Strong leaders have a powerful vision for the future.
MLK Jr. didn’t wish for it…he dreamt about it.
“I slept and dreamed that life was a beauty. I awoke and found that life was a duty.” -Ellen Cooper
What is your dream for American health care?
We are the average of the five people we spend the most time with. -Jim Rohn
Provider: “Inflation is making it hard for us to pay our employees and keep the lights on. We need higher reimbursement for theses CPT codes. We’ll terminate the contract if we don’t hear back or cannot come to an agreement.”
Payer: “Due to inflation we are not able to entertain any rate increases at this time. Our CEO needs to continue his $25 mil base salary and if we give you an increase, he won’t meet his bonus goals.”
Provider: “No worries. Please notify your patients ASAP that they should find another provider. Their services aren’t covered here anymore.”
When two elephants fight, it is the grass that suffers. –African proverb
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?
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.
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!
Did you know that payers in the individual market and small group market only spend ~75%-80% of each dollar of premium on medical care? They get to keep the rest of the money to spend on activities like marketing, lobbying, administration, and the paying out of dividends. Meanwhile, payers in the large group market spend ~85% of each dollar of premium on medical care. This percentage is known as the medical loss ratio (MLR).
Where are most of your patients? Have you noticed varying access by market segment? Mark Farrah Associates lists the leaders in each segment. How much of your time and focus are you spending on the difficult part?
Remember, prescription drug spending only accounts for 9% of the $4.3 trillion US health care spending. What costs can be avoided by investing in your drug?
“The most important thing is to be where your feet are.” -Jalen Hurts
Our work IS our worship.
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.
William Stafford
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.
It’s incredible how the single thread can bring order to the teeming problems.
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.
