90-minute Webcast on CD
   
Managing Trend in a Transparent Environment 
A Three-Year Case Study
 
Webcast held May 22, 2008. Now available on CD.  
 
This three-year case study is a powerful example of the cost savings and clinical quality that can be achieved when PBM and plan sponsor incentives are completely aligned.

Neighborhood Health Plan (NHP), a non-profit plan serving 181,000 Medicaid and commercial members in Massachusetts, and MedMetrics Health Partners, a non-profit PBM affiliated with the University of Massachusetts Medical School, have enjoyed a completely transparent, full pass-through business partnership since January 2005. Both organizations are committed to an evidence-based approach to clinical programming and decision-making. Within that shared philosophical and collaborative framework, they implemented a broad array of management strategies and innovative technology solutions to achieve impressive results.
  • Neighborhood Health Plan’s adjusted pharmacy PMPM utilization trend has been kept to an average of 2% over three years, well below current industry-wide trends.
  • Generic utilization rates have increased from 68% to a precedent-setting 78% level, which equates to a three-year savings to NHP of over $32 million.
  • NHP’s overall effective rate of reimbursement for generic drugs went from AWP minus 51% to AWP minus 69.3%. This higher performing MAC program has yielded three-year savings of $10.5 million.
  • At the same time, the clinical rigor of NHP’s Pharmacy and Therapeutics Committee decision-making and clinical programming strategies has increased significantly.
Learn how this health plan and its PBM partner effectively implemented strategies for managing drug trend and drug mix in a transparent environment.
 
Learning Objectives:
  • Quantify the economic value of a completely transparent, full pass-through PBM business model.
  • Identify innovative clinical and technologic solutions that drive enhanced control over drug expenditures, facilitate provider and patient education, improve overall satisfaction levels, and enhance health outcomes in a transparent environment.

Agenda: 

2:00 – 2:30 pm
 
David Calabrese, RPh, MHP
Chief Clinical Officer
MedMetrics Health Partners
Boston, MA
 
2:30 -- 3:00 pm
Catherine Pappas, PharmD, MBA
Director of Pharmacy
Neighborhood Health Plan
Boston, MA
 
3:00 – 3:30 pm
Questions and Answers
 
 
More About the Speakers…
 
David C. Calabrese, RPh, MHP, is chief clinical officer with MedMetrics Health Partners, a non-profit pharmacy benefit management (PBM) organization in Worcester, Massachusetts. This organization, directly affiliated with the University of Massachusetts Medical School, provides full-service PBM support for public and private sector third-party sponsors. As part of the MedMetrics executive leadership team, Calabrese maintains oversight responsibility for all components of MedMetrics’ clinical and analytics programming.

Calabrese was formerly director of pharmacy with MedVentive, LLC (formerly the CareGroup Provider Service Network), a management services organization providing support to six hospitals and more than 2,500 ‘at-risk’ physicians in the Boston area. He also previously served as clinical pharmacy coordinator for Harvard Pilgrim Health Care. Calabrese received both his bachelor of science in pharmacy and his master of health professions degrees from Northeastern University, where he currently maintains academic affiliation as an assistant clinical professor in the Bouve’ College of Pharmacy and Allied Health Sciences. He also is clinical editor of the peer-reviewed pharmacy journal, Formulary. He has spoken at numerous forums and published on a variety of topics pertaining to pharmacy management in the managed healthcare arena.


Catherine Pappas, PharmD, MBA, is the director of pharmacy with Neighborhood Health Plan, a non-profit managed care organization providing health care throughout Massachusetts. Neighborhood Health Plan provides coverage for 180,000 lives providing coverage for state Medicaid members, as well as commercial account and individuals. Neighborhood Health Plan is also providing plans for all aspects of the Massachusetts Health Care Reform Initiative to provide affordable health care to all residents of Massachusetts. Dr. Pappas’ collaborates with the health plan’s PBM on new and existing pharmacy program development, manages an $80 million dollar pharmacy budget, and co-chairs the P&T committee.

Before joining Neighborhood Health Plan, Dr. Pappas was senior clinical pharmacist for Biotech and High Cost Medication with Tufts Health Plan in Massachusetts. She received her doctor of pharmacy from the University of Kansas and her master in business administration in Health Care from Anna Maria College. She also holds a degree in chemistry from Manhattanville College.
Dr. Pappas is an active member of the Academy of Managed Care Pharmacy, and the American Pharmacists Association. She has spoken nationally on specialty pharmacy.
 
Confirmation and Participant Credentials
Once your registration is processed, you will receive an email confirmation with a link to the Accuconference Website to sign in to get your participant credentials. Your credentials will include the dial-in telephone number, unique PIN (Participant Identification Number) and a Web link.
 
System Requirements
To participate in the Webcast, you will need a telephone and a computer equipped with an Internet connection, Windows 2000 or XP, and one of the following browsers: Internet Explorer 5.0 or higher, Netscape 5.0, or Firefox. Recommended system requirements are Pentium 4 with 1.4GHz, 512RAM, and a 100Mbit Network Card. A Pentium 3 and Windows 98 are minimum requirements.
 
CD $279. 10% discount for PBMI members.




Copyright 2007 Pharmacy Benefit Management Institute, LP