The Evolution of PBMs with The "PBM Princess", Rachel Strauss of EHIM

Join host Spencer Smith on another episode of Self-Funded with Spencer, as he welcomes the PBM Princess, Rachel Strauss from EHIM.

In this engaging and informative podcast episode, Rachel shares valuable insights about the Pharmacy Benefits Management industry and EHIM's merger with ProCare Rx. Rachel and Spencer also take a deep dive into the importance of transparency in PBMs and how it affects the relationship between PBM and clients.

Rachel shares her journey of becoming a PBM consultant and how she found her niche as a problem solver, helping clients navigate complex healthcare systems and policies.

This episode discusses PBM selection and highlights the challenges of determining which PBM would work best for your company. Rachel shares her thoughts on a pricing model called "Cost Plus", which Mark Cuban has popularized recently in the world pf Pharmacy Benefit Management.

Additionally, the podcast highlights the need to align PBM incentives to client goals, the importance of understanding client priorities, and writing RFPs that align with them.

In this engaging conversation, Rachel shares her prediction on the reporting mandates that will track dollars and rebates, potentially affecting the earnings of some companies.

Another important aspect of Rachel's work is in fixing problems, rather than just identifying them. She explains that her role is not just about diagnosing issues but providing actionable solutions that can make a difference in the lives of patients and providers. Rachel's work is guided by her passion for improving healthcare access and quality, and she encourages others to find their own purpose and drive in their work.

Don't miss the fun banter between Spencer and Rachel as they share stories, opinions, and experiences. Tune in now for an engaging and informative conversation on pharmacy benefits management, self-funding, and everything in between!

Chapters;

[00:00:00] Introducing "PBM Princess" Rachel Strauss

[00:02:32] PBM Princess's Impact in Sales & EHIM's Merger

[00:05:50] The Rise of Transparent PBMs

[00:08:59] EHIM's Integration into ProCare for Advanced Tech

[00:11:59] Navigating emotional experience of company acquisition

[00:14:46] Navigating the Complex PBM Industry

[00:17:44] Pharmacy Benefit Management complexities and Mark Cuban's involvement

[00:20:26] Spread Pricing in Pharmacy Benefit Industry and Mark Cuban's Launch

[00:23:22] Strategies for Saving Costs in PBM Industry

[00:26:14] PBM Tactics and Rebates Issues

[00:29:05] The Deceptive Nature of Pharmaceutical Rebates

[00:32:04] EHIM's formulary strategy and committed rebate transparency

[00:35:00] Private Equity in PBMs

[00:40:37] Turning Healthcare Data into Actionable Insights

[00:43:30] Customized Services for Diverse Client Goals

[00:46:30] Third-party Vendor Blacklisting and PBM Priorities

[00:49:30] Debate on Ozempic coverage for weight loss

[00:52:27] Insurance Coverage of Bariatric Surgery

[00:55:19] Creativity and Collaboration in PBM

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