The Character of Healthcare — A Light in the Darkness
“Let light shine out of darkness” – 2 Corinthians 4:6. When we talk about character, there is no greater darkness in healthcare than the Pharmacy Benefits Manager (PBM) industry. You simply need to open the Wall Street Journal, New York Times, Los Angeles Times, or Washington Post to find yet another article on shady PBM practices — not that anyone reading this blog needs an education on the hidden fees, backroom deals, and lack of transparency in the PBM industry! That is why it is so redeeming to find a shining example of healthcare character in such darkness. Allow me to tell you the story of MedOne.
MedOne was born out of the second oldest continuously family-owned and operated pharmacy chain in the U.S. — Hartig Drug, which was started in 1904 and remains owned and operated by fourth-generation family members. The “aha moment” for MedOne came in 1999 when Hartig Drug’s CEO, Richard Hartig, noticed the pharmacy benefit invoice for the Hartig Drug self-funded health plan was substantially larger than what he was reimbursed as a pharmacy on those same prescriptions. Questioning the value of the large mark-up created by the incumbent PBM (putting it nicely) and asking himself “How hard can it be?”, Richard cobbled together a mousetrap allowing him to self-administer Hartig Drug’s pharmacy benefit plan and, subsequently, realizing significant savings.
What ensued was more of a crusade than a sales strategy as Mr. Hartig knocked on every employer’s door across Hartig Drug’s Midwestern footprint to educate them on the PBM pricing practices that were harmful to the patient, plan, and pharmacy. The pitch was simple. “You and your member are charged $40 for a script, and I’m paid $20. Why don’t I just bill you what I am currently getting paid, plus a small per script fee to cover my administration cost?” In addition, Richard would ask the owners of these businesses, who sit at the intersection of employee satisfaction and cost containment, a few key questions:
- When is the last time you’ve spoken to a pharmacist about your pharmacy benefit plan?
- Do you ever wonder why you don’t pay your PBM a fee for the services they provide?
- Did you select your pharmacy benefit administrator or was it selected for you?
After being met with blank stares, he offered them an alternative — a pharmacy plan where the cost of medication is simply the cost of that medication as paid by the pharmacist. Over time, this simple model grew into a full service PBM platform which Richard named MedOne. MedOne now helps organizations of all sizes facilitate direct, pass-through pricing with high-performing pharmacies and therapies as a foundational element. Once the ability for the plan and member to win has been established, MedOne helps improve what and where members fill prescriptions to achieve measurable savings and outcomes.
I love the MedOne story because it illustrates how one courageous man can take the simple truths about honest value in healthcare and transform those into a platform that challenges decades of self-serving industry practices. Seizing these truths and transforming them into honest opportunities for better health and a better healthcare system is the type of healthcare character that should serve as an inspiration for all of us!
Published on: 12.19.19