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PODCAST

The Astonishing Healthcare Podcast

If you’ve ever wondered what pharmacy benefit managers (PBMs) do, why the pharmaceutical supply chain is so complicated or the pace of change in healthcare seems so slow, how vendor purchasing decisions are made, or why our nation’s electronic claim administration infrastructure must be updated, Astonishing Healthcare by Judi Health (Capital Rx) is the podcast for you. Covering everything from niche and broad pharmacy and health benefit topics to regulatory change, disruptive technologies, and macro

health & fitness medicine

All Episodes

00:17:37

AH005 - Star Ratings, MTM, & CMS Translation...

The Astonishing Healthcare Podcast ·

2024/02/16

Discover the ins and outs of Medicare Star Ratings and CMS translation requirements in this insightful podcast episode. Join Justin Venneri and Jay Tran, PharmD as they delve into the significance of Star Ratings for health plans and Medicare payers, discussing what the ratings are based on, what drives bonus payments, as well as the role of medication therapy management (MTM) in star ratings and upcoming changes in the eligibility criteria. Additionally, this episode explores the importance of the

en-us

00:23:36

AH004 - Data, Fiduciary Responsibility, and Reversing...

The Astonishing Healthcare Podcast ·

2024/02/09

In this episode of the Astonishing Healthcare Podcast, Jeffrey Hogan, President of Upside Health Advisors, shares his insights on the current state of healthcare and the challenges plan sponsors, including employers and other payers, face. He discusses the importance of aligning supply and demand in the healthcare system in the post-COVID era, the significance of the Consolidated Appropriations Act (CAA), and the importance of establishing a process to evaluate plan data.

en-us

00:16:01

AH003 - What's New in the Partner Channel, with Brian...

The Astonishing Healthcare Podcast ·

2024/02/02

Brian TenEyck, National Director of Consultant Relations at Capital Rx, shares his insights on the pharmacy benefit management (PBM) industry in episode 3 of The Astonishing Healthcare Podcast. He discusses the importance of early engagement in pharmacy procurement, increasing utilization of GLP-1 drugs and prior authorization (PA) approval rates, and the need to hold PBMs accountable for managing plan spend. Brian notes the importance of monitoring per member per month (PMPM) cost trends vs

en-us

00:28:57

AH002 - A Former Pharmacy Program Director's View on...

The Astonishing Healthcare Podcast ·

2024/01/26

Bridget Mulvenna joined Erickson Senior Living to manage pharmacy costs and develop the pharmacy program. She ended up applying what she had learned over years of working in various pharmacy settings and in pharmacy procurement to their pharmacy benefit programs. In this episode of The Astonishing Healthcare Podcast, Bridget shares why it's so hard to control pharmacy costs, as well as her thoughts about reining in specialty drug costs, rebates, coverage of GLP-1s, and the most astonishing thing

en-us

00:39:35

AH001 - Building a PBM: Tech, Navigating Growth, and...

The Astonishing Healthcare Podcast ·

2024/01/19

Capital Rx Co-Founder & CEO AJ Loiacono discusses the path to becoming a pharmacy benefit manager (PBM). He describes why and how using JUDI® aided in the development of a next-generation enterprise health platform, recounts the challenges of growing through the pandemic and transitioning to a distributed workforce, and shares what plan sponsors need from their PBM partners and what is most astonishing to him (hint: it relates to knowing the cost to administer a pharmacy benefit plan)!

en-us

105 results

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