Hope for Health Care – CoverMyMeds Innovators Making a Difference

February 04, 2019  |  Austin Raper, Ph.D.

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We’re a huge advocate of #championsofhealth, a major theme at HIMSS19. A lot of CoverMyMeds’ industry experts are attending HIMSS this year and are ready to engage in discussions from real-time benefit check (RTBC) to the growing importance of specialty.

In this article, we’re featuring a few of those individuals: our Senior Director of Provider Services & Operations and chairperson of the Real-Time Benefit Check National Adoption Scorecard, Miranda Gill, VP of Product Development & Strategy for Specialty and resident specialty expert, Ben Stormer, and SVP & General Manager of the Payer Vertical, David Holladay whose personal experience and knowledge led him to CoverMyMeds.

CoverMyMeds: Thank you all so much for taking the time to talk. It’s a busy time of year, with all the preparations for HIMSS19 underway. The passion that each of you has for your jobs is inspirational. Why did you choose a career in health care?

Miranda Gill: I chose a career in health care because I knew if I worked hard enough, I could make a tangible difference in people’s lives. As a young nurse, I had the opportunity to intern in bone marrow transplant at a large academic medical center in Ohio, and quickly learned that walking alongside patients who had to fight for each day gave me purpose. I became passionate about delivering cancer care and found that I often learned more from my patients than they might have learned from me. It’s incredible to see that small changes in care delivery can improve outcomes, and that is powerful.

Ben Stormer: It was not my original intention to land in health care. I was more interested in technology and how it can be applied to simplify complex problems. Nevertheless, my career eventually took me to the health care space and I unexpectedly found the challenge I’d been looking for. It wasn’t long before I realized the great need for modernization in health care and opportunities where technology could make a difference. I am excited at the opportunity to use my background in systems, data and product development to positively impact patient care.

David Holladay: I’m not sure there was ever a definitive decision to choose a career in health care, but rather, a series of continual steps that led me to stay. With a transactional background in the credit card industry, it was easy to make a leap to pharmacy transactional services. Once inside of the first used, and most used, benefit of healthcare, I was hooked. I could make a difference. Some of my loved ones have suffered from technological inefficiencies that exist in health care. I could clearly see a day when I or my family would need to lean on the system which made me determined to be a part of making it better for all.

CoverMyMeds: We count ourselves very lucky that you all found your way to CoverMyMeds. The passion and direction you articulate is clear in the work you produce day in and day out. That being said, reading between the lines of your responses, it’s clear the U.S. health care system needs some help. In your opinion, what is the biggest challenge or obstacle facing patients today?

MG: Great question! There’s no one answer as numerous challenges face patients today, but I think many of them are solvable. If I had to pick one, I think it would be helping patients to leverage their own health information for shared decision making. Patients know themselves and their history better than anyone; however, getting access to and sharing their records with new providers and teams in a timely, concise and meaningful way can be incredibly challenging due to system limitations and other restrictions.

BS: That’s very true, Miranda. Adding to that, most patients today simply don’t know what to do. What I mean by this is everything is so complex. Navigating health care can be impossible for patients. Even for those of us working in the industry, the system is not straightforward. “Am I seeing the right doctor? How much will this doctor visit cost? Does my insurance cover this therapy? Can I afford the medication?” Patients lack the answers and it leaves them feeling helpless. It’s our job to make health care easier for patients. To give them some control over a process that seems uncontrollable.

It’s our job to make health care easier for patients. To give them some control over a process that seems uncontrollable. - Ben Stormer

DH: Exactly. Patients are asked to be consumers without the right tools to be a good consumer. As Ben mentioned, the process is difficult to understand. Other industries have tools readily available to aid consumer decision making, but health care has fallen behind in achieving this level of visibility. For years, many incorrectly assumed that baby boomers would not use health technology. Tell a person in their 70s or 80s that their grandchildren are moving away and then hand them a smart phone; they will figure out a way to video chat to connect with their loved ones. Regardless of age, patients are ready to take control of their health care through technology.

Patients are asked to be consumers without the right tools to be a good consumer. - David Holladay

CoverMyMeds: It seems the main theme here is really patient empowerment. Building tools that patients can use to take charge of their health care. Along those lines, which emerging technologies or policies stand to make the most difference in making patients well?

MG: I think that giving patients more visibility into cost of care and options for affording it can make a big impact. So many patients abandon their medications or become non-adherent because of cost-related issues. One technology that may be able to help is real-time benefit check (RTBC), which gives patients visibility into out-of-pocket costs, while still at the doctor’s office, and gives them an opportunity to consider affordability options with their providers.

BS: I am a big advocate for value-based care. I think it can address many problems in today’s health care system by changing the underlying mindset that has set us up for disappointment. Value-based care puts the patient first and tweaks current incentive models for more responsible decision making.

DH: I am behind Miranda and Ben on this one. We have to start putting the patient first. There is plenty of room for improvement when it comes to consumer choice in health care. How silly is it that you don’t know what it will cost when you go to the doctor? As Miranda mentioned, tools like RTBC stand to make a positive difference in giving patients some of the visibility that they need to make informed personal health decisions while allowing physicians the ability to provide personalized care.

CoverMyMeds: Thank you all again for sharing your stories and perspectives! It’s easy to have a positive outlook on the future of health care when we have champions like you paving the way.

All three of our champions expressed excitement for HIMSS19 and collectively look forward to connecting with stakeholders across the industry.

Interested in meeting Miranda, Ben and David (along with our other experts) at HIMSS19? Stop by booth 3278 to connect.

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