When you think of a pharmacist, what comes to mind? Do you think of a person who dispenses your medication at a pharmacy and then sends you on your way? Or do you think of a person who can help you manage your treatment after you leave the pharmacy and act as a health advocate with other members of your healthcare team? Better yet, do you recognize your pharmacist as someone who can help you navigate pharmacy benefits, including suggesting less expensive alternatives and working with your doctors to make changes? And is this person a critical member of your care team? At Blue Shield, we believe that pharmacists and pharmacy technicians are uniquely qualified for all of these services. To help improve the value and experience of pharmacy care, Blue Shield is redesigning the pharmacy ecosystem into one that is affordable, equitable, and high-quality. We recently talked with Salina Wong, senior director of Clinical Pharmacy Programs, on the work she and her team are doing to reimagine pharmacy care for our members and the healthcare industry.
What first brought you to Blue Shield?
“My parents and I are immigrants. When we came to the U.S., my mom chose to get a white-collar job, which was hard for an immigrant, so that we could get good health insurance. She realized that was important with a growing family. Blue Shield was considered the best insurance you could get. So, it has always been part of my history in the U.S. to think of Blue Shield in a very positive light. When I was choosing between a position at Blue Shield and another health plan, Blue Shield was the natural choice.”
Could you walk us through Pharmacy Care Reimagined?
“Pharmacy Care Reimagined is our bold initiative to ensure every person has safe, equitable access to sustainably affordable prescription drugs. To achieve this, we are focusing on three pillars:
- Transforming the end-to-end prescription drug ecosystem
- Investing in personal, high-quality experiences
- Building powerful solutions with technology and data
In August, we announced a major milestone in this work, a new prescription drug supply chain model that will improve drug price transparency and lower costs. Drug costs are skyrocketing. When I first started my career, the most expensive medications on the market cost around $50 to $75 per prescription. By the time I started working at Blue Shield, the most expensive medications were around $200 to 300 per prescription. Today, there are medications that cost hundreds of thousands of dollars. And, in many cases, the reason why a drug is priced so high is not well explained by the manufacturer or related to other players in the ecosystem adding costs unrelated to drug therapy.
While tackling the high cost of drugs is critical to affordability, we are also working to make sure that healthcare dollars are paying for high-value services that improve health and wellness. We are investing in experience, quality, and technology initiatives so that members and providers have safe, convenient access to medications. For example, we are investing in technologies that improve drug cost transparency when it matters most – when a new prescription is being ordered or a current prescription is being renewed. We created pay-for-value initiatives so that pharmacists and pharmacist technicians practicing at the top of their license can help us reach our clinical quality improvement goals. We also created a Pharmacy Advocacy initiative where trained pharmacy technicians connect with providers and assist Medicare and Individual & Family Plan (IFP) members (the majority of whom are elderly and patients with disabilities and disease) whose drugs have changed due to annual formulary updates. We are committed to continually evaluating digital and physical ways to make our pharmacy benefits easier, more convenient, and accessible.
These are just some of the ways the Pharmacy Services team at Blue Shield is investing in bringing the Pharmacy Care Reimagined vision to life.
This is my 20th year at Blue Shield, and fortunately for us, our president and chief executive officer, Paul Markovich, is committed to making prescription drug care accessible and affordable for all. Not all leaders understand or recognize the importance of pharmacy care and how integral it is to whole person care the way Paul does, and he has championed this cause with passion. Pharmacy care is not going to change overnight, but I am proud that we have the leadership support to make a difference.”
Tell me about some recent team projects and accomplishments.
“When I think about accomplishments that are having a major impact, I think about how we have been able to continue to grow our drug cost transparency services to improve visibility about drug prices to our physicians, pharmacists, and now more recently, to members. In partnership with our Information Technology and Digital Experience teams, plus our vendor, Gemini Health, we implemented our price check tool, Price Check My Rx, for members, which is available online and for mobile.
When logged in as a member, you can go to the pharmacy page to see how much you will pay for a new or existing medication and any lower-cost alternatives. We created the tool to automatically show pricing and alternatives for existing prescriptions to give our members an 'aha' moment, since most people refill their medications and never think to ask if there are less expensive options. This allows them an opportunity to talk to their doctors and say, 'My financial situation has changed, and I really need to consider lower cost alternatives.' The tool gives members the opportunity to discuss any concerns with their doctor before going to the pharmacy, rather than finding out it is too expensive and/or not covered by insurance at the pharmacy. We have been told by one of our consultants that this tool is best-in-class, so I am very proud of that.
I am also particularly proud of the work my team has done in Pharmacy Care Reimagined to create a network of pharmacist providers and pharmacy care centers so that we can leverage pharmacy professionals working at the top of their license to support our quality and affordability goals at scale. With a shortage of primary care providers (PCPs), pharmacists can help manage and evaluate drug therapy to free up more time for PCPs to address other medical needs. Our network of pharmacist providers come together each year in our annual Blue Shield Pharmacy Council meeting to share best practices, solutions, and new ways that pharmacists are part of the healthcare team. At our recent meeting in September, they shared different ways that they are helping to address social needs of their patients to improve medication adherence. The annual Pharmacy Council meeting is highly rated among participants, and we routinely receive praise for being a great plan to work with, recognizing the value of pharmacists.”
What are some strategies you use to help support and empower your team, boost productivity, and achieve benchmarks and meaningful outcomes?
“I work hard to use feedback to help me become a better leader, and make sure I am paying attention to Blue Shield’s values and leading by them. I am not perfect, so having feedback is an important way to keep me accountable. Also, it is important to make sure that not only am I boosting team morale and making sure they are acknowledged for the good work they do, we also practice recognizing our own personal successes. When you do not acknowledge or recognize your own contributions to big and small successes, it can wear on your ability to be productive or stay motivated.
My team and I have also been working on answering the question, 'So what?' when it comes to the work we are doing. This is not always easy, but we need to make sure that we are engaged in high value work that drives quantifiable results towards our organization goals and for our members.
I also think fun is important. We do not have to throw parties, but infusing humor and light moments, acknowledging each other’s foibles, is a stress reliever and helps keep us connected to each other."
What advice would you give to a pharmacist or other professional whose goal is to join the Health Solutions team at Blue Shield?
“Put on your seatbelt, it is going to be a great ride. There is a lot to learn, and you will be contributing to health care in ways that you could have never imagined. I can say that even after almost 20 years, there is always something new that I am learning. My advice is to stay inquisitive, stay in a learning posture. Do not think that just because you are in a certain job or role, that is all you do. You can contribute in so many ways. Draw upon not only your professional learning, but your human, real-life learning, and bring that to work so that we can create a healthcare system that is truly worthy of our family and friends.”