Last Month brought us news of the indescribable aftermath of Hurricane Katrina. I consumed all the information I could find at first, but then, like many Americans, I had to step away from the media for a while. I had to let the reality sink in without the narration of a news anchor.
LAST MONTH brought us news of the indescribable aftermath of Hurricane Katrina. I consumed all the information I could find at first, but then, like many Americans, I had to step away from the media for a while. I had to let the reality sink in without the narration of a news anchor.
When I turned the TV on again, stories of hope and courage came to the forefront. In our own industry, plans, pharmaceutical companies and providers of every kind donated millions in cash and resources. On top of that, many of them created support processes to help evacuees get unprecedented access to medicine and care. Many of the day-to-day managed care requirements were waived in favor of quick access to urgently needed care.
For example, national and regional plans pledged to suspend prescription copays and referral and prior authorization requirements while also promising to pay member claims with any provider at the "in-network" level. TriWest Healthcare Alliance announced that it would make healthcare services readily available to National Guard families, as well as to active duty military families and retirees who have been displaced.
This issue of MANAGED HEALTHCARE EXECUTIVE contains must-read news analysis about the Gulf Coast situation and what we can learn from the experience, especially from an IT perspective (See Newswire).
HOMETOWN LEADERSHIP
This month's issue also contains the Executive Profile of Jeff Ingrum, CEO of Health Alliance, a provider-sponsored plan in the Champaign-Urbana, Ill., area . Ingrum told me during our meeting in his office recently that his plan has fared better than some provider-sponsored plans because it has balanced expansion with targeted service to a niche market of state employees for the past 25 years.
He's a native of the Champaign-Urbana area with a CFO's background. He says that when he was first approached to take over as CEO of Health Alliance in 1997, he hedged.
"It sticks out in my mind because it was April Fool's Day," Ingrum says. "My first thought was that they were fooling. At the time, I felt my skills were better suited to CFO. But I probably underestimated my creativity in the visionary role of the CEO and the relationship skills you have to have."
HERE TO SERVE
Finally, I'd like to reintroduce myself to each of you. This summer, I was promoted to the position of editor-in-chief of MANAGED HEALTHCARE EXECUTIVE. My vision is to produce quality content that reflects the issues you plan for and respond to.
Healthcare moves in all dimensions, so keeping an ear to the ground is a formidable task for anyone. I am grateful for the excellent direction of Senior Editor Tracey Walker who can generate the best in critical information at a moment's notice, for the artistry of our new Senior Graphic Designer Brian Smith, and for the business acumen of our highly experienced sales and publishing leader Dan Corcoran.
Please contact me or anyone on the MHE team with your ideas and feedback. It's an honor to serve healthcare's decision makers.
Julie Miller is editor-in-chief of Managed Healthcare Executive.She can be reached at julie.miller@advanstar.com
David Calabrese of OptumRx Talks New Role, Market Insulin Prices and Other Topics 'On His Mind'
April 13th 2023In this month’s episode of the "What's On Your Mind podcast," Peter Wehrwein, managing editor of MHE connects with the now Chief Clinical Officer of OptumRx Integrated Pharmacies, David Calabrese. In this conversation, David touches on his transition in January as OptumRx’s former chief pharmacy officer and market president of health plans and PBMs to his new role as Chief Clinical Officer where he now focuses more on things such as specialty pharmacy to home delivery — with an overall goal of creating whole-patient care. Throughout the conversation, Calabrese also touched on the market’s hot topic of insulin prices and behavioral health services within the OptumRx community, among other topics.
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Briana Contreras, editor of Managed Healthcare Executive, spoke with Nancy Lurker, CEO and president of EyePoint Pharmaceuticals. Nancy shared a bit about EyePoint and how the organization’s innovative therapies are addressing patient needs through eye care, and most importantly, she addressed C-Suite positions like the CEO role. Nancy shared advice for those seeking to reach the CEO level, especially toward women in healthcare and other roles, and what it takes to run a biopharma company.
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The deliberate disconnection of Change Healthcare to ring fence a cyberattack entered its seventh day today. Prescribers are finding ways to get pharmacy claims processed, and UnitedHealth Group says disruption to the dispensing of prescriptions has been minimal. But independent pharmacies want more information and protection from financial consequences from pharmacy benefit managers.
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