Outcomes: Insights Beyond the Counter

outcomesbeyondthecounter

Outcomes: Insights Beyond the Counter is a thought leadership podcast that brings together voices from pharmacy, payer, life sciences, and across the healthcare industry to explore the trends, innovations, and strategies shaping the future of patient care. From medication management and adherence to pharmacy intelligence, automation, and clinical outcomes, each episode delivers expert perspectives and actionable insights to help listeners stay ahead in a rapidly evolving healthcare landscape.

Episodes

  1. Aug 4

    Transforming Member Outreach Through Pharmacy | Outcomes: Insights Beyond the Counter

    In this episode of Insights Beyond the Counter, hosts Shane Hallengren and Amit Patel unpack the rapidly evolving world of health risk assessments (HRAs) and social determinants of health (SDOH) across Medicaid and Medicare. Fresh off the Medicaid Innovations Forum, Amit shares insights from health plan leaders navigating a post–Public Health Emergency landscape defined by redeterminations, workforce shortages, and persistent challenges with member contactability. Shane reflects on his years supporting Medicare performance programs and draws parallels between the two sectors—especially around how HRAs have shifted from simple “check‑the‑box” tasks to powerful tools that uncover transportation barriers, food insecurity, medication access challenges, utility instability, and more. Together, they explore: Why SDOH data is only valuable when it leads to meaningful action How community pharmacies—as trusted, accessible care touchpoints—are uniquely positioned to conduct sensitive assessments The growing importance of rural health transformation and how pharmacies can close engagement and adherence gaps How Outcomes is supporting pharmacies with technology, workflows, and scalable programs that enable efficient, person-to-person care What the future may hold as Medicaid and Medicare strategies continue to evolve If you’re passionate about healthcare innovation, population health, or the expanding role of pharmacy, this conversation is packed with real-world insights you won’t want to miss.   bAbD9itevfyqL9dOrV3V

  2. Jul 22

    CMS’s Intent to Return the CMR Completion Rate to the Star Ratings Program | Outcomes: Insights Beyond the Counter

    In this episode, host Ross Frei, Senior Product Manager and resident MTM/CMR strategist, sits down with Cindy Henry, Director of Payer Products at Outcomes, to unpack one of the biggest changes hitting Medicare Advantage plans: CMS’s intent to return the CMR completion rate to the Star Ratings program beginning in measure year 2027. Ross and Cindy explore how the industry reacted to the latest CMS Advance Notice, why the CMR measure’s return matters, and how MTM strategy has quietly shifted during its two‑year placement on the display page. Together, they outline the pressures plans are feeling—from shrinking margins to rising expectations around clinical quality—and the renewed focus on the value of medication therapy management, total cost of care, and local pharmacy engagement. A key topic throughout the episode is the impact of CMS’s expanded MTM eligibility criteria, which significantly increases denominators for 2025 and beyond. Cindy explains how this shift forces payers to rethink scale, budget, ROI, and operational models, while Ross shares Outcomes’ cut‑point predictions and how performance is likely to redistribute once the measure becomes active again. The conversation also highlights Outcomes’ strategy to support both health plans and community pharmacies as they prepare for 2027. Ross describes work underway to reduce documentation burden, streamline workflows, leverage new technology, and allow pharmacists to practice at the top of their license—ultimately helping MTM delivery scale without sacrificing quality. By the end of the episode, the message is clear: Plans that begin modeling, staffing, vendor alignment, and workflow modernization now will be best positioned when Star Ratings recalibrate in 2029. Listeners are encouraged to explore Outcomes’ latest prediction models and analysis at outcomes.com   bAbD9itevfyqL9dOrV3V

About

Outcomes: Insights Beyond the Counter is a thought leadership podcast that brings together voices from pharmacy, payer, life sciences, and across the healthcare industry to explore the trends, innovations, and strategies shaping the future of patient care. From medication management and adherence to pharmacy intelligence, automation, and clinical outcomes, each episode delivers expert perspectives and actionable insights to help listeners stay ahead in a rapidly evolving healthcare landscape.