Churn

A low churn rate means you can continue business as usual, but a high one means time to shake things up. Why do your patients discontinue your drug? Is it really because of safety/efficacy issues? Or could it be due to discontinuity of care?

Payers and providers can renegotiate their contracts mid-year, resulting in network changes. They’re not proud of it, but they do it due to financial pressure. What they don’t realize is that such simplistic across-the-board cuts only achieve marginal savings that often result in higher total systems costs and poorer outcomes.

What if one of your patient is left to find another provider in the middle of his treatment? The No Surprises Act helps with this…kind of.

The doctor-patient relationship cannot be overstated. It is the main factor that influences adherence.

What’s your churn rate?

Car Without Wheels

Did you know that a patient’s in-network provider could change at any time before the end of the policy’s term?

Did you know that even if a procedure is listed as covered under a plan, all tests and ancillary services normally associated with the procedure might not be covered?

Formulary placement is just one access hurdle. If your drug is covered but is facing one of these access barriers, you just bought a car without wheels.

Servant

Imagine the company you’re working as a person. How is he expected to show up in the world?

Even though he can’t vote, marry, or take custody of a child, your company is a legal personhood who owns property, enters into contracts, lends/borrows money, sues/gets sued, and pays taxes.

Think about an insurance company. He will raise his medical loss ratio…if he’s asked to. He will provide coverage for all drugs in a category…if he’s asked to.

A good servant does it because he’s asked to. A great servant does it because he gets to.

Outstanding people have one thing in common: an absolute sense of mission. -Zig Ziglar

By the way…us employees are serving a servant. Imagine that!

This. Is. It.

“The most important thing is to be where your feet are.” -Jalen Hurts

Our work IS our worship.

Never Let Go of the Thread

It’s comfortable to sit back than to stand up. But it’s safer the other way around.

Once we’ve made up our mind to fight, what we realize is that there are many fights to fight. Too many for any single person.

But all of us pursuing the same goal is amplifying.

There is a thread you follow.
It goes among things that change.
But it doesn’t change.
People wonder about what you are pursuing.
You have to explain about the thread.
But it is hard for others to see.
While you hold it you can’t get lost.
Tragedies happen: people get hurt or die;
And you suffer and get old.
Nothing you can do can stop time’s unfolding.
You don’t ever let go of the thread.

William Stafford

It’s incredible how the single thread can bring order to the teeming problems.

Patient Voice

Meticulous journalism can shine light in a way unique from forecasting reports and clinical backgrounders. I have found that nytimes.com can help us understand the voices of the patients we seek to serve. It can’t get easier than this: right from our chairs. (I’m not paid to mention them)

See if you have access to nytimes.com through your employer. If not, your local library should.

The therapeutic areas are there.

Something Happened in the 1980s

When America flipped the script on Capitalism post-WWII, we began to feel its shocks in the 1980s, and now we’re witnessing Capitalism collapsing on itself.

Our health care was along for the ride. Elisabeth Rosenthal did the important work of narrating this in her best-selling book, An American Sickness. If you’re in Market Access, you NEED to read this.

Pharma, Payers, and Providers were asked to show up for service. What we’ve served is a tragedy of commons.

But it isn’t what it is. It’s what we make of it. It’s up to us. We can flip the script.

Watch your thought because that becomes your action. Watch your action because that becomes your habit. Watch your habit because that becomes your character. Watch your character because that becomes your destiny.

Hind vision is 20/20. The Baby Boomers did the important work of showing us that greed shatters. It’s on the Millennials to do the generous work of ushering a new era that actually endures: an era of human dignity. Even if we don’t live another 40 years to witness its effects.

Second-Largest Payer Segment: Patients

What we’re selling is expensive. Period.

Who’s picking up the tab for the health care bills?

#1: Federal government pays for 34%
#2: Households pay for 27%
#3: Private businesses pay for 17%
#4: State and local governments pay for 15%
#5: Others pay for 7%

Turns out that patients, collectively, are bigger payers than commercial payers. And 40% of them are in medical debt.

When I shine a light, both you and I can see better.

Magic Show

Great magicians are good at misdirection. They work their magic while distracting the audience by directing their attention to something else.

Did you know that prescription drug spending only accounts for 9% of the $4.3 trillion US health care spending? Hospital care accounts for 31% and physician/clinical services account for 20%.

Somehow, we’ve come to believe that pharma is responsible for our pricey health care.

Avada kedavra.