Premise Health Full Pharmacy Introduction
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This document summarizes Premise Health's pharmacy solutions, which aim to provide more convenient access to medications and a deeper level of care. Key points include: - Pharmacists play an essential role on care teams by coaching members on behavior change for better health. - Solutions include medication dispensing and monitoring, counseling, disease education, immunizations, and prescription delivery through onsite, near-site, virtual and event-based access. - Integrating pharmacy solutions is intended to improve health outcomes, healthcare costs, medication adherence, and maximize prescription benefits through formulary management and savings programs.
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Premise Health Full Pharmacy Introduction
- 1. © 2022 Premise Health. All material contained in the presentation is extremely confidential and is not for distribution. Pharmacy Solutions that offer more convenience and a deeper level of care 10/22
- 2. © 2022 Premise Health. All material contained in the presentation is extremely confidential and is not for distribution. 2 Pharmacy Overview Access: Onsite / Nearsite / Virtual / Event / Connected Devices Our pharmacists go beyond simply dispensing medication by playing an essential role on the care team, coaching members through behavior change for better health Solutions that offer more convenience and a deeper level of care: • Medication dispensing and monitoring • Over-the-counter medications • Member counseling, coaching, and guidance • Disease-specific education • Variable copay assistance program • Immunizations • Workers' compensation medication • Formulary review and management • Medication therapy optimization • Prescription delivery
- 3. © 2022 Premise Health. All material contained in the presentation is extremely confidential and is not for distribution. 3 Improves healthcare outcomes Improves health outcomes and overall healthcare costs Relationship building increases member satisfaction Reduces healthcare spend Medication adherence impacts downstream medical costs and avoidable health incidences Opportunity to maximize prescription benefits and formulary savings Influences healthy behavior Employees make smarter healthcare choices Members become the owner of their health journey Integrated Value of Pharmacists
- 4. 4 © 2022 Premise Health. All material contained in the presentation is extremely confidential and is not for distribution. © 2022 Premise Health. All material contained in the presentation is extremely confidential and is not for distribution. 4 Collaborative member of the care team > Collaboration with healthcare providers > Focus on prevention, managing, and caring for complex members > Health outcomes-based care Consultative Providers > Focus on relationship building > Lifestyle medicine approach > Member education and coaching > Ongoing condition monitoring and medication adherence Member-centered, caregiver role
- 5. © 2022 Premise Health. All material contained in the presentation is extremely confidential and is not for distribution. 5 Delivering Value Through Multiple Channels Premise Health pharmacy solutions offer more convenience and a deeper level of care Member Experience and Trust > Consultative approach and relationship building > Turning transactions into interactions > Caring for overall member health and wellbeing Adherence and Clinical Outcomes > Proactive approach via Care Complete > EHR integrated with other solutions > Coaching and behavior change > Follow-up to ensure success Benefit Plan and Preference List > Generic dispensing > Therapeutic interchange and formulary support > Variable copay and customized plan design > Specialty medication management Ingredient Cost Savings > Scale and buying power with pass- through savings and transparency > Significant over-the- counter product discounts
- 6. © 2021 Premise Health. All material contained in the presentation is extremely confidential and is not for distribution. © 2022 Premise Health. All material contained in the presentation is extremely confidential and is not for distribution. 6 Designing the Right Solution Pharmacy Benefit Plan Strategy Dedicated Pharmacy model Clinical pharmacy Provider dispensing Virtual Pharmacy Product Integration Primary care Occupational Health Fitness Wellness Connected Care+ Implementation Timeline Immediate Future What are you trying to solve? Member experience Clinical quality Financial value Access to care Other: Productivity, culture, etc. Care Delivery Model Onsite or Nearsite Wellness Center – local population, virtual and in- person care, events Digital Wellness Center – national population, virtual only
- 7. 7 © 2022 Premise Health. All material contained in the presentation is extremely confidential and is not for distribution. Ready to move forward? If so, Premise will schedule a follow-up meeting to discuss Pharmacy in more detail
Editor's Notes
- Purpose: To give a snapshot of pharmacy at Premise Use this as your “one slide” about pharmacy if limited on time or needing to provide basic information Complete list of services: Medication prescribing and monitoring Chronic condition management Over-the-counter medications Member counseling, coaching and guidance Disease-specific education Variable copay assistance program Vaccinations Ensuring appropriate and cost-effective drug therapies led by pharmacist and provider oversight committee: Claims analysis, formulary review and management Clinical program review and risk mitigation, including prior authorization and compliance review Customized formulary and clinical program recommendations Coupon formulary - carve out automated and manual coupons that drive utilization of wasteful medication choices Medication therapy optimizations (therapeutic interchange program) Typical pharmacy focus is on prescription volume & revenue Premise Health’s focus is on developing and implementing appropriate, evidence-based, cost-effective treatment plans Increased OTC discounts due to Walgreens relationship and buying power All of these programs are included in our onsite pharmacy solution, at no extra cost to the plan sponsor. Other population-specific programs: 340B (common in Native American / Tribal communities) Delivery: Leading organizations everywhere are always looking for new ways to keep their people at their best. More and more, that means turning to dedicated pharmacies. At Premise Health, we’ve built our pharmacy programs on the idea that, as one of the most visible and accessible members of a healthcare team, pharmacists can also have the biggest impact. With their focus on influencing healthy behaviors, increasing medication adherence, and reducing healthcare spend – it’s clear – our pharmacists do so much more than dispense medications. They take the time to get to know members and learn what it takes to promote better health Takeaway: Premise Health pharmacies increase adherence by 10%. Along with this, members accessing dedicated pharmacies are 22% less likely to have a gap in care.
- Purpose: To demonstrate the integrated value of our pharmacists. This slide outlines their role in influencing healthy behavior, improving health outcomes, and reducing healthcare spend. Delivery: The value our pharmacists play in the lives of member is second to none. As one of the most visible and accessible members of the care team, pharmacists can have a huge impact. When you give members pharmaceutical resources that make their personal health goals easier to manage and achieve, everyone benefits. Influence healthy behavior Employees make smarter healthcare choices Members become the owner of their health journey Improves healthcare outcomes Improves health outcomes and overall healthcare costs Relationship building increases member satisfaction Reduces healthcare spend Medication adherence impacts downstream medical costs and avoidable health incidences Opportunity to maximize prescription benefits and formulary savings Takeaway: Premise Health pharmacists offer more convenience and a deeper level of care that makes significant impact on organizations across the country.
- Purpose: This slide outlines Premise Health’s consultative approach Note to Speaker: The previous slide outlines the Care Complete framework for creating the opportunities for pharmacist-member interaction. This slide lays out defines the consultative approach to total member care and health, with focus on member-specific outcomes via coaching, behavioral change generalist training, lifestyle, and more. Delivery: Our consultative approach is highly collaborative and tailored to the member. Our pharmacists are in a unique position to help members make smarter healthcare decisions. This all starts with building individual relationships to create a sense that better health is a key part of company culture. This member-centered, caregiving role takes shape in a few different ways: Focus on relationship building Lifestyle medicine approach Member education and coaching Ongoing condition monitoring and medication adherence Along with this, our pharmacists are part of our members’ broader care team. This coordinated approach allows pharmacists to have a better understanding of members’ needs and provides personalized support and education: Collaboration with healthcare providers Focus on prevention, managing and caring for complex members Health outcomes-based care Takeaway: By building relationships with both providers and members, Premise pharmacists help improve outcomes and reduce downstream medical costs.
- Purpose: This slide outlines the way in which our pharmacy solution delivers value. Delivery: Our pharmacy solution delivers value through multiple channels including ingredient cost savings, benefit plan and preference lists, adherence and outcomes, and member experience and trust. Here’s how: Ingredient cost savings: Scale and buying power with pass-through savings and transparency Significant over-the-counter product discounts Benefit Plan and Preference List Generic dispensing Therapeutic interchange and formulary support Variable copay and customized plan design Specialty medication management Adherence and Clinical Outcomes Proactive approach via Care Complete EHR integrated with other solutions Coaching and behavior change Follow-up to ensure success Member Experience and Trust Consultative approach and relationship building Turning transactions into interactions Caring for overall member health and wellbeing Takeaway: Our teams not only help members navigate the healthcare system and their benefits plan to their optimal state, but it’s proven to supercharge client cost savings and drastically improve health outcomes. Additional details: When many folks evaluate pharmacy benefits and spending, their reaction is the same: drugs cost too much! At Premise, we agree. However, unfortunately a lot of unnecessary complexity, waste, and industry misalignment lead to the issue being far more complicated than meets the eye. We feel that this complicated problem calls for a simple solution: integrating pharmacy solutions across Premise digital and in-person care delivery models. 1. As mentioned, the Premise pharmacy model solves for transparency and aligns with our client partners by employing a true pass-through cost structure. We bill medication costs at the exact amount that we pay for them, ensuring that we are delivering value by cutting out the industry middleman. We also employ this approach with over-the-counter (OTC) products, generating OTC offerings for our members and creating direct value on both cost and convenience. 2. Although the price of medications is a very important and visible element to evaluate, we have to go layers deeper to help effectively improve drug spend at both the member and client level, and effectively improve clinical outcomes and lower the overall cost of care. Not only are we focused at selling medications at the best possible cost, but we place additional focus on ensuring the right medication leaves our doors, every time. That said, we employ a number of proactive programs aimed at ensuring every medication selection is the most cost-effective, clinically appropriate, member-centered choice. Doing so enables members access to the right medication most likely to help them achieve the desired clinical outcome, with the most cost-effective drug therapy. 3. It’s important to note that while medical spending is a spend for services, which carry some inherent value that all agree upon – pharmacy spend is spending money on a thing. A physical product that on its own, has zero value. The value of that product is only realized if members take it home, utilize it correctly, and stay optimally adherent to their therapy to achieve the desired outcomes. Our programs not only improve member access to the right medications, but also to the right people that ensure their success. Our pharmacy care teams proactively engage, educate, and coach members on an ongoing basis to ensure their treatment is successful. In doing so, we leverage our pharmacy as a key tool to improve clinical outcomes, reduce gaps in care, and lower the total cost of care due to avoided medical utilization. 4. But doing all of this isn’t easy, and it requires close relationships and trust built between a member and their pharmacy care team. Pharmacists are one of the only highly-trained medical professionals in our country that are completely accessible without an appointment or without being behind closed doors. However, in many community pharmacies, member access to pharmacists is becoming increasingly limited. Our pharmacy model positions the pharmacy team as a critical member of the broader healthcare team and channels their expertise for good. Our teams not only help members navigate the healthcare system and their benefits plan to their optimal state, but it’s proven to supercharge client cost savings and drastically improve health outcomes.