Artwork for podcast Reconstructing Healthcare:  Innovative Solutions For Employers To Lower Their Healthcare Costs
Andy Reeves | OptiMed Health Partners
Episode 549th October 2019 • Reconstructing Healthcare: Innovative Solutions For Employers To Lower Their Healthcare Costs • Reconstructing Healthcare: Innovative Solutions For Employers To Lower Their Healthcare Costs
00:00:00 00:41:42

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  • Specialty Drugs
  • Specialty Pharmacy vs. Retail Pharmacy
  • Pharmacy Benefits
  • Misaligned Incentives
  • Price Transparency 
  • Medication adherence versus compliance
  • Quality of care 
  • Cost Savings

In this episode, Michael introduces you to Andy Reeves, the Co-owner and CEO of OptiMed Specialty Pharmacy. Join us as we discuss how OptiMed Specialty Pharmacy is bringing transparency to the market and helping employers circumvent traditional specialty pharmacy distribution channels to lower costs.

Here’s a glance at what we discuss in this episode:

  • Andy’s experience as a clinical pharmacist and what motivated him to become an entrepreneur 
  • Key issues that are impacting our health care delivery system and how misaligned incentives are increasing costs  
  • How siloed health care impacts employer and employee costs
  • OptiMed seeks to harmonize health care for the consumer through integrated services to reduce overall costs 
  • How a specialty pharmacy differs from a retail pharmacy 
  • The difference between medication adherence and compliance 
  • How OptiMed addresses medication adherence 
  • How OptiMed engages employees as an alternative specialty pharmacy option
  • OptiMed offers an alternative distribution source to employers providing a more cost-effective option by charging a flat fee for their services 
  • Typical savings an employer might see when using OptiMed Specialty Pharmacy
  • How the acquisition cost + admin fee model that OptiMed uses differs from the traditional AWP Discount model + Rebate Model used by Traditional PBM’s and carriers
  • How to leverage an incentive copay structure to steer employees to utilizing OptiMed 
  • How OptiMed takes a proactive versus a reactive approach in redirecting employees at the point of care 
  • An example of egregious pricing for infusion drugs in a facility vs. the pricing that could have been achieved with OptiMed
  • Why stop loss and third party vendors are interested in programs like OptiMed 
  • How OptiMed functions as a liaison between the patient and providers to help patients with continuity of care and manage costs
  • OptiMed provides clients with detailed reporting that includes quality metrics, performance, and member reporting 
  • OptiMeds ability to import quality pharmaceuticals into the United States that provide savings between 40-70%
  • What encouraged Andy to launch Ascend PBM in 2017
  • Why leadership should encourage disruption and view their health care benefits as a risk mitigation strategy 
  • To learn more about OptiMed Health Partners visit: