AEE4: Co-pays, Contracts, and the 'Knives' That Are Out for PBMs, With John Gorman

John Gorman is founder and executive chairman at Gorman Health Group (GHG). In this role, he has led the development of the industry’s leading consulting practice and several entrepreneurial ventures in government health programs. John’s work focuses on Medicare, Medicaid, and Affordable Care Act strategy, governance, and turnaround of distressed health plans. Prior to founding the firm, John served as assistant to the director of Health Care Financing Administration’s Office of Managed Care, where he provided day-to-day management and served as the external liaison for the Medicare and Medicaid managed care programs. During the 1993 debate on national health care reform, John was chief lobbyist on health care financing issues for the National Association of Community Health Centers, an organization of federally funded primary care clinics for the medically underserved. John’s career in Washington began as press secretary and staff director for US Representative John Conyers, Jr (D-MI), then chairman of the Government Operations Committee.

00:19 How Pharma and suppliers to providers are being impacted by needing to produce outcomes. 00:31 Future huge sources of revenue for manufacturers. 00:37 Cutting out the PBM. 01:28 “They are basically rebate machines.”—John 02:23 “How far do you want to push the disruption of your biggest customers?”—Stacey 02:36 “All they’re going to have to do is wait a couple years.”—John 04:03 Getting away from rebates and into a different business model altogether. 05:13 “It’s not skin in the game, and it’s not a game—this is people’s health care.”—John 06:40 EP189 with Alex Jung of Ernst & Young.