Rebel Human Resources Podcast

Bonus Episode: Reinventing Healthcare with Erik Wallace

April 08, 2022 Kyle Roed, The HR Guy Season 2 Episode 93
Rebel Human Resources Podcast
Bonus Episode: Reinventing Healthcare with Erik Wallace
Show Notes Transcript

Erik has spent the past 10+ years developing, implementing, and executing commercial strategies with Smith & Nephew operating in the medical device industry. He has held a variety of commercially focused roles, including executive level leadership. Erik has a proven track record of delivering results through incremental top and bottom-line growth. He has led
large complex global portfolios, developed, and executed brand strategies, including multiple marquee product launches. Erik has extensive experience in leading sales teams, built out
multiple specialty sales strategies and scaled selling organizations behind them. Throughout his career he has driven change through inspirational leadership and strategic problem
solving.

Erik was energized by Goodroot’s mission and challenge of ‘Reinventing healthcare. One system at a time.’ He himself is an example of ‘Free and Amplify’ enacted. By stepping away from a prominent role and promising career path in medical device, Erik has been freed to unlock Goodroot’s full potential, pulling from his previous experience certain to deliver amplified results. Erik is focused on finding the best talent to scale the commercial
enterprise for Goodroot. There is hidden potential in extremely talented professionals across the market today. Once they are freed and put in an environment where that potential is
unlocked through trust, enablement, and personalized development they are sure to produce remarkable results.

ewallace@goodrootinc.com

www.goodrootinc.com
 https://www.coeorx.com/ 

Rebel HR is a podcast for HR professionals and leaders of people who are ready to make some disruption in the world of work.

We'll be discussing topics that are disruptive to the world of work and talk about new and different ways to approach solving those problems.

Follow Rebel HR Podcast at:

www.rebelhumanresources.com
https://twitter.com/rebelhrguy
https://www.facebook.com/rebelhrpodcast
www.kyleroed.com
https://www.linkedin.com/in/kyle-roed/



Buzzsprout - Let's get your podcast launched!
Start for FREE

Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.

Support the show
Erik Wallace:

There are some really innovative companies there are innovative programs that bolt on, there's no and then I think the end of the day is how do you actually educate, measure and then implement. And it's not easy to do.

Kyle Roed:

This is the rebel HR Podcast, the podcast where we talk to HR innovators about all things people leadership. If you're looking for places to find about new ways to think about the world of work, this is the podcast for you. Please subscribe for your favorite podcast listening platform today. And leave us a review revelon HR rebels are right rebel HR listeners extremely excited for our conversation this week, this is going to be a good one. If you have anything to do with your employee benefits, you are going to want to tune in here and listen to this whole thing. So with us today, we have Eric Wallace. He's the Chief Commercial Officer at good root. He is also the president at CCO EO. And we are going to be talking about the mission of reinventing health care, one system at a time, and some of the steps that we can take to innovate and drive for change within our employee benefits programs. Welcome to the show, Eric.

Erik Wallace:

Thanks, guy. Appreciate it.

Kyle Roed:

But I'm really excited for for the conversation. We were talking before I hit record. And you know, this is just going to be I think, really interesting to dive into this space and talk about this. But before we do I want to ask what got you into the pharmacy and healthcare space?

Erik Wallace:

Well, it's a good question. You know, if you look at my career sort of in its in its infancy, and a commercial perspective and sales, I was carrying a pharmaceutical bag. So in some ways, I've sort of been in this side of the industry. And then I spent a significant amount of time in the medical device industry, specifically in orthopedics in the surgical arena. And my pathway there was sort of unique if I did carry a bag there when I first started, and then quickly sort of entered this interesting role and got this sort of reputation of being what I used to call like, the wolf from Pulp Fiction, I was like the cleaner, they would just send me into these super complex problems, whether it be portfolio driven, market driven, m&a driven, and so really what I've been doing is designing commercial strategy. And then scaling commercial enterprise, both from sales and marketing perspective. And I, I've had a lot of success in that I really love solving complex problems, that at its core, it's sort of that simple. And I love leading people in finding talent. So you combine all those things together, it is sort of a good fit. And Mike Waterbury, who's our CEO and chairman at good route, he and I live in the same town and we've been friends for a long time. And you know, maybe about the 20th time, he explained to me what he actually was, pharmacy benefits, is when I was able to realize the potential if you could scale that, from a sales and marketing perspective. So that's exactly why I ended up in this space. I've been a student of this space for a little over a year now I've pretty good command, at least, I think kind of on the pharmacy side. My colleagues might just be nice, very nice to me. So anyway, so that's how I landed here. It's been a wild ride, and then I'm really excited about where we're headed.

Kyle Roed:

Well, that's, that's, that's funny. The Wolf from from Pulp Fiction, you know, that brought back a specific, you know, perspective and, but and I'm thinking about, you know, your comments, solving complex problems, I think, you know, there's probably no better space to be in than the medical industry, then. As it relates to complex problems. And, you know, one of the, one of the big challenges that I've faced in, in my career is making sure that we have a good total comp and benefits program for for my employees. But trying to understand the all of the opportunities that are out there, some of the challenges that are out there and and ultimately, just trying to make a good decision. For my employees, it's going to be the best decision for my employees from you know, balancing all of the different levers that are there. It's just hard. It's it's super hard. So, so as you approach your role as as, as Good route and at colio. You know, what, what is your approach? How do you how do you approach the the complex world of pharmacy benefit management?

Erik Wallace:

Well, I'm going to answer that. But I just want to jump off what you said, which is in your in your role on in the podcast and your community, but as well as what we do day in and day out, like, that is really hard. That role is a challenging role. And what Bennis, I mean, kids think about any instance, in our history. You know, at least in the, in the modern era, where benefits couldn't haven't played a bigger role, think about the current environment last two years, and what that does to culture, and retention of talent. And like just that whole dynamic, and then you take a market, like pharmacy is just a sliver of the benefits you deliver. Right, it's 30 cents on the dollar of healthcare spend that an employer invests to provide care to their, to their employees, right, which is their number one asset. So but then you take the complexity inside of pharmacy, it's like, well, how do you make sense of all that noise? Right? All these catch words in the the mid tier organizations and the big three powerhouses and what's gimmicks? And not? And how do you make sense of all that. So I just wanna, I just want to say, like, I, I interface with HR leaders all the time, every day, I'm in my past life, and today, and it's, it's complex, and I'm not just, you know, placating to the audience here. I think I see it clearly. So, apologize for the segue, but I had to, I had to just respond to that. Pharmacy Benefits man, when I started talking about via expression getting sprayed with a fire hose. And it, it took a while for me to start to understand, right, it is not as simple as making a pill, transferring it through a wholesaler to a pharmacy and dispensing it to a patient. That's like, that's like the iceberg. That's what happens above the surface, the transfer of data and dollars underneath between a PBM rebates, claim adjudication, the health plan, how do the rebates flow all the way down to the group? Right. It's hyper complex, I think the important piece is to take it sort of bite by bite. And through this conversation, I'm going to do my best to just stay at about 30,000 feet, and just try to make it sort of ingestible, if you will, or digestible

Kyle Roed:

apps? Absolutely. Yeah. And I mean, I can tell you, that's about where I'm comfortable stand. You know, and, and the truth is, you know, especially, you know, my roles my current role, I'm really a generalist, you know, I have to, I have to know a lot about, you know, a little about a lot. Yeah, and I have fortunately, I have a wonderful team, and one person in particular, that deals with a lot of the, you know, the the processing and some of the some of the more detailed nuances of benefits administration. But then the other the other aspect there is, you know, I'm very reliant on my third party experts, my you know, my benefits brokerage teams, you know, my PBM, my health plan administrators, to make sure that we're pointing in the right direction, but, but I think one of the challenges that I face as well is, that means that all of the all of the potential things that could work or all of the innovations are always filtered through, through through somebody else and somebody else's exposure. And one of the things is, that's a challenge, I think, is always is understanding the context of where those recommendations are coming from. And, you know, is, is somebody getting a commission? Because of this recommendation, right? Or is this actually really best for my employees? And those are the, you know, that's where it gets really, really complex on on our end, as a plan sponsor trying to figure out okay, what what is right, you know, what is the actual employee experience, because, because, really, at the end of the day, you already touched on this, it's just about making sure that our employees are happy with what they have. And and if they aren't, guess what, they can probably walk down the street and find somewhere where they're happier with what they have. And so, you know, it's you can't afford to have a black mark in your in your benefits program. So, so I'll pause there and take a breath because I want to shift and understand a little bit about how, how good route and how colio How do you how do you face kind of that, that challenge or what's what's your approach to the industry and some of the complexity there.

Erik Wallace:

So I mean, the way we're designed good are essentially we are a community of small companies, all independent companies, and our companies execute at very specific points in the pharmacy benefit delivery landscape. Okay, so in that way, there's one of the ways we address it, which is sort of specialization and what we deliver, right? We have a significantly experienced team, we have like well over 500 years of pharmacy experience from all different filter points, from the pharmaceutical manufacturer, to running PBMs, to running specialty pharmacies to clinical pharmacists, that active retail as well as in standard private clinical settings. We have our own PT committee. So like, we have a lot of experience with a small team of 70 people across our businesses, right, which to say that 70 employees is smallest sort of bizarre. It's not small, but in the world, right, in the benefits space that's small, right doesn't typically align with really strong leveraged benefits, deals or pricing, if you will, right. So that's one of the ways we do it. And I think one of the things I've tried to bring here, as I learned this base was finding a way to deliver it out to those third parties, I predominantly engage with TPAs and brokers and some of the third parties that you read, you leverage and lean on as well as your your peer group here in our audience today. But what's even more important is than delivering and in a fashion that I take all the complexity, but I deliver it. And here's just the net value from an economic perspective, what could you expect to spend, but then also clearly call out, here's how much disruption is involved. Right. And so I think, in that way, what's interesting is I'm, I'm trying to present it back in a way that's different than how brokers or TPAs typically ingest it. So it's a little hurdle for me, but as soon as I can get them there, it's very easy for a plan sponsor to be able to see the decision tree and understand how much savings do I want to drive to? And what is it going to mean to my people? How noisy will it be? Right? Which 100%, I think was a sliver of what you have on your plate. But that's my approach.

Kyle Roed:

It is. But yeah, you're 100% Spot on. I think that's like, if I think about this, like an equation, it's like, it's like, Yeah, where's the balance here, you know, it, because we're always looking for ways to make this more economically, you know, feasible. And, you know, for an employee that doesn't deal with this on a on a regular basis. And, and, you know, or even an HR professional is listening right now, that maybe isn't directly related to their benefits. Like, you know, a lot of times we're just trying to find enough savings, so we don't have to increase those premiums, because we're not, we're facing the inflation of a, you know, a, you know, an insurer that all the network fees are going up, and now we have to do this or stop loss contract is, you know, because we had a higher claim exposure, now we've got to, now we've got a, you know, a double digit increase, which I know, many people are facing, and especially with, with COVID-19. No hitting their, their plans right now. And so it's Yeah, so we're trying to do that, out of the goodness of our hearts to try to prevent, you know, premiums from going up. But, you know, the other question, the other flip side of the coin is always, how painful will this be, you know, how noisy will this be? And ultimately, you know, if it's, you know, roughly 30% of a, you know, a plan, you know, how much of your day do you want to take up the other? You know, the other thing so, yeah, that's that's your spot on there? Uh, huh.

Erik Wallace:

I mean, changing human behavior is in in and of itself. Very challenging, right. And so if you drive to anything, any change every year, like, I just like to think about myself as an employee. It's like, oh, another renewal another, like, I got to auto enroll your renewal window, like, I gotta go back in and do all these selections. Right? And like, I can tell you right now, like, I haven't even downloaded the carrier mobile app, which would like help me interpret mine medical benefits for my family in a better way. Like so.

Kyle Roed:

It's you and 85% of everybody else in this. Yeah. That's the truth.

Erik Wallace:

Yeah. So yeah, so I think like there are some really innovative companies. There are innovative programs that bolt on, there's no and then I think the end of the day is how do you actually get Okay, measure and then implement. And it's not easy to do.

Kyle Roed:

Yeah, I think you're so spot on. It's funny, I'll tell a story here. So we, you know, in a past role, we had a a PBM change. And it was not, it was not well received, there was, you know, some of the prescription list changes changed. And some people who were on some prescription for 20 plus years, were asked to go try a different prescription, and they had our, you know, their doctor didn't want them to and, you know, so, you know, in his HR, you're like, usually, you're the person getting the call, and you're like, Listen, I don't want to know, but they're telling you anyways, and you're like, that's too much information. Thank you. You know, but, I mean, we just we fought that we find that all year, you know, and I mean, it was just kind of a an issue. So we made the decision, because of that noise. We were like, well, we're gonna switch to a different pharmacy program. So we switched. And guess how mad the people were, that we made a switch from the, from the Benefit Program by the way that they hated. But just because we made a change, they were still mad, even though we made the change because of their feedback. That's like, Listen, guys, we're just trying to do our best. Now, it worked out for the better. But you know that that's a great example, like a case study and how much people hate change, even if it's like changed for the better. It's like people are still like, Oh, this is terrible. Why are we doing this? Why are you doing this to me?

Erik Wallace:

Yeah, I mean, I can give you a couple stats here, which I'm not going to get into the weeds of what we do, but in some of the ways that you can get to better economics from a pharmacy perspective. It's sort of honing in the delivery network, right, partnering more with a couple entities and we'll call that a network is retail pharmacies, it's CVS Rite Aid, it's Walgreens, it's all the places our people go, where they have had their prescription either sent there, if it's a new prescription, or their maintenance medications are there, right? One of the things you can do is you can narrow the network, you can literally say we're gonna carve CVS and Kroger out of the network. And when we do that, it's gonna unlock all these additional savings. Now, you, you know exactly

Kyle Roed:

what's going to happen. I can feel it right now.

Erik Wallace:

The phone is going to ring, because I really want to go where I've gone, which is to CBS. But I want to arm you with this. There are 13,257 McDonald's in the United States. Do you ever have a hard time finding a McDonald's if you're looking for one now, ever, there's 88,000 pharmacies. It's today, it's 2.1 to 2.1 to every 10,000 people in the US. So now, if you could get the same drugs at a lower cost, which would help your employer maintain the employee contribution to gain access to the same level of care, but you had to go across the street to Walgreens from CVS? That might that might be as small of a hurdle, you have to jump over to get to it. But the reality is, it's not easy. Yeah, it's kind of you're gonna get a phone call, it's gonna happen.

Kyle Roed:

It's usually a phone call, when somebody's standing in line, six people behind them and they're like, this gap in this PPP insurance. There, you know, you guys are trying to nickel and dime us or, you know, that's usually the context that the calls get, at least get to my desk. But yeah, I can hear it now. I mean, I can, you know, I think probably half our audience is probably they could just feel the anxiety boiling. And then when we're talking about restricting networks, because they've lived it, right. What it is a great example of it like, and what you just described, you know, about kind of the approach as well just, you know, we can't overlook is the importance of, of how do you communicate the change, then how do you roll it out? And what, you know, what is the disruption, but then how do you? How do you actually manage that? That change? You know, what is the communication protocol? You know, is it big, bold letters don't go to this provider, they are not in network, right. So,

Erik Wallace:

yeah, there's, you know, I think it is a society, right, there's, if you can put it in someone's hand and their phone now. We're going to find the ability to influence that behavior, which is going to just arm them with data and influence the decisions right. You know, I think a lot of those scenarios even like myself, I have my own daughter, eight years old, hurt her knee dance. I was trying to figure out where can I take her for an MRI. And there's a lot of different price points out there in the market. So now I'm like, outside of my eyes, I learned a little bit enough about pharmacy to manage that. But now I'm in medicals I with my daughter, I'm told I can only go to a pediatric facility. But like, my point is, if we if we if we find a way to get the education of the data in someone's hand, and I can just think you see that with some of these cash card companies. Right, like good or excellent place, single care, sign racks. And I know your audience is hearing that question. Like, yeah, why is there a lower price? I'm good RX verse, my copay that you're paying for? How could that be? Right?

Kyle Roed:

Yeah, I mean, so let's, let's maybe, you know, get a little bit specific there. I think you know, that that is a question. I've had that question before. You know, I've in the similar vein, I've got the question, you know, why are generics cheaper? If I don't run them through insurance? If I go to a certain like, you know, discount retailer? You know, it doesn't make any sense to me, you know, do we have bad insurance? That's usually kind of the context of the question, or why did why don't we have good enough insurance to make it cheaper? So what, you know, what is the approach? How did why does the industry work that way? And what what is the, I guess, what is the mechanism that allows that to make sense?

Erik Wallace:

Well, I would tell you this. It is. So I, I'm a finance major. So I like to think about economics and the law of efficient markets. This is an example of a market exposure. Okay, I'm going to try to explain how it came about and what the current state is, and why this is something that every plan sponsors here. Right. So where cash started discount cards is really where it started. Good RX single Karen center X they did what I was just referencing was put the power of data and information in the palms of the Consumer Direct. Right. So they ran a DTC approach bottom up, and they just put the power of choice and data. Now where do they get that pricing? Right, which I think is what you're starting to get at? Well, how could it be lower than a generic kind of insurance? How could someone walking in next to me behind me online, pick up the same drug and have no insurance, and I have this great plan from this amazing employer. And they're paying a lower price than my copay? That's why we get the questions. And it makes sense, that market doesn't that that's inefficient in the market, it's going to regulate. So what happens is like Well, good RX and single care insider X, do they give you a search API to search a drug and your zip code, and what it does is it pings all of the different MCIS won't get lost in these acronyms. Very simple. That is the price point that a PBM sets for that drug in that specific retail chain. Okay, that's the price to buy it there. Okay. So, like good RX is an example. They will ping X number of Mac lists. They will find access to the lowest price and that's it code and they will guide you to that. They'll give you a pathway to that. And then when you click on the coupon, they give you a bin in PCN, which allows you access to that price, you show the, you know, the clerk or the pharmacist of the register. And that gets punched in and you get access to that. Okay, so you get a good price. But as a plan sponsor, what's the issue with that? When that claim, adjudicates would, would you see that? Would your PBMC that? No, it's outside of accumulators, it's outside of the UN design formulary controls, like all the other things you'll hear about that market, right. So one of the things we we have believed in one of our sort of innovations in this space, or what we're driving towards is the belief that if you have insurance, you should not have to download apps, and search drugs while you're standing in the pharmacy to get the price that is market available. Right. If you have internet, phone or computer, you can go on search and download a coupon and get that price. So when we haven't churned why now it's complex, sort of, but at the high level of 30,000 feet. People are making money inside of that drug, that generic adjudicating on the benefit at a higher price. Right now what what starts to really sort of boil the mind is this PBM that could be the one that delivers your benefit. And you owe a $20 copay for a drug. And then you search a cash card, and you find it for 15. It could be the same PBMs Mac list that's offering that price. That's the inefficiency in it. So like what we've done is driven down a path to get to, you should have that in your benefit. It should do it automatically. You shouldn't be searching apps and coupon codes, like she didn't get it. So I hope that I kept that high enough. But the does that help? Are there areas you want me to sort of dig into? Yeah, I

Kyle Roed:

mean, I think well, first of all, I mean, I think inefficient market is probably the correct term. It's definitely you know, to me, it almost reminds me of it's like, when my grandma used to get the, you know, the Sunday ad paper, and she'd go through and find, okay, which place has the cheapest ground beef this week, and which place has the cheapest milk? And then she, you know, that she she strategically figure out? Okay, this is the grocery store, we're going to, yeah, it's kind of, it's kind of the same idea. I think the thing, you know, the thing that, for me is, like, kind of infuriating about the entire pharmacy. Industry is the fact that, yeah, it is it couldn't be the same PBM Right. Like, that's just goofy. That's and that's, you know, that's somebody taking advantage of an inefficient market and making making money. Right. And, and, you know, at the end of the day, we're just trying to offer a good benefit to employees. We're trying to make this as frictionless as as possible. But it's just it's hard to navigate. So I am curious to understand, you know, so how do you do that, like, so, you know, let's say I guarantee you that there's a bunch of listeners right now who are like, I've had this conversation. So I don't like the answer that I give people, which is basically, I mean, before this, now, I have a much more enlightened answer. But my previous answer would have been well, it's just like a coupon book, it's just a little bit cheaper, if you go to the right place, and they have, you know, there's, there's like, it's like, on sale, like, it's just a deal. And it's but it's outside of insurance. So you just have to know that it won't count against deductible or anything like that. And but, you know, so, but so I think everybody's sitting here thinking, Yeah, I don't, you know, I really don't want to have this good RX thing. It's confusing. It's complicated. It brings up a ton of questions and, you know, in my employees minds, but how do I uncouple that from, from, you know, from my plan, how do you how do you approach this in a in a plan design, to make sure that that it is feasible, and that people actually do get that kind of that leverage lower price? Regardless?

Erik Wallace:

Yeah, so I mean, I think what we've done is, beyond the belief that you should have a right to it is, then how do you build the technology or just the sort of business acceptance of doing that. And we I have partners inside of Khoja PBM partners, who win pre negotiated contract terms have agreed that when there is a lower cash price, they're going to adjudicate on that price? Automatically, right, there's some really good players in this space, who are trying to disrupt it and just take, you know, sort of a fair novel fee to deliver pharmacy benefit services. So that's one way we do it. Now. Another big benefit is it then in the it stays inside of the benefit file, it stays inside of the data file, which means it stays inside of accumulators accumulators are kept whole. Okay. So there's some complexity that I'm not going to get lost in that. But the point is, when it happens at the point of sale without the employee or the member having to do anything, when the system is simply doing it at the switch, which is what happens is they punch codes in behind the scenes, right? They will unlock that savings. But there's another piece here, which is which is really, really important. Today in the market, right? If you think about how many millions of users use these different Cash App platforms every day and every month, it's significant. They would not use them if there wasn't value. Right? wouldn't happen. They wouldn't come back with complaints if there wasn't value, right? If you search it two or three times and it never hits, you're not gonna continue to pull it out on your phone and search it when you're standing in line. Right? So we know that they're okay. But all you're comparing is member copay member route a packet to the cash price. Alright, so when you do execute it the way that I'm sort of describing to you in our in our sort of innovative deal design, it goes beyond just cash versus copay, which is the tip of the iceberg. And I'll give you an example. So if I'm standing in a pharmacy, and I was going to pay $20 copay for a specific drug, a branded drugs, or you know, the high end generic, I was going to pay 20. And the plan was going to pay 80 behind me, okay. But there was a $50 cash price for that drug on the market. Now, it would never hit 20 copay versus 50 Cash, it would never hit in the sort of the standard consumer design. Right. But when you do it, at the least of logic, including member pay and plan pay, what I do is select a $50 copay. Keep the member whole at a $20 copay. And the plan pays 3980. Right, there is a significant amount of savings that gets unlocked when you get inside of it. So it really is disruptive. But that piece no one sees no one sees below the waterline of just what's happening, which is what do I pay out of pocket versus what I could get in this app. So that it's like some significant leverage keep keep the accumulator. So it's in the file, it's important. Right? And then unlocking additional leverage which exists, so I got maybe a little deeper there. I hope that makes sense.

Kyle Roed:

Yeah, I think, you know, the, the takeaway there from from, from this conversation, and I think it's, it's something to consider for anybody listening is, you know, listen, you know, you don't just have to accept everything at face value. If there's, if there's a cheaper cash price, there's probably an opportunity for savings there. And, and even just being open minded to it, as long as you understand the employee experience impact, you know, you've got to be open minded to this stuff. Because I mean, you know, one of the other examples maybe to, you know, continue to stay in the weeds a little bit just because this is, you know, kind of fascinating for me is, you know, thinking about like specialty meds, you know, something like, like, let's, I don't know, HUMIRA. A great example, or, or one of these other things that you see on TV, these things are 1000s of dollars a month, you know, and I see these on my, on my spent in my reporting, and I'm looking at these, and I'm like, what, like, what is this drug that I can't pronounce that we're spending hundreds of $1,000 a year on? And somebody's like, oh, yeah, well, that's just, that's maybe maybe two members that have this specific, you know, condition that need this. And it's just like mind boggling. So. So I'm assuming that there's similar opportunities in that space?

Erik Wallace:

Yeah, I mean, that in the pharmacy world, what I hear from individuals like yourself, and this in this audience base is there's two main issues. And we just talked about one, which is why as a lower price, I'm going to express my copay. We talked about that. The next is specialty trend, how fast it's increasing, and then how much spend is involved. And what's crazy, and we talked about this before we started recording here, two to 5% of your claim volume, on average now, which is the specialty claim volume, right? It's a smallest section of your total claims adjudicated represent over 50% of the spend on average. And it's 2% of your membership usually. And I think what's important in that if that's something vilifying the member, these are specialty meds are like life, life sustaining or quality of life sustaining meds, I mean, they are the people you need to take care of the most. Right, right. So, but that part of the industry, Kyle, you've watched it happen live like it has gone vertical. And it's been this the churn game of rebates, and specialty distribution fees on specialty pharmacies, and it just has just spooled up. That's that's a driven. So, yes, there are a lot of different strategies and how to control that. Right. But mind you, none of those strategies could be not delivering those meds to those patients. Right. Right. Not that's a non negotiable. And that's And so finding the right vendor that can take you through that path is one of the things we do, right. So like I negotiate deals with either the PBM that offer some of those services in house like We had a conversation about one of the PDFs you use today. And you're I would say, you're on sort of the forefront of some of the strategies that can maintain access to these life sustaining meds, but significantly helped to control that trend. And that spent, which inevitably, will cost more to deliver the same benefits to your people. Right, like, that's going to be the impact. So, you know, I think that there's a variety of solutions there. Like who we one of the first measures I have in the market, when I'm working with a vendor, whether it's PBM derived, or it's a third party specialty company that executes those types of solutions, is how how they handle the member experience. And, you know, there's Patient Assistance out in the market, right, pharmaceutical companies will support patients based on their, you know, earnings. Right. And, and sort of their tax records, whether or not they qualify, there's a significant amount of money that's available to that organizing the pathway to that is not easy. Right? You're referencing haven't gone down some of those Bad's right.

Kyle Roed:

Paperwork, nightmare. Yeah.

Erik Wallace:

And scary. Yeah, these are not the patients that you can go down a path where in order to get patient assistance, you can't have specialty benefit coverage for that drug, you won't qualify. So you think about what you're saying, you're saying, wait a second, these are sickest people are the people that need the most support. And we're not just making a fiscal decision. But we are going to tell them that they don't have coverage under the plan, in order to get them the same drug they're on in order on Maka savings. Right. So you get lost at that at face value. But the savings is critical to maintain more access to better health care and sustainable costs. Right.

Kyle Roed:

Right. It's just, you know, I think it's a great example of one of those things where it's not black and white, right? You know, it's and when you're dealing with with an employee health benefit, or a pharmacy benefit, or anything related to people's need for quality of life or life, you know, needed drugs, then, you know, it's really not something you can mess around with, you know, and it's not, it's not just about member experience, it's about making sure that they have great access, and that they're not so confused, that maybe they miss out on even getting, you know, their pharmacies filled. And now you've got a, you know, a catastrophic concern on your hands. And, you know, at the end of the day, EHRs got to be the ones with that top of mind and making sure that they're protecting their employees, you know, well being through through, you know, offering great, great support and service, so, well, you know, I mean, this is one of those things, it's like, when, before we hit record, I think you asked me a question like, how, you know, how knowledgeable are you in this space? And, you know, my honest answer was, I can't claim to be an expert on anything related to pharmacy benefits, because I, you know, I just don't have that depth knowledge. And it's such a dynamic industry, that, you know, I it changes too much. I mean, you know, if you claim to be an expert, you know, just wait till tomorrow, or wait till some new law passes, or wait till some new program comes out, or it's just, it's just so hard. So, you know, appreciate you helping us navigate through this and think through some of those scenarios. What would be kind of your maybe your final advice or a piece of recommendation that you would give to our listeners as they consider some of these, these benefits programs for their groups?

Erik Wallace:

I think you have to find a level of expertise with significant breath. Right. So it's one of the things that I think, sort of it's allowed me to learn this space rapidly. But it also allows me to tailor good solution to my to my clients, which is, I see all of the PBMs all of the vendor solutions, we've experienced them, we measure them either men colio, or in our pharmacy consulting team all anoraks. So we have command over the space. I think that piece is important because you need someone that can actually roll out your options with experience knowing how to take you through that. Right, especially in your seat. How when do we get ahead of like adjusting a contract, sort of easy and timing. But the next piece comes in? Well, if we're going to roll a specialty program, how much runway do we need to have? How many specialty patients do we have? How do we get to them? What's the cadence? What's the messaging? Right? How do we ensure that any of those disruptions aren't and if you have an experience against it, it's pretty hard to go after, you know, savings, which can again, sustain span. So I think that that's really important. And then there's so many layers, you just have to you have to unwind incentive. Like one of the things I pride myself on with Kobe, when the team is a flat fee across all the choices, it's a fair fee, and I deliver all the savings to the grocery fine. I'm not underwriting deals 50 Life Group to 5000 Life Group, it's the same deal, right? And delivered in a format that's easy to digest. And you can see what are the fiscal benefits was the disruption and you know, you have experienced that takes you down that journey. So there are really good solutions out there, even if you don't come to us. It's worth exploring.

Kyle Roed:

Absolutely. And I think, you know, a couple things that I appreciate from that approach. First of all, you know, that incentive piece, you know, we can't shortchange that in any way, shape or form, you have to understand how your partners are being compensated and incentivized, you know, is it is it a percentage of what they claim you saved? You know, is it a cut off the top of something else, like, you know, you have to dig deeper, what looks like maybe a good sticker price may not be the best results, right? And you've got to kind of get to ask those questions. And you really do need a partner in your camp in your foxhole, working through this. Because, unfortunately, because of because of the market in general, unfortunately, there are some incentives that aren't right. You know, and, and that can happen, but I would also say, you know, be open minded. At the end of the day, the best programs that I've been involved in any sort of change programs, benefits programs, you know, as long as the program's themselves, were logical and workable. It all came down to the connection between the organizational communication, employees being taken care of feeling taken care of, and making sure employees got connected to the right people at the right time for their needs. And that doesn't happen without a great strategy to roll out in a focus on member experience. You've got to have those, those things in mind. So, Eric, great content, we are going to shift gears I'm fascinated to hear your responses to the rebel HR flash round. So three quick questions are, are you ready? I'm ready. All right. Question number one, what is your favorite people book?

Erik Wallace:

Okay, so I am admittedly a Malcolm Gladwell junkie. Okay, but I'd like it to be new. Alright. So like the outliers, you know, typical, just amazing, amazing books. I'll give you one I think is really interesting, which is, it's your ship. And I'm not safe. I knew I would try to get get one in there that you maybe haven't heard of. This is Captain Michael abris off who took a Navy ship that was in sort of the last measured metric position to the top. And it's all about people, culture, leadership. It's phenomenal.

Kyle Roed:

That is a new one. You got me on that one. I'm gonna have to check that one out. Alright, question number two, who should we be listening to?

Erik Wallace:

So Dr. Bricker, AZ healthcare, he's with first stop health now as their CMO. He offers just what I consider to be really sort of genuine, insightful, sort of video didactic explanations kept in a nutshell, explaining all different aspects of the business. I would be remiss if I didn't just and I don't have any, any relationship directly with the first bill or Dr. Ricker, but like, I was a student of this space, and I had to learn rapidly. So I love why we delivered it, I think it would, it would be valuable.

Kyle Roed:

Yeah, I can use it as simple as possible. So if I can get it, then it's worth listening to. Alright, last question, ton of great content, I think you're doing some great things in the space. So how can our listeners connect with you and your organization's

Erik Wallace:

so we're up on on LinkedIn, I think today, that's probably the best place to go. You can check us out on our website, as you know, quick links to get to each of our company's LinkedIn handles and we're constantly posting articles. Our thought leaders are posting articles around different segments of what we're exploring, you can see sort of where we're going, partnering with a lot of you know, pretty important events and initiatives. So I think that's that's probably the best place to go.

Kyle Roed:

Awesome. And we will have all this information in the show notes. So pop open your podcast player. Check it out. I'm sure many planners Girls are coming up here and starting to think about this year in the spring and summer for next year. So, you know, now's the time to get educated, learn, listen, and get prepared to to help off your organization, the best, total comp and benefits possible. So, Eric, thank you again for sharing your expertise. Thanks for the time here today and have a great yesterday.

Erik Wallace:

Kyle, I appreciate it very much. Thank you.

Kyle Roed:

Thanks. All right. That does it for the rebel HR podcast. Big thank you to our guests. Follow us on Facebook at rebel HR podcast, Twitter at rebel HR guy, or see our website at rebel human resources.com. The views and opinions expressed by rebel HR podcast are those the authors and do not necessarily reflect the official policy or position of any of the organizations that we represent. No animals were harmed during the filming of this podcast. Maybe