Decoding the insurance industry

Jeff May, Northern Sky Healthcare Consulting

Missed the Webinar?

Preferred provider networks, capped dispensing fees, rejected claims, prior approvals, managed formularies, pharmacies owned by insurance companies and pharmacy benefits managers—the private health insurance industry is increasingly complex, and a growing source of stress for frontline pharmacy teams.

“It can be overwhelming,” says Jeff May, a pharmacist, healthcare executive and founder of Northern Sky Healthcare Consulting with more than 20 years of experience working with stakeholders in the private health-benefits sector.

The Canadian Foundation for Pharmacy is pleased to present “Decoding the insurance industry,” a one-hour webinar led by May to demystify the insurance sector and arm pharmacists with the knowledge they need to better navigate—and influence—the actions of insurers and other decision-makers. You’ll learn about:

Each stakeholder’s role;
The economics of health benefits insurance;
The driving forces of change, including high-cost drugs and wellness in the workplace;
Vertical integration in the sector; and
The evolution of preferred provider networks.

“When you understand the stakeholders involved, their strategies, how they make money, the economic forces that drive them, and how all of that impacts pharmacy, you learn how you can influence the industry,”, says May.

While many of the forces “are trying to take business away” from community pharmacy, continues May, there are also “forces that support pharmacy.” First and foremost among the supports: your patients, the members of private drug plans.

“Plan members have the power. That’s the good news story,” says May. “The relationship that your pharmacy has with the patient, the consumer, is absolutely critical. They can be your advocates.”

In his webinar, May will discuss how pharmacy teams can deepen their relationships with plan members, and what they can do themselves to advocate on behalf of their profession.

There is no cost to attend this virtual webinar on June 11, from noon to 1:00 pm.