellence, into maternity center of excellence and a number of center of excellence as some of our. Key recent partnerships that we have done HSS in New York for orthopedic. They're the best in the world.

And we continue to seek OG partners like them. We just recently also partnered with the Cleveland Clinic for the expert medical opinion service that we're providing. To our members. So we continue to add to that list and expand. We do believe the future is this partnership, this hybrid partnership of bringing the consumer closer to the provider, which are the health systems, and how do we collaborate and innovate with them to deliver better care for the consumer and the employer.

I lied. It's not my, here's my exit question. In terms of the experience, I mean, you talked about, a good RX experience or whatever. Yeah. It sounds like you're, you're bringing that, set of tools down significantly. For the employee? Yes, Yes. For the staff member, yes. know you're not a technology company per se, Uhhuh, you're an experience company, but what does that technology platform look like?

Yeah, absolutely. And while we are very much an experience company, it is on the foundation of an incredible piece of technology that is supporting the consumer day in and day out.

And so when we build every single one of the care experiences, whether it's surgery or oncology or pharmacy, we think about at the time, Build or design, how is this going to integrate and interconnect into the ecosystem? Because you can build the most incredible piece of technology. If it can intersect with the broader healthcare ecosystem, you're gonna go nowhere.

And so that is one of the key foundational pillars of Transparent is we know we can't do it alone. This healthcare system is extremely complicated. Employers today already have ecosystems that they have developed, and so our technology is designed to interconnect, intersect, integrate into. Data freely across the ecosystems in order to deliver better care for the employee.

Yes. Thank you. Pleasure. Thank you again. Always good to see you, bill.

Another great interview. I wanna thank everybody who spent time with us at the conference. I love hearing from people on the front lines and it's phenomenal that they've taken the time to share their wisdom and experience with the community. It is greatly appreciated.

We wanna thank our partners, CDW, Rubrik, Sectra and Trellix, who invest in our mission to develop the next generation of health leaders. Thanks for listening. That's all for now.

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