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What The PBM Industry Should Focus On In 2025 | with Julie Wasserman
Apr 8, 2025
Julie Wasserman, VP of Sales for VerusRx, brings her extensive health benefits expertise to discuss the future focus of Pharmacy Benefit Managers (PBMs) in 2025. She emphasizes the importance of transparency to build trust with employers and encourages direct employee engagement through innovative software. The conversation explores the impact of GLP-1 medications on employer health plans, highlighting the need for careful cost management. Tune in for eye-opening insights on how PBMs can adapt to enhance healthcare affordability and outcomes.
01:17:49
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Quick takeaways
- Julie Wasserman emphasizes that true transparency in the PBM industry is achieved by understanding how they are compensated, fostering trust with employers.
- The podcast highlights the importance of aligning financial incentives in PBM structures to prioritize members' healthcare interests over profit margins.
Deep dives
The Evolution of Claims and Healthcare Costs
The podcast discusses how the landscape of healthcare claims has significantly evolved, particularly since the implementation of the Affordable Care Act (ACA). It highlights that having a million-dollar claim, once considered rare, has become common, attributed to the removal of lifetime and annual maximums on claims. This legal change has led to hospitals being capable of charging higher amounts, as there are no longer limitations on claims. The conversation raises questions about the implications of this, including the rising trend in costs and the factors contributing to it, such as advances in gene therapy and inflation.
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