OR_Sempre Health_ Josh Benner: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Kyle Wildnauer-Haigney:
Hey everyone! Welcome back I’m your host Kyle Wildnauer-Haigney, and today I have the privilege of interviewing Dr. Josh Benner. Josh is founder, president, and CEO of RxAnte, a pioneering provider of advanced analytics, patent technology, and high-touch pharmacy services that get more from medicines. The company’s solutions increase quality scores and lower costs by improving prescription drug use in medically complex and vulnerable populations. A leading voice on medication adherence, Dr. Benner’s award-winning research, and numerous publications have shed new light on the problem of nonadherence and identified promising approaches to improving it. Dr. Benner received his Doctor of Pharmacy degree at Drake University and his Doctor of Science in Health Policy and Management from Harvard University School of Public Health. He was a postdoctoral fellow in health services research at Brigham and Women’s Hospital, Department of Pharmacoepidemiology and Pharmacoeconomics. Dr. Benner is currently a member of the Health Policy and Management Executive Council at the Harvard T.H. Chan School of Public Health and an entrepreneur in residence at the Harvard i-Lab. Thank you so much, Josh, for joining the call today.
Josh Benner:
Thanks, Kyle. I’m delighted to be here.
Kyle Wildnauer-Haigney:
So maybe to start off, I’d love it if you could share, what inspires your work in healthcare?
Josh Benner:
Great question. Well, personally, I guess it goes back to when I graduated high school, I was 100% confident I wanted to be a pharmacist. And when I think back on those days, I think it was because healthcare is really important and it’s deeply personal to people, and it’s also often mysterious. And I think I enjoy making hard things easier for people. But by the time I was done with pharmacy school, I was sure that, equally sure, that I was not going to be a pharmacist in the traditional sense, and that I would much rather focus on the population-level problems with how we use prescription drugs in our country. And there’s this notion that drugs are very powerful and they can help a lot of people, but they can also be very harmful. And so that makes answers about which drugs work best for which people and how really hard. And it drew me to those fields you just mentioned, pharmacoepidemiology, clinical decision analysis, and health policy throughout graduate school. So I’m really inspired by the challenge of making healthcare better, more accessible, and less mysterious for people and using technology to extend solutions to the millions of people who need them.
Kyle Wildnauer-Haigney:
That’s awesome. And I’d love it if you could share maybe a little bit more about how you and RxAnte is adding value to the healthcare ecosystem.
Josh Benner:
Sure, well, maybe I’ll pick up on that problem of how we use prescription drugs as a country. So for reference, I think the last number I saw was that in 2020, our country spent about $535 billion dollars on prescription drugs. That’s about 5% growth year over year. What’s really interesting, though, Kyle, is we also spent, according to the most recent study I’ve seen on this, $528 billion on underuse, overuse, misuse, the consequences of how we use prescription drugs, and that number was estimated in 2018. So think about how close those numbers are, $535 billion on drugs themselves, $528 billion on the consequences of how we prescribe and fail to adhere to prescription drugs. So if we think about that and step back, for every dollar we spend on prescription drugs, we’re spending another dollar because of how we use them, and, you know, that suggests that the real cost of prescription drugs to our country could be cut by up to half. And so that really motivates us, that gets us out of bed every morning, to focus on how we can make medications work better for people, and that’s why we’ve adopted kind of the tagline of getting more from medicines. So our company’s ten years old and we’ve seen a lot of policy changes over that ten-year period to try and address this problem, and in particular, that’s included the development of pharmacy quality measures, which I had an opportunity to be a part of, that measure, the quality of prescribing and taking of prescription drugs, and then the adoption of those quality measures in quality-based payment programs in the Medicare Advantage program and now also in managed Medicaid programs. And so we’re really excited about the fact that the time has come to make better medication use a shared responsibility throughout the healthcare system because of some of these policy changes, and RxAnte is a response to those changes. So what our company is doing is providing pharmacy care management programs, starting with technology like predictive analytics and software to manage the workflow of patient-level drug therapy management. We’re helping our clients, who are health plans, find the needles in the haystack, the patients who really need the most support, and then bring that support to those patients so that they are on the right regimen and able to stick to it. And by doing that, we help those health plans improve quality scores, we help them save money by reducing their share of that $528 billion-dollar problem, and we’re doing that today, for now, 26 million lives throughout the country.
Kyle Wildnauer-Haigney:
Wow, that’s some significant scale, I imagine, with 26 million lives, multiple months of data, at least, right, on each of those individuals that you’re probably really generating some high-quality insights that then you can deploy to those new customers.
Josh Benner:
That’s exactly right. It’s usually years of data that we have on those patients. And when we use that data correctly, we can identify patients who need higher levels of service and lots of insights, as you suggest. One of the insights that we’ve learned over the last few years, most recently, is that there is a subset of the population, a really small 9 or 10% of the Medicare population, for example, that has extremely acute needs for higher levels of drug therapy management even than you can deliver with telephone or technology alone driven services. And so it’s led us to develop a new offering that we call the Mosaic Pharmacy Service, which is a value-based and heavily technology-enabled pharmacy service, where our subsidiary becomes the pharmacy for these patients and takes over management of their regimen, working with their prescribers to help them reconcile the regimen to the simplest, the safest, and the most affordable regimen possible. And then we deliver monthly clinical services and specialized packaging to help patients adhere to that ideal or optimized regimen. And we’re really excited about the early results in terms of outcomes from that service. But it’s just an example of what you were saying, if we have the data on a large population, you can identify insights and needs that that population has and then respond with new services and solutions.
Kyle Wildnauer-Haigney:
Yeah, I mean, that sounds amazing, taking kind of the function of pharmacy and applying all the insights and technology that you guys have built over the past decade to really turbocharge, right, that capability for that specific population that needs it most. You’re, not to be redundant, but one question I always ask guests is, kind of, what makes it, what is it that you do that is different from what’s available in the market? I imagine, I mean, I’ve never heard of that service, but I would love it if you could illuminate that for us.
Josh Benner:
Sure, well, I mean, I think one of the differences in what we do is that we are really technology first in the sense that we’ve adopted a tagline that if you know the future, you can change it. And so our analytic technology is where everything starts. And it brings us the insights about which patients need higher levels of support and which ones will be fine on their own. And so that’s a key differentiator in our approach to population health management. We also have gone on to develop software that turns those kinds of predictive insights into actionable workflow for patients’ healthcare providers, and for our own pharmacy service. And so it’s translating the insight from analytics into action at the patient level, that’s really another differentiator, and Mosaic is a response to that. So I would just add one other differentiator that’s unique to Mosaic, which is that we are pioneering a value-based business model for pharmacy. And I think, I say pioneering because we’re not aware of other pharmacies that work this way, but the fees that Mosaic charges for the care management, the pharmacy care management services that it’s providing for these very complex patients are all at risk for the outcomes that Mosaic delivers. And so we’re excited and truly heartened by the fact that there’s a role for pharmacy and value-based care and we’re helping pioneer it.
Kyle Wildnauer-Haigney:
I love that, absolutely love that. And I’d love to hear, kind of, as you’re building this really unique capability and kind of business, what was one of the biggest setbacks that you have experienced, and what was the key learning there?
Josh Benner:
Well, there are setbacks every day, as you know, when you’re building a business. And so it’s sort of fun to think back on what some of the biggest ones might be. Certainly, we’ve all lived through the COVID setback and tragedy over the last few years, and it’s ongoing. It, in our case, brought us a ton of opportunity in the sense that COVID resulted in these seniors who are medically complex and vulnerable, the ones that we were trying to bring an innovative pharmacy service to, it resulted in them having to stay home and essentially be out of society for a period of time, and their access to healthcare was limited. And it was a huge setback for that population, and it was a setback to us because we had just launched a pharmacy service that was founded on the principle that we were going to come to homes and visit these patients’ lives and begin our relationship with them through a home visit. But it turned into an opportunity because we learned how to adapt our model to a virtualized home visit where we do the same thing for patients, but by telephone or over a video consult. And then of course, because these people had such acute needs during the worst of the pandemic, it ended up being an accelerant to enrollment in our pharmacy service. Another one we’re dealing with today, of course, is the labor market. There’s a lot of demand for the personnel who do what we do, whether they be technical experts in analytics and data science, or whether they be the pharmacists and technicians that we employ at Mosaic. And so we’ve had to really step back and analyze our culture and our company and what it is that makes this a great place to work and make sure that we’re communicating that, and besides offering competitive compensation and benefits and things like that, it’s about making sure that people understand the mission of your organization, and it’s something we try to focus on every day as an employer.
Kyle Wildnauer-Haigney:
I’ll just mention from my own experience, the intersection of digital technology and healthcare, both really challenging labor markets, there’s a chronic undersupply of technical individuals and also clinical individuals. And so, as you’re building out that business, I can only imagine how critical the culture and those differentiators are to succeeding in that market. You know, maybe you’re, kind of, looking forward, shifting gears, I’d love to hear, what are you most excited about today, in kind of, within the context of the pharmaceutical value chain?
Josh Benner:
What a great question. I mean, I think there are so many things we’re excited about. I think I’m excited about the fact that this notion of improving how we use, how we prescribe, and take prescription drugs has come. That time has come because a body of research has made its way through policy and had an impact on the financing and incentives in the healthcare system, and it’s now a shared responsibility. So I’m very excited about that. I’m excited about the potential for innovation in how we deliver pharmacy care management to high-need patients. And maybe the thing I’m most excited about is that the outcomes we are starting to see, which include dramatic reductions in hospitalization rates and dramatic reductions in total cost of care. For patients that are in the service of Mosaic, tell me that we’re creating real value by helping people optimize and then stick with the right medication regimen and working with their providers, their multiple prescribers in order to do that. So that’s especially exciting because of the value-based model that we’re trying to pioneer, and it’s, I have to tell you, Kyle, it’s what gets the team out of bed every morning. It’s the statistics about the difference we’re making at scale, of course, but it’s also, and this is the part that makes my mom most proud too, it’s the difference we’re making for individual patients, those patients that motivated me to get into this field in the first place, and the stories that come back on the comment cards or in the phone calls or in the little gifts that some of our patients send us that tell us that one person at a time we’re making a really big difference where there wasn’t a good solution before for managing medications.
Kyle Wildnauer-Haigney:
We know when mom is proud, you’re on the right track, and total cost of care within the pharmacy is a very exciting mission and focal area, so that’s great. Maybe, before we conclude, if you could just share one closing thought and where listeners can get in touch with you.
Josh Benner:
Sure, I guess my closing thought would be to expect more from the pharmacy experience. We should all do that and we can get more from medicines, but we have to expect more from those who prescribe and bring our medicines to us. And so I would encourage your listeners to think about opportunities for innovation there. We would love to be in touch with folks who are interested in what we’re doing. They can hit us up through the RxAnte website. I’m easy to find on LinkedIn, or they could email me at JBenner@RxAnte.com.
Kyle Wildnauer-Haigney:
Awesome, well, Josh, thank you so much for coming on the show today. A pleasure speaking with you. I hope you have a wonderful day.
Josh Benner:
Thanks a lot, Kyle. You too.
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