Medication Therapy Management with Anna Hall

eorge grombacher 0:02
ANNA Hall is a clinical pharmacist. She is the Chief Compliance Officer of outcomes, operating Inc, their healthcare tech company working to create thriving communities through better pharmacies and access. Welcome to show Anna.

Anna Hall 0:18
Thanks, George. Thanks

george grombacher 0:19
for having me. excited to have you on. Tell us a little about your personal life more about your work, why you do what you do. Great.

Anna Hall 0:27
Well, I’m a pharmacist by training I’ve spent most of my year though, kind of as a non traditional pharmacist, I taught at the University of Florida, and had an opportunity to jump into something that was kind of booming in the 2005 2006 era when Medicare Part D began paying for prescription drugs for for Medicare patients. And as part of that the government required that Medicare patients be offered what’s called medication therapy management. So I think when that first came out, a lot of us didn’t even know exactly what that meant. But I have spent most of my career having an opportunity to really shape and define what that offering would look like for Medicare beneficiaries. And I guess as far as my personal life, you know, I’m a I’m your typical mom, two kids, two dogs. Lots of lots of fun and exciting things, watching them grow up, but excited to be here and excited to talk about what we’re doing it outcomes.

george grombacher 1:36
Awesome. No, cats, Anna, just just a couple of dogs.

Anna Hall 1:40
I kind of kept it simple with two dogs, but I have two or three cats, depending on the day one likes to come and go and I have six chickens. And that’s, that’s my animal limit. At the moment. I’ve been known to have some goats and other farm like animals. But anyway, yeah, yeah,

george grombacher 1:59
there’s some additional bandwidth you might fill in with some goats or something else who knows? Who knows? Awesome.

Anna Hall 2:06
I guess I am a little exciting in the animal. Yeah,

george grombacher 2:09
yeah. When you start peeling the layers back. I love it. Roughly speaking, how long ago? Was it that Medicare Part D started paying for medication?

Anna Hall 2:20
Oh, gosh, I think that the Medicare Modernization Act, which brought that along, came around in 2003 might have gone live in 2006. Right around those years, and then those MTM program started kind of between 2006 and 2009. When that kicked off, so you’re taking me you’re taking me back, but I think those right,

george grombacher 2:44
got it, and it’s medication therapy management. And yeah, what is what is the purpose of that.

Anna Hall 2:51
So medication therapy management is where Medicare Part D plans are required to offer patients that are on a certain amount of medications, or have a certain number of disease states are expected to spend a certain amount on medications overall, both what their plan pays and what they pay. Medicare said, you know, patients on on medications can run into problems where their drugs might interact, they might interfere with other disease states. And if if we’re going to support making sure that people are on medications and staying healthy, we want them to get a medication review at least once a year where they can go over their medications with a pharmacist. I can talk about our model in a minute, preferably their their personal pharmacist that knows them well. And review those medications, look for any potential problems, and really allow that pharmacist to serve as a liaison between the patient and the prescriber, helping them optimize their drug regimen so that it works for them works for you know their preferences works for their disease states and does what it’s supposed to do to keep them healthy.

george grombacher 4:04
I can’t imagine even starting with a project like that, I know that y’all are working with almost 50,000 pharmacies. So it’s so many people that are taking and gaining access to this program and government and everybody else wanted to make sure that they stay safe and the program runs effectively. So that’s just a lot.

Anna Hall 4:29
Our our platform and outcomes really provides that connection between those Medicare plans, Medicaid plans, even you’re seeing do medication therapy management or MTM for short now, and then manufacturers have really realized the value in just having those conversations with patients that are on these critical therapies and making sure that they do well on them. So outcomes we really provide a connection. We have both pharmacy dispensing platforms that pharmacies are doing their everyday dispensing work in. And then we have a clinical platform that connects those health plans to that community pharmacy to present opportunities so that those pharmacies can be reimbursed to complete that clinical care and those MTM reviews with patients. So that’s the gap that we’re filling, making it streamlined for pharmacists to both dispense and then do that clinical work in one platform in their everyday workflow.

george grombacher 5:34
And when you decided to become a pharmacist, is this is this the kind of work that you envision doing, Anna? How did this happen?

Anna Hall 5:43
I had I yeah, I sometimes wonder that too. I had no idea. I mean, MTM was not a theme when I see a Florida in school. So it is it is I have found our home and MTM, it is what I hoped pharmacy would be I started in a small independent pharmacy called Magnolia pharmacy. And I would go and deliver medications next door to a nursing home or long term care facility next door for patients. Actually, it was an assisted living facility next door and take people their medications and I would get to talk to them. They would ask questions, you know, I’d have to at that point in my career, I’d have to go back and ask the pharmacist and get them an answer. But I mean, it was the dream pharmacy life for me getting to talk to people and help them with their concerns about their medication. So to end up today. And to be honest, it was it was through connections and staying in touch with people that I went to school with and teachers of mine that when MTM came about, you know, we had an opportunity to define what it would be what it would look like and teach pharmacist all over the nation how to do it because it was a new thing. You know, it was organizing, how do you sit with a patient and go over these medications? And how do you break away from that routine of dispensing all day long to make sure you have staff and you have time to spend this time with the patients? So you know, it just kind of happened and it’s been a it’s been a fun ride. And it’s an exciting place to be

george grombacher 7:21
no doubt about that. All right. So medication therapy management. I don’t want to use the wrong term dispensing is here’s here’s some here’s some medication to take. And then the MTM is a consulting function. What is the right term?

Anna Hall 7:39
Yeah, we’re clinical, we like to call it clinic pharmacist clinical services. And you know, over the years, George, the reimbursement for dispensing has gone down. Even sometimes when you fill a medication, your pharmacist even ends up when it’s all said and done with a negative reimbursement for that medication. And I don’t know any profession that’s in business to make negative dollar amounts. So you know, or even, you know, very low margin amounts, which we’ve seen that that margin and dispensing declined over the years. So it’s very important for pharmacists right now who aren’t trusted there. This is the one person in your healthcare that you would see more times a year, picking up your medications than any doctor any other provider that you see. And, you know, they’re there. They’re available, they have that relationship with their patient. This is an opportunity for MTM, or what we call clinical services for them to use, what they’re really trained in their medication experts and the patient trust them, they have an opportunity now to be reimbursed for their cognitive skills for talking to that patient about how their medications are working for them, what problems there could be with them. You know, I know people need this because my own friends and family call me all the time. Just wondering or what do you think about a drug people just want to know that in the health plans and the manufacturers, they need people to do well on the therapies that they’re on. Ultimately having a pharmacist work with the patient. Due to health care costs, it keeps people out of the hospital. I think something like one in three hospitalizations are due to some issue with a medication. So, you know, pharmacists are really, I think the key we saw it, you know, during COVID that highlighted for the world that pharmacists are the most accessible person that we needed to get vaccines out. Right. So the pharmacist were there. I think everyone knows that. And outcomes. We have a network, like you said of almost 50,000 pharmacies across the nation all in one platform, health plans, manufacturers, whoever is needing to get that intervention done with the patient. It can be loaded right in front of the pharmacist in their everyday work for them to maximise on that opportunity and for the pharmacies. That is an extra stream really becoming an essential stream of revenue back into their pharmacy?

george grombacher 10:06
How long before it’s just robots?

Anna Hall 10:10
Oh, gosh, wow. You know, I think you’re always going to need the pharmacist, the pharmacist cognitive skills, the the one able there to talk to the patient about the medications. But you’re you’re not wrong, George, you’re not wrong. There are many functions in dispensing that a pharmacist has completed over the years that can be automated, that can be done by technicians. So it’s critical for pharmacists and pharmacists have been on a fight for what we call providers that is to be able to bill for their clinical work for years and years. But in April, kind of expanding on that initial, that initial requirement for MTM to be part of the Medicare Part D benefit. CMS kind of upped the ante they expanded MTM for 2025. So there’s gonna be in 2025, an entirely new population of patients that are eligible to receive the service for you to the patient reimbursed by the plan to pharmacists to complete it 2025 whole new population whole new revenue stream available for pharmacists. So it’s really critical for pharmacists to be using software like we provide and able to work into their everyday workflow where the dispensing stuff, you know, it can happen, it can be automated as much as possible, but that they still have this clinical stream of revenue there. And they’re spending their time working with patients and helping them optimize their medication regimens.

george grombacher 11:45
Yeah, what a big opportunity. And how are people receiving it? Just because it’s an opportunity doesn’t mean that they want to, or maybe most pharmacy pharmacists were lucky where they got into it to be able to have that interaction?

Anna Hall 11:58
Yeah, I mean, I’ve taught hundreds of students, George, and I can tell you right now, the students coming out of colleges of pharmacy and pharmacy schools, they are trained to do this. I mean, they spend hours learning how to work with patients, how to talk to patients, how to communicate with patients, and they’re ready for it. The model is there, the revenue is there, the opportunities are there. We have the largest network of engaged pharmacists, I think some of the biggest barriers that we’ve seen over the years and studied over the years are patients wanting to engage in that. I mean, they they haven’t, it wasn’t a thing in the past. You know, they have pharmacists was behind the counter, not always approachable, busy head down dispensing medications. Patients don’t necessarily realize they might call a pharmacist friend and ask them something but they don’t realize they can talk to their very own pharmacists there. Some patients see it as encroaching on their relationship with their doctor or afraid the pharmacist will say something to upset the doctor against what the doctor is saying. But you know whether a patient realizes it or not, pharmacists are working with doctors day in and day out looking out for those patients and the medications that they’re taking and making sure there’s no problem. So I’d say to patients, get to know your pharmacists, they’re the easiest provider you can access. Ask them a question anytime. And if you’re on Medicare, find out if you’re eligible, especially coming up in January of 2025. Many people will be eligible that weren’t before, find out if you’re eligible for the service and take, take them up on that once a year medication review if your plan if you’re someone eligible for that with your plan. And, you know, for pharmacist, I would say if you’re not engaged, let us help you get engaged, you know, reach out, if you’re not sure how to use the software, if you’re not sure how to work it into your workflow. Our model provides a streamlined process fairly easy to document and don’t be scared. I mean, we we can teach you how to how to do these how to do them efficiently, and how to do them in a way that you’re getting that clinical revenue so that you can support a hoarding staff to to do these clinical services.

george grombacher 14:20
So would you Is it easy to walk me through that actual process? If I’m the patient walking up to the counter, you’re the pharmacist. How does that? How does it go? How does your technology help?

Anna Hall 14:34
Yes, so if you’re a patient that is eligible for a medication review, when you come in to do that medication review, we’re gonna go over each one of your medications. We’re going to make sure we have a complete list of those you’re going to get a copy of that list at the end. This is one of the best parts of it for the patient. People love getting that consolidated list that they can have with them. that they can take to their doctor that they can write on if something changes and keep track of what’s going on and follow it on a daily basis when they’re taking their medications. And then we’re going to look for any drug therapy problems as what we call them or medication related problems, we’re gonna look and see is there, you know, and have a conversation with you, that’s the key of this medication review is it actually is required to be interactive, you know, we’re gonna find out how you’re feeling many people are on medications, and you know, they might be filling it. But the truth is, they may not be taking it because they’re worried about something, they’re, they’re not sure they think it makes them feel a certain way. I know my own mom had a medicine, she said, I’m not taking it anymore. It makes me cry every day at 1pm. You know, and I don’t know if that’s true or not but the truth, it’s her truth, whether that was really happening or not. She believed that was happening, and she wasn’t going to take that medication. So we needed to find something different. But you don’t you know, you don’t know those things. If you’re just picking up bottles, taking them by the labels, and no one’s having that conversation. So we’re going to go over a list of your medications, make sure you get a copy of that list, make sure we know how you’re taking them. And then answer any questions that you have. And then if we see anything that we think is a potential concern, or something we need to talk about, we’ll talk to you about that. And if it’s something we need to ask your doctor about, we’ll see if that’s something you want us to help you do many people really appreciate. Just having somebody that’s willing to help them communicate what they want their doctor to know, because they’re not always sure how to say that. In addition to your medication list, you get the patient gets out a takeaway that’s called a medication action plan. And any of those things we talked about, that you might not be able to remember after our conversation, we’ll document it there. So that you have that to take away and think about, and we can talk about it again next time, you know, that we get together on your medicines. So very simple. I think there’s like an 80 to 90% satisfaction rate. Once a patient engages, they really enjoy talking to their pharmacists, many people will say, you know, when can we do this again? So

george grombacher 17:14
I can see. Yeah, for sure. I can see, there’s probably a good chunk of people who are have a question, but they’re reticent because they don’t want to be a bother or whatever the case may be. And once they get the opportunity, hey, this is a time that I’ve allocated set aside to answer all of your questions public. Oh, you know what, there’s actually this thing. I’ve always been curious about that. So just giving them the opportunity to have that conversation is powerful.

Anna Hall 17:42
Yeah, do you? I mean, if you ever have a question about a medication or just wondering, is this really the right option? For me? It’s medication is so personalized. I mean, it’s so what works for one person, I’ve taken things that I’ve dispensed to people and thought of it as a fairly harmless drug and look down and my ankles were swollen up, like I let that be like, it just doesn’t work for me. And I never thought that I would have that problem with that medication. You know, it’s it’s very personal. And you’re the only person that knows how it’s impacting you. So. So being able to talk to someone and have that conversation and kind of figure out, okay, if this isn’t working, what might that’s really important.

george grombacher 18:27
And I’m confident from a compliance perspective and that patient’s information is private. When you do come up upon a case, like you mentioned, where your ankles swell up, is that information that can be shared with the drugmaker and the doctor, people consent to that? How does that work?

Anna Hall 18:51
Yeah, so when, when we’re talking about providing care under the HIPAA privacy laws for patients, one of the nice things about our model is it’s their personal pharmacist who, you know, is the provider for this farm for this patient, and works with them day in and day out and for them to communicate on behalf of the patient back to the patient’s doctor who is their health care provider, those things are allowed for under HIPAA. When it comes to manufacturers and clinical programs that support manufacturers, that’s a different story. When manufacturers want to support adherence programs or programs that help support take patients taking a therapy and staying on it and handling side effects or, you know, just knowing how it works. The manufacturers actually don’t get the luxury of knowing information back about that patient because they’re not a provider for that patient. So they’re typically supporting those and working with our pharmacies who have a right to be serving that patient and who already know what drugs they’re on. And providing support for those medications by having the pharmacy administer that program directly with their patient. So yeah, so in those cases, the direct patient information does not go back to the manufacturer. That’s

george grombacher 20:09
how it works. Oh, Anna, thank you so much for compliance

Anna Hall 20:13
around all of that. Yeah,

george grombacher 20:15
I can only imagine. I appreciate you coming on where can people learn more about you? How can they connect with outcomes? Operating Inc?

Anna Hall 20:23
Yeah, well, we have a website outcomes.com Pretty easy to find, we have a form on there. And if you’re a if you’re a pharmacist, if you’re a health plan, if you are a manufacturer, and you want to learn more, you can just fill that out, someone will be back in touch with you immediately. You can also find us on LinkedIn. You can find me on LinkedIn. I’m excited to work with anyone who’s interested in talking to us if you’re a pharmacist, not in our network. You gotta get in you got you’re missing. There’s money available for you, I’m sure of it. If you’re if you’ve got patients, I’m sure we have work available for you, and clinical intervention. So let us know we’ll get you we’ll get you set up.

george grombacher 21:04
Excellent. Well, if you enjoyed as much as I did, enter your appreciation and share today. share with a friend who also appreciates good ideas, go to outcomes.com check out everything that Anna has been working on and we’ve been talking about. You can find them on LinkedIn as well. If you are a pharmacist, get in touch to figure out if this is a program that you can be offering to your patients to get better results and outcomes. Thanks again, Anna. Thank you. Thanks,

Anna Hall 21:30
George.

george grombacher 21:31
Till next time, remember, do your part doing your best

george grombacher 16:00
So if I want my iPhone, and my Tesla and my Bitcoin to work, we need to get the metal out of the ground.

Pierre Leveille 16:07
Absolutely. Without it, we cannot do it.

george grombacher 16:13
Why? Why is there a Why has production been going down.

Pierre Leveille 16:21
Because the large mines that are producing most of the copper in the world, the grades are going down slowly they’re going there, they’re arriving near the end of life. So and of life of mines in general means less production. And in the past, at least 15 years, the exploration expenditure for copper were pretty low, because the price of copper was low. And when the price is low, companies are tending to not invest more so much in exploration, which is what we see today. It’s it’s, it’s not the way to look at it. Because nobody 15 years ago was able to predict that there would be a so massive shortage, or it’s so massive demand coming. But in the past five years, or let’s say since the since 10 years, we have seen that more and more coming. And then the by the time you react start exploring and there’s more money than then ever that is putting in put it in expression at the moment for copper at least. And what we see is that the it takes time, it could take up to 2025 years between the time you find a deposit that it gets in production. So but but the year the time is counted. So it’s it’s very important to so you will see company reopening old mines, what it will push also, which is not bad, it will force to two, it will force to find a it will force to find ways of recalibrating customer, you know the metals, that will be more and more important.

george grombacher 18:07
So finding, okay, so for lack of a better term recycling metals that are just sitting around somewhere extremely important. Yeah. And then going and going back to historic minds that maybe for lack of technology, or just lack of will or reasons, but maybe now because there’s such a demand, there’s an appetite to go back to those.

Pierre Leveille 18:33
Yes, but there will be a lot of failures into that for many reasons. But the ones that will be in that will resume mining it’s just going to be a short term temporary solution. No it’s it’s not going to be you need to find deposit that will that will operate 50 years you know at least it’s 25 to 50 years at least and an old mind that you do in production in general it’s less than 10 years.

george grombacher 19:03
Got it. Oh there we go. Up here. People are ready for your difference making tip What do you have for them

Pierre Leveille 19:14
You mean an investment or

george grombacher 19:17
whatever you’re into, you’ve got so much life experience with raising a family and doing business all over the world and having your kids go to school in Africa so a tip on copper or whatever you’re into.

Pierre Leveille 19:34
But there’s two things I like to see and I was telling my children many times and I always said you know don’t focus on what will bring you specifically money don’t think of Getting Rich. Think of doing what you what you like, what you feel your your your your your, you know you have been born to do so use your most you skills, do what you like, do what you wet well, and good things will happen to you. And I can see them grow in their life. And I can tell you that this is what happens. And sometimes you have setback like I had recently. But if we do things properly, if we do things that we like, and we liked that project, we were very passionate about that project, not only me, all my team, and if we do things properly, if we do things correctly, good things will happen. And we will probably get the project back had to go forward or we will find another big project that will be the launch of a new era. So that’s my most important tip in life. Do what you like, do it with your best scale and do it well and good things will happen.

george grombacher 20:49
Pierre Leveille 21:03
Thank you. I was happy to be with you to today.

george grombacher 21:06
Damn, tell us the websites and where where people can connect and find you.

Pierre Leveille 21:13
The it’s Deep South resources.com. So pretty simple.

george grombacher 21:18
Perfect. Well, if you enjoyed this as much as I did show up here your appreciation and share today’s show with a friend who also appreciate good ideas, go to deep south resources, calm and learn all about what they’re working on and track their progress.

Pierre Leveille 21:32
Thanks. Thanks, have a nice day.

george grombacher 21:36
And until next time, keep fighting the good fight. We’re all in this together.