The Evolution of PBMs with the PBM Princess - Rachel Strauss

The Evolution of PBMs with the PBM Princess - Rachel Strauss

Issue 35 of the Self-Funded with Spencer Newsletter

Episode 92 of the?Self-Funded with Spencer?podcast features Rachel Strauss ?? , of EHIM, Inc. powered by ProCare Rx Dubbed the "PBM Princess" by her peers because of her flair for fashion coupled with her vast knowledge of pharmacy, Rachel is my go-to guest whenever I need an update on the PBM world. More details below!

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Join host Spencer Smith on another episode of Self-Funded with Spencer, as he welcomes the "PBM Princess", Rachel Strauss from EHIM.

In this engaging and informative podcast episode, Rachel shares valuable insights about the Pharmacy Benefits Management industry and EHIM's merger with ProCare Rx.

Rachel and Spencer also take a deep dive into the importance of transparency in PBMs and how it affects the relationship between PBM and clients.

Rachel shares her journey of becoming a PBM consultant and how she found her niche as a problem solver, helping clients navigate complex healthcare systems and policies.

This episode discusses PBM selection and highlights the challenges of determining which PBM would work best for your company. Rachel shares her thoughts on a pricing model called "Cost Plus", which Mark Cuban has popularized recently in the world pf Pharmacy Benefit Management.

Additionally, the podcast highlights the need to align PBM incentives to client goals, the importance of understanding client priorities, and writing RFPs that align with them.

In this engaging conversation, Rachel shares her prediction on the reporting mandates that will track dollars and rebates, potentially affecting the earnings of some companies.

Another important aspect of Rachel's work is in fixing problems, rather than just identifying them. She explains that her role is not just about diagnosing issues but providing actionable solutions that can make a difference in the lives of patients and providers. Rachel's work is guided by her passion for improving healthcare access and quality, and she encourages others to find their own purpose and drive in their work.

Don't miss the fun banter between Spencer and Rachel as they share stories, opinions, and experiences. Tune in now for an engaging and informative conversation on pharmacy benefits management, self-funding, and everything in between!

Chapters:

[00:00:00] Introducing "PBM Princess" Rachel Strauss

[00:02:32] PBM Princess's Impact in Sales & EHIM's Merger

[00:05:50] The Rise of Transparent PBMs

[00:08:59] EHIM's Integration into ProCare for Advanced Tech

[00:11:59] Navigating emotional experience of company acquisition

[00:14:46] Navigating the Complex PBM Industry

[00:17:44] PBM complexities and Mark Cuban's involvement

[00:20:26] Spread Pricing in Pharmacy and Mark Cuban's Launch

[00:23:22] Strategies for Saving Costs in PBM Industry

[00:26:14] PBM Tactics and Rebates Issues

[00:29:05] The Deceptive Nature of Pharmaceutical Rebates

[00:32:04] EHIM's formulary strategy and committed rebate transparency

[00:35:00] Private Equity in PBMs

[00:40:37] Turning Healthcare Data into Actionable Insights

[00:43:30] Customized Services for Diverse Client Goals

[00:46:30] Third-party Vendor Blacklisting and PBM Priorities

[00:49:30] Debate on Ozempic coverage for weight loss

[00:52:27] Insurance Coverage of Bariatric Surgery

[00:55:19] Creativity and Collaboration in PBM


#PBMs #pharmacybenefits #consultants #EHIM #ProCareRx #specialtydrugs #transparency #rebates #formulary #privateequity #dataanalytics #medicalcompliance #Ozempic #obesity #bariatricsurgery #creativity #partnerships #healthcareindustry #podcasts #podcastingtips #podcastingcommunity #businessstrategies #salesindustry #employersponsoredplans #specialtypharmacy #pharmacycosts

Robb Higdon

Sales Leader, Co-Founder, Successful Exit Entrepreneur, and Builder of Relationships

1 年

Here’s a question (non-business related) ??Spencer Smith, CSFS?: How many different suit jackets do you own? I’ve got a few, but your collection appears to exceed my own.

Lee Hertz

Advanced Analytics to Benchmark, Negotiate, and Audit Pharmacy Benefits

1 年

A great episode for any self-funded benefit manager. The candid commentary on the PBM industry is refreshing. As background while driving or doing other work it is wonderfully informative.

??Spencer Smith, CSFS?

?? SVP - ParetoHealth || ??? Host - Self-Funded w/ Spencer || ?? “Self-Fund or Die”

1 年

FYI - for some reason Spotify hasn't synced yet, so click the link in the article that takes you directly to the episode. Will update once it has synced!

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