Improving Your Outcomes with a Fully Integrated Medication Adherence Solution
Episode 522

Jason Rose, CEO at AdhereHealth

Improving Your Outcomes with a Fully Integrated Medication Adherence Solution

Today’s podcast features Jason Rose. Jason is the CEO of AdhereHealth, a healthcare technology leader supporting health plans, self-insured employers, and other risk-bearing entities for medication adherence insights and healthcare outcomes.

In the podcast, Jason talks about how his company is focusing on medication adherence for patients to mitigate hospitalizations and mortality and how data can identify patients at-risk who have adherence issues and ensure that the patients have the medication they need. He also talks about ways his company addresses the pharmacy gap, connects pharmacy and medical data, and identifies patient issues to improve outcomes. Jason shares how his company helps health plans reduce cost and benefit from the state on value-based care reimbursement. We learned a lot from our conversation with Jason, and we hope you’ll find great value in it as well. Enjoy!

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Improving Your Outcomes with a Fully Integrated Medication Adherence Solution

Episode 522

Recommended Book:

The Culture Code

Best Way to Contact Jason:

jason.rose@adherehealth.com

Company Website:

AdhereHealth

Improving Your Outcomes with a Fully Integrated Medication Adherence Solution with Jason Rose, CEO at AdhereHealth transcript powered by Sonix—easily convert your audio to text with Sonix.

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Saul Marquez:
Welcome back to the Outcomes Rocket. Saul Marquez here, and today I have the privilege of hosting Jason Rose. He’s the CEO of AdhereHealth with nearly twenty five years experience in healthcare technology, Jason’s a serial health I.T. entrepreneur. He’s focused on launching disruptive products that drive digital health innovation and also value based care outcomes. His career includes leading data driven product development, corporate strategy, business development and beyond. One of his recent experiences is at Inovalon. Over the past decade, he served as the senior executive supporting the company from Startup through IPO as executive vice president and Strategic Development Officer, Jason led development of several blockbuster products at Inovalon and marketed expansion of the company’s technology presence across the health care marketplace. His prior experience includes time at Cerner, Cap Gemini Ernst and Young Inspiris, an Ardent Health Services. Ultimately, he’s focused today on making a difference in medication adherence of five hundred billion dollar problem in the United States alone. He and his firm are working diligently to bridge the gap between social determinants of health and medical data, as well as the data at the pharmacy to help you bring a medication. Adherence to keep your patients out of the doctor, keep them healthier for longer periods of time. So with that introduction, I’m privileged to host Jason on the podcast. Jason, welcome.

Jason Rose:
Yeah, thank you, Saul. Really looking forward to this conversation.

Saul Marquez:
So what would you say is a hot topic you feel should be on everybody’s agenda today and and let’s talk about how AdhereHealth is approaching that topic.

Jason Rose:
Yes. Thanks, Saul. That’s a great question. Obviously, the hot topic is, is Covid-19 and how can we prevent the spread of the pandemic, the disease? How can we mitigate the hospitalizations and ultimately mortality for these patients? And that is clearly not not just even on every person that’s focusing on health care, but really just every person in the civilized world is focusing on these really important issues. So there was a report that I was anticipating would come out a couple months back, and it probably came out about two weeks ago from the Centers for Disease Control that described 90 percent of the hospitalizations due to Covid-19 related disease, but 90 percent is hospitalizations, had patients that had a underlying disease. And most of those people that were hospitalized were also elderly. And these are the patients that are most at risk. And typically the highest cost patients within at risk populations. And understandably, those are the people who are effectively getting hospitalized. So we need to find ways to to focus on reducing those hospitalizations and ultimately deaths. So Saul, I guess, regarding what AdhereHealth is doing about that, we we consider ourselves a part of this solution. And our company is a medication adherence technology, health care company. So we are focusing on ensuring that the patients that need to be on their medications are getting access to them, understand why they’re taking these medications, why the doctors prescribed them and making sure that they are able to pay for them, that they are taking them on a prescribed basis for evidence based guidelines and their doctor’s orders and that they continue to take them. And we believe strongly that that is a core focus, that the health care universe really, really the world should be focusing on to prevent the continued hospitalizations that the world is experiencing right now.

Saul Marquez:
Yeah, that’s a a great focus area. And, you know, as as we think about capacity and and the issues that we have with, you know, making sure that if you don’t need to be in the hospital or the emergency room, then don’t be there. And so, you know, adherence is one of those things that’s a huge problem. Maybe maybe you could give us an example, Jason, of how you and your organization have have created, you know, better adherence and better outcomes with what you guys do.

Jason Rose:
Yeah absolutely, Saul. So I’m going to give you a specific example from a health plan that we work with right now, that it will help resonate what we do and how we go about it. So when we engage with a health plan, what they do is they provide us with all of their membership data for eligibility, pharmacy claims, often medical claims, hospital discharge data. And that comes across to us daily at a discrete level of patients. And there’s specific diseases and the drugs that they’re on to prescribe them where the pharmacies that they’re getting them from are, if they’re low income, subsidized, et cetera. So we take in that data daily and we identify where there is risk for patients to to to take their drugs and to overcome any what’s called social determinants of health or SDOH. And we use that data to prioritize which patients we reach out to in which doctors are reaching out to their patients on their panel. So give you a really good example of how we use that data. And this is just last week as an example we identified one patient is out of tens of millions, frankly, but one patient that has I think she’s got seven different doctors. She’s got four different chronic diseases. She’s taking 17 drugs a day. And she is obviously high risk. So she is quarantined at home and she is Spanish speaking and she’s worried about leaving her home to get her medications, as she should be. So we identify her her as a high risk patient. Here’s the interesting fact. Most of the patients we deal with historically may fit that profile, but they have adherence issues, meaning that they’re not taking their drugs on the evidence based guidelines. Why this particular patient actually is nearly 100 percent adherent on every drug she’s supposed to take. She’s extremely vigilant about it. But, yes, she when we reach out to her to sort of check in on her well-being and make sure that in the midst of this pandemic, we want to make sure that she was getting everything she needed because the health plan asked us to. And we actually left the voicemail without giving any of the CPHI on the voicemail just to ask if we could talk to her about her health. But she called us back and she was so worried about not getting her drug because she wanted to stay here and that she asked we could help her overcome access issues with her pharmaceuticals. So we we own a pharmacy as well, which is called AdhereRx. And in the process of discussing her different pharmacy benefits and her health plan, she she elected to enroll in our pharmacy and our pharmacy we already have all the medications and the doctors that she’s has today and the pharmacies. So we reviewed those drugs with her, make sure she still wanted all of these medications. And then we enrolled them in the pharmacy and within a couple days or so till she received those medications to her home via a private courier. I don’t think that she had a credit card. So she’ll have to pay in cash on delivery, which is something that we do. So we’re not using FedEx or U.P.S. to deliver to her. We’re actually delivering with a private courier. And then she she now has the medication she has to prevent her from actually having to go into a grocery store or pharmacy or even her mailbox, frankly, allows her to be able to pay for them and actually space out the payments so that she can afford it because have 17 medications and, you know, even with a minimal copay through her insurance is expensive. So she actually even enrolled her, she;s 77 years old, she actually asked her son to be enrolled, too. So this is is a good used example of high risk patients, data driven technology and clinical workflow, and then ultimately closing the loop to make sure that this patient was getting the needs that she did in this orchestration. And we do that every single day as well.

Saul Marquez:
Well, that’s such a great example, Jason. And, you know, just thinking about the relief that she must have felt and the, you know, peace of mind that the payor is experiencing, knowing that this type of work is happening behind the scenes for their biggest risk patients. Tell me a little bit about employers. Right. Because my mind goes to. Lawyers and the potential benefits of of us, you know, an employer that provides insurance. Well, you know, pays for their for their employees health.

Jason Rose:
Yeah, absolutely. So it’s very similar. And I’ll break your question down to two different areas. You’ve got employers that have active employees and then you have employers who have retirement benefits to go with Medicare. So they still owe a health care relationship with their retired employees. So we we actually work with both. So in the case of the employer that has patients, I’m sorry, employees, rather, we very similar model. We’re undertaking the data on a daily basis to identify all the different issues that that patient might have. We usually actually in the commercial employer market, we’re usually actually grouping pharmacy gap issues to provider patient panels. So we are looking at the actual provider group and we’re identifying where we see a nucleus of patients in volume to both facts, the data to the doctors practice group’s office and then have a nurse nurse conversations, review each patient in their panel that appear to have a gap in pharmacy. So a lot of the times we actually see the data gap that the pharmacy gap in the medical data. So so if you think about a pharmacy benefit management company, they usually don’t get the medical data they usually get only the pharmacy data Right. know we’re receiving both. So we’re looking if you think about medication adherence in the three different buckets you have, number one. Did the patient initiate the drug regimen, the first pattern in first dispensing? Two, are they taking it by evidence based guidelines? And three, did they discontinue the drugs that they’re supposed to stop taking it at some point to this those three areas? So in the medical data, we can identify here’s a patient that has, let’s say, epilepsy, and they’re at risk. They don’t take that drug for epilepsy. It’s been prescribed to them, presumably by the doctor, to be hospitalized or had some bad outcome. So we’re actually using the medical data, identify the patient is not even taking that drug at all. And then we’re reaching out to the doctor in the practice group because we can see that he’s told he or she is the one that did the diagnosis, that the patient actually hasn’t initiated the drug process because they may not even know that. So and then we have and there’s there’s conversation we and then we follow to make sure that the patient eventually fills a script. In the case of the Medicare side, where it’s a retirement benefits. We’re usually working both with the doctors and we’re working with the retired employee directly as well to overcome similar issues that we talk about with the patient prior, which is, you know, why are these patients not taking their drugs inherently? If it’s over half of Americans, the status 50 percent of Americans, young adult and old, don’t take their drugs as they should by evidence based guidelines. So we’re seeing that in the data patterns and we’re reaching out to the patient to identify why are they not getting the drugs that they or more than doing them as often as they should. There’s issues with it. So in that conversation with the patient, we will have conversations such as, do you understand the medications that have been prescribed to you? We’ll get into if it’s a low income, subsidized patient. We’ll get into your food in your refrigerator. Right. Do you have access to your doctor transportation to get to your pharmacy or your doctor to get the care you need? And so in the health and benefits which we load into our platform and our clinical CRM workflow, we’re overcoming each of these issues. I called Maslow’s hierarchy of needs food, water, shelter, health literacy. We’re identifying these issues were coming each one to get them eventually to the Right Med. And then that way we can avoid medical costs and improve quality.

Saul Marquez:
Very good. Very good. Yeah, it’s interesting to hear the flow. So where do you guys sit in the supply chain of it all? You know, if somebody is listening, you know, one of the leaders listening to this say, fascinating, you know, where do you guys fit in? You know, is with the PBMs. With the benefits companies, with an insurance company. Tell me about how you guys fit into that Supply-Chain.

Jason Rose:
Yes, so anyone who is taking risk on their patient population is typically a client for us. So we do a tremendous amount of work with health plans. The health plans sometimes are fully insured. Sometimes the commercial population they may be in ASO meaning that they’re really just administrator of helpline benefits for the self-insured employers. So we’re typically working with the plan, but we also do work directly with the larger employers as well, because effectively it’s the same pattern. It’s just we can get a larger group of employers through a health plan. And so that’s that’s sort of the commercial sector. If it’s a Medicare related patient, then we’re going to work with the Medicare Advantage plans, obviously manage Medicaid plans, dual plans. And in those circumstances, they are not just benefiting from the medical cost reduction from improving medications here. And they’re also getting benefits from the state and federal government on value based care reimbursement increases for quality of care. So, for example, in the Medicare Advantage space, there is a program that’s a part of the Affordable Care Act called Star Ratings for Medicare Advantage. And that’s a six and a half billion dollar annual pool of money that the best performing quality plans in the country for Medicare will get a piece of the Value-Based Care, additional reimbursement for that for the benefit of getting better quality care. And so we work with those health plans directly to overcome those challenges. And so that’s a I’d say that’s the technology side of our of our company. But we also own a pharmacy as well, and we have pharmacy partners. So if you think about you’ve got targeting, engagement, targeting of the patient, engagement with the patient and their doctor, overcoming barriers of care to help them get the right medication and avoid bad things from happening, improve outcomes. But then we are also procuring the right pharmacy for that particular patient as well. So we own our own pharmacy for those high risk patients that needed a monthly comprehensive medication review focusing on drug utilization review and giving, you know, procuring a supply chain, the drug. We are a pharmacy. We’re delivering we are dispensing the pharmacy from our nationwide pharmacies and then delivering it right to the patient store via private courier. But we’re also have pharmacy partners they’re providing compliance, packaging or mail order pharmacy as well. So we’re really a full sort of end to end solution on that side of the supply chain as well.

Saul Marquez:
You know, it’s a very complex business. And any time you get into pharmacy benefits and just adherence, it’s tough. And so, you know, I know that it hasn’t always been a smooth running machine there, Jason. So when would you say is is one of the setbacks you guys have had? And what did you learn from that?

Jason Rose:
First of all, what we’re doing is unique. There is not any other company that I’ve seen or come across that intakes data, identifies risk, stratify as the prioritized, puts it into a CRM like clinical workflow. Closes gaps at full risk breech quality measure and then also produces the drug to the patient’s doorstep. And then we sell everything as a software, as a service as well. By the way, not just are we about thousand clinical personnel across the country or we can use it as a SaaS client wants to do it that way. So there is no other company that’s doing this and it’s just it. I’ll get your question in a moment, but just.

Saul Marquez:
No, it’s good.I’m glad you’re highlighting this Jayson, it’s key.

Jason Rose:
Yeah. So if you think about medication adherence, it’s on an annual basis. It is half a trillion dollars of avoidable medical cost. It’s 16 percent of the entire U.S. health care economy spends. That can be avoided if we actually initiate the medications. We get the patients to take them by evidence based guidelines. And then we discontinued the drugs they shouldn’t be on. So half a trillion dollars every year. And that’s a annals of pharmacotherapy study. That’s about five years old now. So it’s probably, well, north of half a trillion, but that’s the latest information. So it’s critically important, but yet no one’s really focusing on it holistically. It’s certainly not from a data in the clinical workflow perspective. So I’ll start there. So the reason why I bring all that up in the context of your question of what’s the biggest challenge you have, is that anytime that something is new and I say it’s disruptive, it’s going to be harder to explain why this is so important. And so and why it’s so critical in terms of outcomes, which is the name of your podcast as well. So you start with the big challenge. Half a trillion dollars. Number one. Number two. Half of Americans don’t take their drugs the way they should be by evidence based guidelines. Really important. So there you go. Number three, social determinants of health. Why are they not taking them the way they should be? Well, we have to overcome that. One patient at a time, one drug at a time, and make sure they are, you know, time and value money. What’s the most important things we should be focusing on? You really need data tech. You need really strong clinical efficacy. We need outcomes to prove that these things work. And so I’d say that that’s probably the biggest challenge we have as we’re a high growth company. We’re certainly nationwide. Why we have, you know, 30 million patients in our dataset. So it’s nearly 10 percent of the U.S. population. But that is probably the biggest challenge we have, is just helping people understand a very complex subject. But I think people get it when they hear. Well, half a trillion dollars every year. And I can. How does that apply to my particular patient population? How do I actually improve value based care? Can my rat risk population so I can benefit from cost reduction? Also, really, at the end of the day, do the right thing for the member or the employee with MI at risk group.

Saul Marquez:
Yeah, that’s that’s a great call out. And it is very different to me. Mean to end to end service that we’re talking about here. And just brilliant work that you and your team are doing, Jasonto address this half a trillion dollar problem. I mean, that the number is astounding, right.. And and we take a step back and those dollars are dollars that could be going toward other things like, you know, like basically building your business, right. your employer wasting money and then their tax dollars, you know, getting wasted. And, you know, your your work is admirable. What what inspires your work and health care? Why are you doing this? This is hard stuff.

Jason Rose:
Yeah. I mean, personally and I I’ll say personally, I’ve been in health care and health care technology my entire career, about 25 years now. Early on, when I was at my master’s program at George Washington University in the business school, I happened to be working in the the practice groups, I.T. department. And I saw sort of at the ground level in the early 90s, I saw the ground level, how incredibly inefficient health care was. And I was just amazed about how the health care spectrum was just really not embracing tech. And so I went to the dean and the school and I said, I’d like to focus my my MBA Health Services Administration program on health care tech. And they said, well, we don’t have a program for that. So you’ll have to create it and get it approved by the dean. So I did that and I was I also had to get a residency somewhere or an internship with this, and so I approached Cerner Corporation, which back in the day was not as big as they are today. And I’m actually the first graduate intern for Cerner. Yeah. And you were speaking to the first graduates or maybe the only one to that out there. But in any case, I just saw really early on. You know, 25 some 30 years ago that that was just a huge opportunity to leverage data and tech and clinical workflow to improve healthcare and quality of care. And I I personally get deeper and deeper value personally on a day to day basis, because this is not easy work. Like you said, it’s hard that I’m doing something that will help both one patient at a time and populations at a time to improve their lives and reduce costs and things of that nature. I think of everything in terms of you’ve got qualitative and quantitative value. The qualitative value is where we are preventing hospitalizations and poor quality and bad outcomes in terms of a person, you know, a family member or a mom or dad, a cousin, an uncle, etc.. The quantitative value is improving cost, improving value based care reimbursement so we can actually take those dollars and put it to better quality of care and continuing to move the dial. Half a trillion dollars. How do we take a chunk out of that and we get less hospitalizations? And I’d say right now where we are and I’ll go to my my company, every single one of us, we have about a thousand employees nationwide. We’re fully focused and dedicated on this Kovik crisis, and we believe that we are part of the solution. Unfortunately, this crisis is not going to end anytime soon. Even as as Nashville. I was in Nashville, Tennessee. So today they’re opening up the some of the businesses, such as restaurant to 50 percent capacity. And they’re going to measure how things work over a two week increments as a slowly open up to more of a state of normalcy. And it’s probably going to be just fine for those people who are not at high risk. And over time, we’ll get better and better as a country and as a world to deal with that. But the people that are at high risk, which are these people with high with underlying conditions, those are not the people that that are that really should be going outside their home or being extremely careful. And so those people really need to get the most focus and they need to get programs that will improve their overall care. So I go back to data, clinical workflow, overcoming these outcome barriers and getting their medications to them in their home with strong clinical support on a regular basis as well. And that’s really inspires all of our employees because we really feel like this is our our time to step up for society and really be part of the solution.

Saul Marquez:
It’s a strong calling, Jason. And, you know, when you when you think about keeping. These at risk patients safe. I mean, it’s it’s a strong calling and how do you guys are doing? It is is complex, but the result is simple. Right. And so I love your focus. I love your mission driven approach. It’s something that is is inspiring. What we’ll do here now, Jason, is a little lightning round. It’s kind of fun because I haven’t done the lightning round in a while, so I’m excited about it. I got a couple..

Jason Rose:
This is my first. So this will be interesting.

Saul Marquez:
It’ll be a good time. It’ll be a good time. And listeners, you’re fired like, oh, the lightning round. We haven’t heard that in months. And so nice little fresh, fresh approach here for for everybody. What would you say, Jason, is the best way to improve health care outcomes.

Jason Rose:
I really believe strongly that the best way to improve it is to ensure that patients who have underlying conditions and diseases are getting their medications and taking them the way that the doctor has prescribed them. And that will improve dramatically health care outcomes.

Saul Marquez:
What would you say is the biggest mistake or pitfall to avoid?

Jason Rose:
Not leveraging the data that you have available. So whether you be an employer or health plan, the data and the adherence levels for the one of the employees or members or retirees, what have you is sitting in your in your data assets. And that’s the pitfall is is not using that to identify the patients who are most at risk and then doing something about it.

Saul Marquez:
So good. How do you stay relevant as an organization despite constant change?

Jason Rose:
You know, the first thing that comes to mind is listen. So when we approach a new business, a new employer or new health plan, first thing we do is listen. We call it discovery workshop and we listen to what they are already doing because there’s probably lots of great things that they are doing and they identify where maybe there’s some gaps and what we call the medication adherence journey. And and we help fill in those gaps where the data or the analytics, the clinical workflow or the pharmacy supply chain procurement. We just think the best way to stay relevant is listen and be willing to be innovative on ideas to help and fill the gaps.

Saul Marquez:
Love it. What’s an area of focus that drives everything at AdhereHealth?

Jason Rose:
It’s it’s our mission. Our mission is to tackle the half a trillion dollars of avoidable medical costs. So as long as it is supporting that mission, then that is an area that we are focused on doing. And the most effective, efficient way possible.

Saul Marquez:
I love it. And so, you know, one of the things we’d like to do here on the Outcomes Rocket, Jason, is hear our amazing guests’ book reviews. I’d love to hear years and and learn more about, you know, what you are enjoying to read. Or maybe it’s your favorite read overall that you’d love to recommend to us.

Jason Rose:
Yeah, I think I’d probably go with one of the more recent books I read just to keep it fresh. There’s a book by Daniel Coyle called The Culture Code and is a fairly recent book. It’s fantastic. It really focuses on the importance of corporate culture and mission based organizations and how that can produce better business results. And so I really embraced the book. And what the book was trying to do, it’s a pragmatic book. It’s not a not so esoteric. It gives lots of really good examples of why it’s important with scientific research behind it. And I just really liked the book. I just finished about a month or so ago.

Saul Marquez:
Nice. The culture code. Great recommendation, Jason. And folks, you know where to go for the details. Outcomesrocket.health in the search bar, type in Adherehealth. And you’ll see the entire transcript with our interview with Jason. And you also see links to his company adherehealth.com as well as their other firm. So check out those show notes so you can learn more. And so as we as we conclude today, Jason, I love if you could just share a closing thought. And then the best place for the listeners could continue the conversation with you or somebody on your team.

Jason Rose:
Yeah, absolutely. And I’m going to go back to how we started this conversation is with respect to Covid-19. And I would I would strongly suggest that those who are have either employees or healthplan membership or patients in their practice group, etc. who where they are expected to provide care for and support is to focus on these patients who are at high risk right now with these underlying conditions and ensure that you’re doing everything possible to identify them proactively, to have some form of a outreach to them, to check on their well-being. Make sure that there have everything they need food, shelter and other life essentials and especially their medications and ensuring that that is an ongoing process. And that’s something that is not a transactional event. It’s an ongoing program to ensure that these patients really don’t end up in the hospital and overwhelm the hospital system. So that would be strongly encourage.

Saul Marquez:
That’s a great call to action and one that we should all be thinking about. And so, Jason, what would you say is the best place for folks to continue the conversation with you or learn more about what you guys are up to?

Jason Rose:
Well, certainly you can go to our website, which is adherehealth.com. But certainly you can also write me a personal email that’s Jason.rose@adherehealth.com.

Saul Marquez:
Outstanding. Folks, take Jason up on this. I mean, an extraordinary opportunity to take your health and well-being to the next level as well as the populations you care for. Jason, thanks so much for spending time with us.

Jason Rose:
Thank you very much. I really enjoyed the discussion.

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