15 episodes

If you’ve ever wondered what pharmacy benefit managers (PBMs) do, why the pharmaceutical supply chain is so complicated or the pace of change in healthcare seems so slow, how vendor purchasing decisions are made, or why our nation’s electronic claim administration infrastructure must be updated, Astonishing Healthcare by Capital Rx is the podcast for you. Covering everything from niche and broad pharmacy and health benefit topics to regulatory change, disruptive technologies, and macro issues like the trend for drug prices or the total cost of care, we’ve got the information and insights you need. For show notes and additional resources from Capital Rx, visit https://www.cap-rx.com/insights.

The Astonishing Healthcare Podcast Capital Rx

    • Health & Fitness
    • 5.0 • 8 Ratings

If you’ve ever wondered what pharmacy benefit managers (PBMs) do, why the pharmaceutical supply chain is so complicated or the pace of change in healthcare seems so slow, how vendor purchasing decisions are made, or why our nation’s electronic claim administration infrastructure must be updated, Astonishing Healthcare by Capital Rx is the podcast for you. Covering everything from niche and broad pharmacy and health benefit topics to regulatory change, disruptive technologies, and macro issues like the trend for drug prices or the total cost of care, we’ve got the information and insights you need. For show notes and additional resources from Capital Rx, visit https://www.cap-rx.com/insights.

    AH015 - PBM Legislation, Contracting, and More, with Lloyd Fiorini

    AH015 - PBM Legislation, Contracting, and More, with Lloyd Fiorini

    In this episode of the Astonishing Healthcare podcast, Lloyd Fiorini, General Counsel & Chief Compliance Officer at Capital Rx, shares his expertise and experiences from over 25 years in the pharmacy space. He acknowledges that employers and benefits consultants face challenges in a rapidly evolving, complex healthcare landscape and covers several topics impacting health plan sponsors and fiduciaries, including the implications of the Consolidated Appropriations Act (CAA) and avoiding penalties and personal liability through effective procurement processes, and the Inflation Reduction Act (IRA) and how disruptive M3P (the Medicare Prescription Payment Plan) implementation could be. 

    • 17 min
    AH014 - The Rise of Conversational AI: Healthcare Search & Patient Journeys Will Never Be the Same

    AH014 - The Rise of Conversational AI: Healthcare Search & Patient Journeys Will Never Be the Same

    The astonishing potential of artificial intelligence (AI) for personal and professional use, and in healthcare in particular, is what we explore in this episode of Astonishing Healthcare with Christian Ward, Chief Data Officer at Yext, and Carrie Liken, Head of Yext's Healthcare Industry Practice. They discuss the trends they see in search that reflect changing behavior and ultimately influence how people will find information online. Health systems and other healthcare providers must structure their data on the backend and get things lined up properly to ensure accurate search results in a GEO world.

    • 31 min
    AH013 - Redefining Virtual Care: A Blueprint for Effective RPM, with Robert Longyear

    AH013 - Redefining Virtual Care: A Blueprint for Effective RPM, with Robert Longyear

    In this episode of the Astonishing Healthcare podcast, Robert Longyear, Co-Founder of Avenue Health, joins Justin Venneri to discuss virtual care and remote patient monitoring, including the role nurses and pharmacists can play as care models evolve and the importance of timely information exchange.

    • 31 min
    AH012 - Revolutionizing Healthcare: Prime & Capital Rx's Game-Changing Alliance, with Mostafa Kamal & AJ Loiacono

    AH012 - Revolutionizing Healthcare: Prime & Capital Rx's Game-Changing Alliance, with Mostafa Kamal & AJ Loiacono

    This episode of the Astonishing Healthcare podcast features the CEOs of Prime Therapeutics, Mostafa Kamal, and Capital Rx, AJ Loiacono. They join Michael Passanante, SVP of Marketing & Communications at Capital Rx, to share the story behind the strategic alliance between the organizations and their vision to reimagine pharmacy and provide better care to patients across the country leveraging next-generation technology: JUDI®.

    • 18 min
    AH011 - Navigating CMS' M3P, PDE, and Other Regulatory Changes, with Jason Barretto

    AH011 - Navigating CMS' M3P, PDE, and Other Regulatory Changes, with Jason Barretto

    Navigating and understanding government programs in healthcare can be a daunting task. In this podcast episode, Jason Barretto, Vice President of Government Program Operations at Capital Rx, joins Justin Venneri to shed light on the complexities of regulatory compliance and the importance of meeting the intent of legislation and regulations, including the CENTERS for MEDICARE & MEDICAID SERVICES’ Medicare Prescription Payment Plan (M3P) requirements and new Prescription Drug Event (PDE) requirements.

    • 21 min
    AH010 - The Power of PMPM: Holding PBMs Accountable for Total Drug Spend, with Kristin Begley, PharmD

    AH010 - The Power of PMPM: Holding PBMs Accountable for Total Drug Spend, with Kristin Begley, PharmD

    Per member, per month (PMPM) cost plays a crucial role in healthcare, particularly in pharmacy benefit management. On this episode of the Astonishing Healthcare Podcast, Kristen Begley, PharmD, Chief Commercial Officer at Capital Rx, emphasizes the significance of PMPM guarantees and how they help hold pharmacy benefit managers (PBMs) accountable for total drug spend. The PMPM calculation provides a simplified way to evaluate drug spend by dividing the total plan spend by the number of members. This enables plan sponsors and other industry professionals to easily assess the value and effectiveness of their vendors.

    • 21 min

Customer Reviews

5.0 out of 5
8 Ratings

8 Ratings

Nick B. 3857 Evergreen St. TX ,

This is the best podcast. Listen to episode 5

This is my favorite podcast! LISTEN TO EPISODE 5 NOW!

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