Timothy O’Shea, Pharm.D., M.S. | 2024 Emerging Leaders In Healthcare

Timothy O'Shea, Pharm.D., M.S.

I was born in New Jersey and lived there until attended and graduated from the Massachusetts College of Pharmacy and Health Sciences in Boston. I completed a postgraduate year one residency in managed care pharmacy and earned a master of science in health services administration from the University of Wyoming. I have worked for Horizon Blue Cross Blue Shield (BCBS) of New Jersey for over nine years.

In my current role, I lead Horizon’s strategy on specialty drug management, which includes pharmacy case management, site of care, biosimilar strategy, cell and gene therapy and more. In addition, I coordinate clinical programs with 15 health system value-based partners throughout New Jersey, including lower-cost drug alternatives, specialty initiatives, pharmacy gap closure and supporting Medicare Stars program.

I have had work published in Pharmacy Times, Managed Healthcare Executive, the Magellan Rx Report and Relias Academy. I am currently an adjunct assistant professor at Rutgers University’s Ernest Mario School of Pharmacy and am a member of the Academy of Managed Care Pharmacy’s Educational
Affairs Committee.

Please describe a turning point in your career — an event, a eureka moment, an encounter or a salient piece of advice from someone.

Growing up I always had an interest in science and then having the opportunity to work at a grocery store pharmacy in high school provided some early insights into developing a passion for pharmacy. In addition, throughout pharmacy school, I was able to complete rotations in a variety of clinical settings, which helped shape my future interests. In terms of general advice, I always come back to a phrase I heard many years ago, which is, “It costs nothing to be kind,” which is something that I try to keep in mind as I strive to be an effective leader at work,
husband and father.

What are your top two priorities as a leader in your organization and healthcare?

My top priority as a leader at Horizon BCBS is to embody the spirit of the “Triple Aim,” which focuses on improving health outcomes, managing the total cost of care and enhancing the member experience. Each of those three pillars forms the basis of the work my team and I do each and every day specific to prescription drugs.

If you could change one thing about U.S. healthcare, what would it be?

In an ideal world, there would be far less fragmentation in the current healthcare system. Data shows that polypharmacy (simultaneous use of five or more prescription drugs by one individual) has been steadily increasing over the past two decades. This can be exacerbated by individuals seeing multiple providers or specialists whose electronic medical records may not sync with each other, leading to potentially excessive or duplicative medication use. Shockingly, polypharmacy accounts for nearly 30% of all hospital admissions in the U.S.

Name a book or article that everyone working in healthcare should read.

As an avid reader, I will call attention to two books. The first is “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age” by Robert Wachter, M.D., which provides an insightful look into both the enormous advances and also stumbling blocks of healthcare technology. The second is “Biased: Uncovering the Hidden Prejudice That Shapes What We See, Think, and Do” by Jennifer Eberhardt, Ph.D., which covers meaningful insights into identifying and addressing our own biases.

How do you strike the right work-life balance?

As someone with two young children, [I know that] an effective work-life balance is something that is absolutely critical to manage on all sides.Certainly, time management and organization will always be key in all facets of life. But it’s also important to realize that while work is important, there will always be something more to do at work. Unplugging and spending time with family and friends can never be understated.

If you could have dinner with anyone, living or dead, who would it be and why?

From a historical perspective, it would be incredible to have a dinner conversation with George Washington, Benjamin Franklin and the other Founding Fathers of our country.