S03E12: Doctor says, "Show Me Where It Hurts". Patient says: "In the PBM".

Cristy Gupton and Vinay Patel discuss the class action lawsuit against Johnson & Johnson and how their PBM made them vulnerable.

Show Notes

Vinay Patel, a pharmacist and founder of Mako-Rx, has dedicated himself to improving population health management and revolutionizing pharmacy benefits to enhance patient care. Throughout his career he has impacted the lives of thousands of patients, mentored hundreds of students in the medical field, and spearheaded innovative clinical and business projects. Patel's clinical expertise includes managing chronic care for over 2000 patients in primary care clinics, collaborating with multidisciplinary healthcare teams, and implementing initiatives to improve outcomes for pain management and diabetes patients.

In addition to his clinical background, Patel has demonstrated strong management skills, developing effective clinical operations strategies for managed Medicaid clients and initiating pharmacist-led programs to streamline hospital discharge medication reconciliation. He has a proven track record of collaborating with private and federally funded physician practices, saving significant physician hours and generating substantial revenue through innovative clinical programs. Passionate about teaching and continuous learning, Patel brings a wealth of knowledge and dedication to his work every day.

Healthcare professional and host, Cristy Gupton, interviews Vinay Patel about the Lewandowski vs. Johnson & Johnson case. They discuss the reasons for the case, the benefits of a Lewandowski outcome, and the possibilities that could revolutionize Direct Primary Care.

Learn more about the healthcare industry by following the Healthcare Solutions Podcast. Need healthcare consultation, benefits strategy and enrollment, or fiduciary training? Custom Benefits Solutions has your back.

To hear the first podcast Vinay & Cristy recorded together in 2019 go here — Part 1 and Part 2.

Timecodes

[00:00:00] Intro

[00:03:00] Who is Vinay Patel?

[00:07:15] The Fair Market Price for Rx

[00:10:50] How to Choose a PBM

[00:20:10] The Direct Primary Care Practice

[00:27:00] The Employer Control

[00:31:00] Closing

Vinay Patel

Our Guest

Vinay Patel is a pharmacist executive who has focused on population health management, community pharmacy operations, and creating a revolutionary pharmacy benefits company to improve multiple chronic care conditions for thousands of patients, enriched the lives of hundreds of students in the medical field, and infused his creativity to successfully execute innovative clinical/business projects.

Patel’s clinical background includes managing chronic care for over 2000+ patients face to face within many primary care clinics by integrating within a healthcare team with nurses, physicians, social workers, dietitians, and mid-level providers. He has worked with pain management patients to monitor chronic pain therapies and screen for drug abuse. He has worked with diabetes patients to improve an average A1c from 10.1 to 8.5 in an uncontrolled diabetes clinic that he had initiated. He has consulted on 1000s of medication issues in the geriatric population when he was integrated into a house-call medical practice.

His management experience includes engineering an effective clinical operations strategy to help a managed Medicaid client successfully meet Asthma HEDIS program measures. He has also initiated a pharmacist-led hospital discharge medication reconciliation program to effectively ally with primary care physicians in coordinating care for the highest risk patients. He has extensive experience collaborating with and understanding private and federally funded (FQHC) physician practices. He has developed innovative clinical programs that have saved 10000s of unnecessary physician hours and generated over $100,000 in revenue for practices.

Patel has a passion for teaching/learning both within and outside the classroom, he believes it is integral to his character and how he comes prepared to work everyday.

Cristy Gupton

Your Host

Cristy Gupton is an employee benefits advisor and President of Custom Benefits Solutions. Cristy has been part of the employee benefits industry since 1998 and has been named to Employee Benefits Advisor Magazine’s Top 20 Women in Benefits Advising in both 2018 and 2020. She holds a bachelor’s degree in Public Health from University of North Carolina at Chapel Hill and a master’s degree in Health Benefits Design and Health Informatics from University of Lynchburg. She holds the designation of Global Financial Steward from Wake Forest University’s Center for Board Certified Fiduciaries and seeks to help employers be the best fiduciaries they can be.

Cristy belongs to an elite group of benefits advisors called the Health Rosetta and another similar group called Mitigate Partners. Health Rosetta advisors commit to transparency in all their business endeavors, guiding and teaching employers and employees about health plan design and accessing the highest quality healthcare at the lowest possible cost. Cristy is a sought-after speaker on healthcare cost/quality issues and is a national thought-leader and expert on Direct Primary Care; specifically, how DPC doctors’ memberships can be embedded into employer-sponsored health plans, lowering costs, and improving the patient experience. Cristy has written articles for BenefitsPro Magazine and Physician Outlook Magazine. She leads the NC/SC Chapter of the Free Market Medical Association and the DisruptHR Asheville and Wilmington Chapters. Giving back to her community is important and she leads a den of Cub Scouts in Pack 199 and serves the Foothills District of the Boy Scouts of America as their membership chair.