Show:
SRx Market
Strategy
2012 Initiatives
Operations
Special People
100
What is our definition of a specialty drug?
What is Includes drugs or biologics that are either: derived from biotechnology processes which use tissue culture, living cells, or cellular enzymes) OR small molecule oral drugs which are organic compounds and binds to a protein, nucleic acid, or polysaccharide In general, a Specialty Drug meets two or more of the following criteria: Targets the underlying disease pathology rather than treating symptoms Manages complications of disease Targets conditions that are rare, chronic, and costly Requires special distribution channel (e.g. restricted access, REMS, etc) Requires close supervision and monitoring of therapy for safety and effectiveness Requires close supervision or handling related to the dispensing and fulfillment process Non-Specialty drug that is used in combination with a specialty drug
100
The 3 pillars/overarching objectives of our strategy
What is Affordability, Health Improvement/Outcomes, and Superior Service
100
The new clinical application to which our TheraCare program is being migrated,intended to improve clinical quality and efficiency
What is HealthEview
100
Implemented for 1/1/2012 to help achieve an aggregate discount of 16.4% for clients >2000 subscribers
What is the premium fee schedule
100
Three team members that have competed in a road race, relay or obstacle course in the recent past
Who are: Sondra B. Gary H. Rose M. Noel S. Todd C.
200
Industry specialty trend over the next few years
What is 17- 22% 15 -25% (also accepted)
200
2 strategies for aligning customer incentives for the use of the most cost-effective, clinically-appropriate medications, the highest quality, most cost-efficient healthcare professionals, and preferred sites of administration.
What are: 1) develop benefit designs consistently across both the pharmacy and medical benefit and 2) customer incentive programs
200
2 main capabilities that are being delivered as part of Pharmacy Claim Enhancements - Phase1
What are: Auto pay (prior auth waiver) and High Performance Physician Pass
200
2 classes of drug(s) that were added to the SRx drug list(s) based on our 2012 updated definition of SRx
What are: HIV Transplant
200
Three team members that have had or tried interesting careers/jobs in past lives
Who are: Darla C. - Farm Wife Katie D. - English Teacher Maryanne G. - Massage Therapist Jennifer F.-Make up artist Dean M. - Taught special skills to kids Jeff N. - Plumber Kevin O. - Pigeon Driver
300
2 Key Specialty Pharmacy PBM competitors based on marketshare
What is Express Scripts/Medco CVS/Caremark Walgreens -Catamaran (Catalyst +Sxc) Diplomat Pharmacy, Omnicare’s Advanced Care Scripts, The Apothecary Shops, ICORE,
300
Value-based collaboration and reward strategies (rewarding the delivery of the highest-quality, most affordable care behavior, including choice of drug, site of care and condition management) is targeted at this key stakeholder
What are HealthCare Professionals
300
As of 9/1, we can capture this on medical claims, enabling improved clinical management and reporting
What is Medical National Drug Code (NDC)
300
This PSC application was implemented this summer to help improve efficiency and workflow
What is PA Hub
300
Three team members that have hidden musical, mechanical or athletic, talents
Who are: Bruce C. - trumpet Ryan L.- piano and guitar Rebekkah c. - piano Shawn B. - AAA trouble shooting Colleen M.- badminton captain in HS
400
A key traditional carrier competitor that offers mail order pharmacy through CVS/Caremark
What is Aetna
400
A key strategy for providing personalized assistance
What is growing/expanding TheraCare
400
As part of our home infusion strategy, transition activity with CareCentrix and pilot with CORAM has focused on this class/category of drug(s)
What is Subcutaneous IVIG
400
The 6 condition specific teams that have been rolled out at home delivery for service improvement
What are: Hizentra, Hep C Factor Transplant Infertility and oral oncology
400
Descendants of past royalty and/or elected government official(s)
Who are: Bev E. - WIlliam Bradford John P. -
500
Key differentiators of the following traditional carrier competitor include: Integrated benefits with scale Total condition management
What is United HealthCare (Optum Rx)
500
2 home delivery growth strategies
What are Expansion of home infusion services, healthspring integration, onsite model
500
3 of the key performance indicators being built in HEV TheraCare reporting to demonstrate program value
What are: Medication Aderence Condition Improvement Productivity Medical Service Cost(s) Impact
500
We are analyzing requirements for this industry credentialing for 2014, to support our goal to be a leading SRx pharmacy/meet market demand
What is URAC accreditation
500
Two team members that shared a love of animals as their fun facts
Who are: Melanie B- pigs Karen M -dogs