NCPDP Annual Conference: Track Sessions

May 9, 2023

10:30 am – 11:30 am
Rick Jennejahn
Director, Pharmacy Innovation Programs
Excellus Health Plan, Inc.
Michael Burger
Senior Consultant, EHR/EDI Vendor HIT Strategy
Point-of-Care Partners
Kim Boyd
Senior Advisor/Consultant
Boyd Consulting Group, LLC – with Point-of-Care Partners sponsorship for this session
Kyle Tucker
Senior Advisor
EverNorth
1:45 pm – 2:15 pm
Annette Gabel
Grant & Association Development Director
NCPDP Foundation
Kristina Crockett
Vice President of Product Management
CoverMyMeds
2:30 pm – 3:00 pm
Hannah Cardosi
Sr. Manager, Adjudication Product & Strategy
Express Scripts
OmHaraiSriRam Gangaikondan-Iyer (Harry Ram)
Senior Director, PBM Resiliency and Reliability
Express Scripts

May 10, 2023

11:15 am – 12:15 pm
Jessica Hauflaire
Chief Operating Officer
Digital Therapeutics Alliance

Jeff Abraham
Vice President, Co-Lead Digital Health Practice
Health Advances

Daniel Cawood
Product Manager, Interoperability Solutions
MCG Health

2:30 pm – 3:00 pm
Julian Chun, Pharm.D., MBA
Pharmacist, Drug Registration and Listing System, Office of Compliance, Center for Drug Evaluation and Research
U.S. Food and Drug Administration

3:15 pm – 4:15 pm
Corey Hansen, MBA
Chief Executive Officer
Lumistry

Nick Brooke
Head of Revenue and Sales Strategy
Lumistry

Cami Agena, Esq.
Partner
The Phoenix Law Group, PLC

Pharmacists and Pharmacy Technicians can earn Continuing Pharmacy Education (CPE) hours from the ACPE for up to 6 of the 14 concurrent educational track sessions. Click here to view the complete CPE Details for NCPDP’s 2023 Annual Conference.

 

The Value of High-Touch Specialty Pharmacy Medical Benefit (J-code) and PBM Carve Out – The Evolution of the TPA-Employer SpecialtyRx

  • Tuesday, May 9, 2023
  • 9:15 am – 10:15 am

As we are grasping the fact that specialty drug cost continues to rise, the need to have key accountability measures in place to maximize cost-savings and plan efficiency is essential for employers to control their healthcare cost. There are key value-levers on both medical and pharmacy benefits to manage for optimal benefit based on clinical and financial factors resulting in improved patient experiences at a lower cost of care. Despite the use of utilizing prior authorization program and a variable copay program, two additional strategies are being increasingly explored in the market: carving-out specialty medications from the PBM and pharmacy benefits. The value of doing this weigh on key important areas to understand, including the difference of these types of specialty medication when excluded from the covered benefit; the key factors to drive when carving-out specialty; the details of current contractual arrangements with your PBM and your plan language and benefit designs; implementing innovative financial solutions and cost saving programs, both financially and clinically; and how to design clinical utilization management programs, manage drug spend through both the pharmacy plan and medical plan, and adopt alternative treatment programs beyond drug therapy. CPE is not available for this session.

Track Session Speakers

  • Michael Baldzicki, CRCM
  • Chief Brand Officer
  • AscellaHealth
NCPDP-Elite Partner

Covermymeds logo             FDB

NCPDP’s Elite Partner Program establishes the highest level of sustained support for the valuable work of NCPDP in advancing patient safety and interoperability.

Need More Info?

We would love to hear from you. Send us a message with your comment or question and a member of our staff will contact you shortly.

       
Stay Connected