Speaker 1 0:00
So yes, sometimes the cash price will be less, but it also will eliminate the friction. Make it easy for the patient. Eliminate surprises at the counter.

Austin Littrell 0:15
Welcome to Off the Chart, a business and medicine podcast featuring lively and informative conversations with healthcare experts, opinion leaders, and practicing physicians about the challenges facing doctors and medical practices. My name is Austin Latrell. I'm the associate editor of Medical Economics, and I'd like to thank you for joining us today. In today's episode, Medical Economics managing editor Todd Shryock sat down with Joseph Kleiman, president of Buzz Health, to talk about patients who never fill the prescriptions they're given and why their physicians often never find out. A survey from Buzz Health found that 54% of prescribers say patients often or very often fail to start therapy because of cost. Yet only 17% say prescription abandonment is highly visible in their workflows. Kleiman explains why pharmacy, prescriber, and health plan systems still don't talk to each other. Whether cash and discount prices are actually beating the insurance route at the counter, and what he tell the primary care physician who's given up and just tells patients to Google a coupon. But with that said, Joseph, thank you for joining us. Let's get into the episode. I'm

Todd Shryock 1:14
here with Joseph Kleiman, president of Buzz Health, to talk about the challenges of prescription drugs and patients getting access to those drugs. Joseph, thanks for joining me.

Speaker 1 1:26
Thanks so much for having me.

Todd Shryock 1:28
So, Joseph, your survey that you did found that 54% of prescribers say patients often or very often fail to start therapy because of cost. Why has this problem persisted for so long when it seems solvable?

Speaker 1 1:44
You know, some of that's a great question, and I guess to anyone outside of healthcare, it would seem like a pretty, you know, logical thing to have taken care of. I think the biggest problem that you find and why it hasn't been taken care of and still a problem is, I guess, connectivity. Having systems that can talk to each other, whether it's at the prescriber level, whether it's at the health plan level or the pharmacy, having data that is readily available and actually communicating. I think that's the biggest problem.

Todd Shryock 2:23
Only 17% of prescribers said prescription abandonment is highly visible in their workflows. You know what's it going to take technically and operationally to close that feedback loop, so physicians know when a patient doesn't fill their prescription.

Speaker 1 2:41
I think it kind of goes back to my first answer. You have it's going to take systems that talk to each other. It's going to take pharmacy systems, prescription prescriber systems, and health plan systems that communicate and deliver results in one centralized location. I think when that happens, I don't, I don't think it's really because anybody doesn't want it to happen. I think it just it hasn't really been a priority to where all of the systems communicate.

Todd Shryock 3:15
Nearly all prescribers said they'd find it extremely or very valuable to see insurance and discount pricing side by side directly in the EHR, why isn't that already standard in most EHR systems, and what's standing in the way?

Speaker 1 3:34
I I don't think that it's really about anything standing in the way. Technology has really come a long way, and I think we're at a point where these systems can communicate. You can deliver real time at the prescriber level results pricing transparency, results transparency that can help prescribers visualize and make better decisions for their for their patients, sorry.

Todd Shryock 4:04
The survey also shows that when discount or cash pricing is available at the point of prescribing, it gets selected most often. Does that suggest the insurance pathway is not the best deal for patients? And should physicians be looking at cash pay options?

Speaker 1 4:22
I wouldn't say it's not the best option. I think with a lot of this, you run into friction points, and a lot of times, if you don't have price transparency, and it just goes to insurance, there can be pre-authorizations. There can be you know where are they at on their deductible. Any number of reasons that can make it difficult for the patient by the time they get to the pharmacy. When you have systems that talk to each other, when you have those options readily available-cash, discount, card prices, coupons-at that point for the prescriber, there's less friction. So yes, sometimes the cash price will be less, but it also will eliminate the friction. Make it easy for the patient. Eliminate surprises at the counter.

Todd Shryock 5:12
A significant a significant share of price comparisons still happen after the appointment through staff or patients doing their own research. What's the cost of that delay in terms of both patient outcomes and practice burden?

Speaker 1 5:25
Oh gosh, you know it's a lot. It's think of it as when you leave it to the patient, they have to research it. They're still wondering what's going to happen to them when they get to the pharmacy again. It's about friction points when you have it right there, you know you're giving the patient the best price, the best option. It'll really eliminate it because when there's friction, there's uncertainty. You have abandonment. I mean, it's like I want to say 64% Like in the survey, it's like there's this high abandonment rate, and a third of patients right now don't take their medications because of cost.

Todd Shryock 6:10
Primary care physicians often serve as the financial quarterback of their patients' overall care. You know how should they be thinking about their role in in medication affordability, and what tools do they need to help them in that role?

Speaker 1 6:25
You know, I think most primary care physicians they really want to take an active role. I think they really do care, and it goes back to historically you don't have systems that talk to each other, and so it's been difficult. I think as we progress and as solutions get implemented, where you do create and solidify that intersection between pharmacy, prescriber, and health plan, I think that prescribers are going to make a a huge difference and play a huge part in the prescription journey for their patients.

Keith A. Reynolds 7:04
Hey there, Keith Reynolds here, and welcome to the P2 Management Minute. In just 60 seconds, we deliver proven real-world tactics you can plug into your practice today. Whether that means speeding up check-in, lifting staff morale, or nudging patient satisfaction north, no theory, no fluff, just the kind of guidance that fits between appointments and moves the needle before lunch, but the best ideas don't all come from our newsroom. They come from you. Got a clever workflow hack, an employee engagement win, or a lesson learned the hard way? I want to feature it. Shoot me an email at kreynolds at mjhlifesciences.com with your topic, a quick outline, or even a smartphone clip. We'll handle the rest and get your insights in front of your peers nationwide. Let's make every minute count together. Thanks for watching, and I'll see you in the next P2 Management Minute.

Todd Shryock 7:56
Given that the survey included EHR workflow leaders alongside prescribers, what's your message to health systems and practice administrators about prioritizing pricing transparency as an implementation goal?

Speaker 1 8:10
You know, it's we're at a point where the technology's there. It's not difficult. Take it serious. It doesn't just Save the member. It helps with costs at the prescriber level. It helps with costs when at the health plan level. When patients are adherent, when they take their medication as prescribed, I think it really helps the overall health ecosystem. And my message to them would be: It's not that hard. The solutions are there.

Todd Shryock 8:46
And what would you say to a primary care physician who has essentially given up on the system, who just tells patients to Google coupon about what's possible with integrated pricing tools?

Speaker 1 8:57
Well, I think you gotta you gotta put yourself in their shoes, and again, historically, it's been tough. There hasn't been price transparency. It has been difficult to get answers. You do have patients that historically have gotten one price, even when that prescriber is trying to help them. By the time they get to the pharmacy, it's something different. It can be very frustrating. My message to them again is the solutions are there, whether it's through your EHR, whether it's cooperation with the health plan. We have them; they're out there. So do your research, get on board. They're available. Help's on the way.

Todd Shryock 9:40
I'm curious too. What role AI, if any, will play in in helping connect all these systems and in bringing that transparency to the physician?

Speaker 1 9:50
You know, that's a really good question. You get into you know availability or you know capability. Yes, it's capable, but healthcare more than most industries. There's a lot of compliance, and there should be data sharing. I guess you could say is easier than ever, but it must be permitted. I think that if done correctly, structured the right way, I think AI will play a huge part in the prescription journey going forward, but it's going to take steady hands, the right processes, for it to really get to where it needs to be.

Todd Shryock 10:33
And are are we making progress? Are you seeing things get better as time goes on? Are we headed in the right direction?

Speaker 1 10:40
I do. I think you're starting to see, you know, government rulings, you know, whether it be from CMS, other organizations, legislative, where a lot of the barriers, if you will, are being lifted. There's a real spotlight right now on price transparency. When that happens, I think you're going to see really quick movement because again, the technology is there. This isn't about capability. It's not about good pricing availability. This is about tying the systems together, making sure everybody operates from the same you know point of truth, and it's available.

Todd Shryock 11:21
Any final thoughts on this topic that we haven't talked about?

Speaker 1 11:25
Ah, you know it's a great topic, and I'm I'm happy that we're moving in the direction that we're going. My message again would be to whether you're at the pharmacy, whether you're the prescriber, whether you're the health plan, don't push this to the side, it really does help the whole ecosystem when pricing transparency is readily available. The sooner they're available, availability the better.

Todd Shryock 11:50
Great, thanks for joining me today.

Speaker 1 11:53
Thank you so much, Kate. I appreciate you having me.

Austin Littrell 12:00
Once again, that was a conversation between Todd Shryock, managing editor of Medical Economics, and Joseph Kleiman, president of Buzz Health. And a quick note: this Sunday, September 27th through Wednesday, September 30th, the medical economics and physicians practice teams will be in San Antonio for the MGMA annual conference. If you're there, come say hello. If you're not, you can follow our coverage of the sessions at medicaleconomics.com/conference/mgma and physicianspractice.com/conference/mgma and on our social media channels. My name is Austin Latrell, and on behalf of the whole medical economics and physicians practice teams, I'd like to thank you for listening to the show and ask that you subscribe so you don't miss the next episode. As always, be sure to check back on Monday and Thursday mornings for the latest conversations with experts sharing strategies, stories, and solutions for your practice, you can find us by searching "Off the Chart" wherever you get your podcasts. Also, if you'd like the best stories that Medical Economics and Physicians Practice publish, delivered straight to your email six days of the week, subscribe to our newsletters at medicaleconomics.com and physicianspractice.com. Off the chart, a business of medicine podcast, is executive produced by Chris Masolini and Keith Reynolds, and produced by Austin Latrell. Medical economics and physicians practice are both members of the MJH Life Sciences family. Thank you.

Transcribed by https://otter.ai