Pharmacy and Payer Relations Collaboration for Success
Commercial payer policies for hospital and hospital-based clinic administration of high-cost infusions have become more complex over the past few years with the introduction of limited provider, site of care and formulary restrictions. These policy changes can significantly impact health systems both from patient care and financial perspectives. Pharmacy departments should partner with payer relations teams to stay informed, provide clinical assessments of upcoming policy changes and assist with contract negotiations. In addition, pharmacists are well positioned to provide unique expertise in contract negotiations for new payment and delivery models such as the Oncology Care Model and innovative therapies. This webinar will demonstrate select examples of successful collaborations between pharmacy and payer relations teams via a moderated panel discussion.
Target Audience
This activity is intended for pharmacists.
Learning Objectives
Pharmacists learning objectives
At the conclusion of this activity, pharmacists should be able to:
- Discuss payer challenges as related to high-cost drug infusions and the critical need for pharmacy engagement.
- Describe successful collaborations between pharmacy and payer relations teams.
- Describe how innovative payment and delivery models and therapies may impact traditional contract negotiations.
Additional Information
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Faculty
Venessa Goodnow, PharmD, CPEL, MBA, CPh, FASHP, FFSHP
AVP & Chief Pharmacy Officer
Jackson Health System
Jonathan Leesman, PharmD, MBA
Director, Pharmacy Business Services
BJC Healthcare
Staci Hermann, PharmD, MS
Chief Pharmacy Officer
Dartmouth Health
Osama Abdelghany, PharmD, MHA, BCOP
Executive Director, Oncology Pharmacy Services
Yale New Haven Health
Planning committee
Sybil Thomas, PharmD, MBA
AVP, Pharmacy Network
Vizient, Inc.
Thomas W. Cooley, BS, MBA
Executive Director, Pharmacy Services
Brigham and Women’s Hospital, Dept of Pharmacy Services
Gene Rhea, PharmD, MHA
Associate Chief Pharmacy Officer – Retail and Specialty Pharmacy Services
Duke University Medical Center
Jenny Smith, PharmD, MBA
Executive Director, Pharmacy Services
BJC HealthCare
Marina Yazdi, PharmD, BCPS
System Director, Pharmacy Business Strategy
Yale New Haven Health
Identification, Mitigation, and Disclosure of Relevant Financial Relationships
As an accredited provider of continuing education, Vizient, Inc. is dedicated to ensuring this activity presents learners with only accurate, balanced, scientifically justified recommendations, and is free from promotion, marketing, and commercial bias. In accordance with The Standards for Integrity and Independence in Accredited Continuing Education, all planners, faculty, and others in control of the educational content have disclosed the absence or existence of all financial relationships (of any dollar amount) with ineligible companies within the past 24 months.
It is Vizient’s policy that owners and employees of ineligible companies, and any individuals who refuse to disclose the absence or existence of financial relationships with any ineligible companies are disqualified from participating as planners or faculty.
Disclosure of Financial Relationships:
Absence of Relevant Financial Relationships
Vizient, Inc., Jointly Accredited for Interprofessional Continuing Education, defines companies to be ineligible as those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
An individual is considered to have a relevant financial relationship if the educational content an individual can control is related to the business lines or products of the ineligible company.
No one in a position to control the content of this educational activity have relevant financial relationships with ineligible companies.
distributing healthcare products used by or on patients.
Statement of content validity
Vizient, Inc. educational activities are intended to assist healthcare teams advance their professional responsibilities in accordance with the definition of continuing education. It is the policy of Vizient, Inc. to review and ensure that all content and recommendations for patient care within accredited CE is evidenced-based, based on current science and clinical reasoning while ensuring the content is fair and balanced. All recommendations must conform to the generally accepted standards of experimental design, data collection, analysis, and interpretation. Vizient, Inc. does not permit accredited continuing education if it advocates for unscientific approaches to diagnosis or therapy, or if the education promotes recommendations, treatment, or manners of practicing healthcare that are determined to have risks or dangers that outweigh the benefits or are known to be ineffective in the treatment of patients.
FDA off-label/unapproved usage
Faculty/Presenters are required to identify any new and evolving topics for which there is a lower/absence of evidence base. This is to ensure that our content does not advocate for, or promote, practices that are not, or not yet adequately based on current science, evidence, and clinical reasoning. Faculty/Presenters are required to disclose any discussion of (1) off-label/unapproved or investigational uses of FDA approved commercial products or devices and/or (2) products or devices not yet approved in the United States.
Disclaimer: The education provided through this activity is for continuing education purposes only. The views and opinions expressed in this activity are those of the faculty/presenters and do not necessarily reflect the views of Vizient, Inc.
Joint Accreditation Statement:
In support of improving patient care, Vizient, Inc. is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
Designation Statements:
PHARMACY
Vizient, Inc. designates this activity for a maximum of 1.0 ACPE credit hours.
Universal Activity Number: JA0006103-0000-23-081-L04-P
OTHER
Vizient, Inc. will award all other healthcare professionals who successfully complete the activity a Certificate of Participation. Various state license boards and credentialing bodies accept certificates of participation from accredited CE activities to meet CE requirements for license renewals and re- certification. It is the responsibility of the participant to contact their state licensing board and/or certifying body for verification on credit eligibility reciprocity.
Available Credit
- 1.00 ACPE Pharmacist
- 1.00 General CE - Attendance