PBM Reform - What's Changed? What Hasn't? | Doug Hoey, National Community Pharmacists Association

Transcript Disclaimer: This transcript is generated using speech-to-text technology and may contain errors or inaccuracies.

Mike Koelzer, Host: [00:15:00] Doug, for those that haven't come across you online, introduce yourself and tell our listeners what we're talking about today.

Doug Hoey: I'm Douglas Hoey. I'm the CEO for the National Community Pharmacist Association NCPA. We represent, of course, independent pharmacy owners across the country, almost 20,000 pharmacies across the country. And today we're talking about the upcoming N C P A annual meeting. Which is October the 14th through the 17th in Orlando.

And it's really an interesting time for the meeting because of so many changes taking place in community pharmacy, both in the chain world and of course in independent pharmacy and throughout the profession. 

Mike Koelzer, Host: I know you enjoy the conventions. D do you get a lot more work on your plate leading up to that? I know you have long days anyways, 

Does it fill it up beforehand or is it business as usual?

Doug Hoey: Oh no, it definitely fills it up. But one thing and I don't have to say this, but I wanna say it is I have a great [00:16:00] team yeah, it's busy for me, but the team that puts it together from the logistics to the education programs, I mean there's the exhibit hall. I mean that those folks are the ones who are really, Really putting in the sweat.

If you've ever pulled a meeting together of any size, whether it be for the, for the local Pta or the Lions Club you can appreciate how many unseen details go into a meeting for a hundred people.

This is for. 2000, 2,500 people. So you can just imagine all the logistics and details. And our team does a fantastic job of pulling all that together.

Mike Koelzer, Host: Last year I think it was when Lena Kahn, FTC Chairperson, came on the stage. That's right.

Thinking back, Doug, when you talked to her a year ago, I know things run really slowly in Washington. A year later. Now, was it more than expected? Was it less than expected

Doug Hoey: So it was amazing to have the chair of the Federal [00:17:00] Trade Commission come to an independent pharmacy meeting, and the Federal Trade Commission has not been a friend of pharmacy for.

Three decades, four decades, as long as I can remember. So to have the F t C chair fly halfway across the country for a, what, 30, 40, 40 minute interview to accept that invitation from us was pretty amazing.

 so we were thrilled to have her. I had people tell me afterwards that they actually had tears in their eyes to hear her job is to protect competition. And consumers. And so it's not like she has some special affection for independent pharmacy. She has a special affection for protecting competition, and she's seen what PBMs have done to competition in the pharmacy space.

And that's to hear a powerful government official acknowledge the one-sidedness of the relationship between PBMs and pharmacies, and the harm to consumers and the harm to business. That's what really a few people [00:18:00] emotional in the

audience. But to your question, as far as progress over the last year, 

I would say I'm always expecting more. I am doing the six B study, that's the FTC study of PBMs that was announced about 15, 16 months ago, and we knew when that came out that those types of studies take two or three years. That said, I wanna see the results tomorrow. Or yesterday. So those aren't out yet.

And we understand, we've heard through the grapevine, we don't have this officially, that the, not surprisingly, the PBMs are dragging their feet and making it as difficult as possible for the F T C to get the documents they, they need, that no one's, that's not official. That's just scuttlebutt, but not 

Mike Koelzer, Host: of course. 

Doug Hoey: A thing that has happened in the last year is just recently the F T C voted unanimously to disavow previous F T C statements supporting PBMs. And so even though we don't have the results [00:19:00] of the study yet, that's a big deal. I can tell you there's a study on that. The F T C did a report, the F T C report did.

In 2005 or six that just said PBMs are wonderful and there's no conflict of interest between a P B M owned mail order pharmacy, which of course is ludicrous. But that's what the F T C came out with 17, 18 years ago, and that, that study's been. CI cited by PBMs for, 

15 years.

Even though it's now, some kids have graduated from high school since that report came out, and this pulls the carpet out from under, that type of funny business from the PBMs. So FTCs still have independent pharmacies on the radar and we just want 'em to pedal faster.

Mike Koelzer, Host: Talking about the Federal Trade Commission. They released updated merger guidelines. When I see that, I'm thinking, great. Because vertical integration is what's really screwing pharmacy, it seems, is that some of the [00:20:00] stuff they're touching on almost in a separate update here.

Doug Hoey: Yeah, that it certainly relates to healthcare, but it's not just limited to healthcare. So the merger guidelines certainly go way beyond healthcare technology companies. That's a specialty of Chair Khan. So those merger guidelines are gonna get attention from all kinds of business interest groups.

And consumer groups too, Mike. I think we're seeing, just talking about healthcare, which is the space that we know best Pharmacy best of all for sure is the vertical integration in healthcare. Just in casual conversations I have, whether it be with family or friends, outside my pharmacy bubble, the frustration people are having with vertically integrated healthcare, where they're confined their doctors are.

Are basically handcuffed because they're now part of a system that doesn't allow them to do this or that. And so these merger guidelines, they're gonna again, attract a lot of attention. Big business [00:21:00] is gonna go nuts, probably saying they're terrible. We've taken a look at 'em. We'll obviously comment on them.

We have commented on them as they were being prepared. And I was talking with our general counsel this morning and we're overall pretty happy with the draft that the commission has come out with.

Mike Koelzer, Host: I was talking to a guest recently and. They were saying that some of these PBMs make so much money in pharmacies that they're then able to have, like a loss leader, some of their medical procedures, just like selling milk as a loss leader. And it really skews the competition when they're going to price something for a broker that will bring it to a corporation.

 When you've got different ways to make money in that vertical integration, it can really. Make others look bad 

Doug Hoey: there's a reason why Cigna paid almost $70 billion for Express Scripts a few years ago. They didn't do it because they [00:22:00] were a nonprofit charity. They did it because they're making big bucks and they saw that they can, shift.

Funds from one pocket to the other, just like c v s Aetna does and United Optum. But that just because you're shifting money from one pocket to another doesn't mean you're lowering costs. In fact, you're probably increasing costs. So these merger guidelines, again they're going to I'm sure the US Chamber of Commerce will be going ballistic and saying they're horrible and gonna increase costs.

That's the line that PBMs use all the time. But something needs to be done, just again, taking my pharmacy hat off. I think just as a consumer, 'cause I think the vertical integration in healthcare is bad for patients and it's bad for taxpayers.

Mike Koelzer, Host: So Doug, on PBMs we've certainly talked in the past about all their tricks they're up to and so on, and I'm always thinking that when you've got the. [00:23:00] Stakeholders and stockholders in these companies. They want a return year after year, which means that the PBMs get more aggressive and sneakier and all that kinds of stuff.

I'm just gonna go out on a limb and say there hasn't been much change in the desire or the attempts for the PBMs to be Those things I mentioned you know, sneaky and opaque and all that kind of stuff. I'm assuming there's been no difference in what they've been trying to do.

Doug Hoey: Yes is the short answer. Some would point to Express Scripts and United Optum coming out. This, early summer, late spring. With programs that ostensibly would be supportive for independent pharmacy, or at least that's what their announcements said, that, Hey, we're gonna form an independent pharmacy advisory group.

We're gonna do this for rural pharmacies. As long as [00:24:00] they don't have a P S A O, we will play ball with them. n CPA's reaction to that is, has been, actions will speak louder than words. And we found it interesting that these announcements of this independent pharmacy, quote unquote love from these PBMs that have been pretty malicious to independent pharmacies for decades, came at a time when the pressure on PBMs has never been higher.

PBM reform movement has never been stronger. At the same time, you gotta start somewhere, but we remain very, I'm suspicious. We'll believe it when we see it. Frankly, I'd love to be proven wrong. I'd love for the PBMs to come out and actually have a bonafide business relationship with independent pharmacies versus the take it or leave it, shove it down your throat contracts that they've been using for the last 30 years.

But yeah I'll believe it when I see it.

 So business as usual for them, although other things we're seeing in the market, [00:25:00] the recent announcement from Blue Shield of California where they're dropping C V Ss health for everything but specialty that has had some ripple effects. I did find it interesting that they kept C V Ss specialty, 

which is, the majority of.

Pharmacy revenue, prescription drug revenue is in specialty. So I wonder if back could, womb socket how upset they were hey we still have our specialty but I think they were upset 'cause their stock fell,

Mike Koelzer, Host: 

A good dip.

Doug Hoey: yeah. Yeah. And I, so I think it could be the first shot across the bow if employers begin to seek alternatives, To PBMs.

 Mike, one thing you mentioned a few minutes ago brokers and of course I'm sure this caught brokers attention. They're the other middleman that we don't talk about nearly as much, but I think, [00:26:00] they're, they are almost as much of a problem as the PBMs, these brokers that come in and recommend to employers.

Surprise, surprise time and time again. The big three PBMs over and over again. There was a recent expose on the brokers that just in the last few months that I thought was very interesting and maybe, sunlight's the best disinfectant. And so we've seen that with PBMs. My hope would be we're gonna start to see some of that sunlight on the brokers.

Because they also need reform in order to get the lowest cost for patients and the best care for patients there, there needs to be reform of those middle men as well.

Mike Koelzer, Host: C v s might be enjoying that, of not dealing with the 

98% of the claims that don't have profit compared to the 2% of specialty that has like over 50% of the market or something like that. However, what you're saying, Doug, I think that [00:27:00] people just read headlines and so if corporate leaders can see that, at least it piques their interest to say, what's going on here?

Doug Hoey: Yeah. I think that one of the biggest reasons for the momentum is just a lot of people, whether it be in the business community, whether it be in the regulatory, the legislative committee communities, and somewhat in the media. PBMs and PBMs are raising costs.

And I think to your point, if you're an employer, you don't know all the ins and outs. You certainly don't know the details, but you're reliant, you're thinking, I don't really know what's going on with my P B M, but I'm hearing all this, all these stories about it. My broker always tells me to use, fill in the blank with one of the big three.

Maybe I should question my broker.

And so to have the one two punch of, we need more stories, like the story from it was an investigation by a publication called [00:28:00] stat. We need more information, more stories like that so that when employers are saying, yeah, maybe my PBMs are not actually looking out for me, they don't have a fiduciary responsibility to look out for me.

Maybe I should check out my broker too.

And there's also some efforts to not do away with brokers, but use an independent broker that does have a fiduciary responsibility. That, so there's some movement afoot that way too.

Mike Koelzer, Host: It'll take a little bit of time, but it's Carvana that's trying to do away with the. Sales rep and on and on and I think it's a trend that certainly brokers have to look out for. Alright, Doug, one of the guys on my team is all excited about 2024 with new d i r directives coming down from the state of Michigan, so on, and my comment to him is, don't hold your breath.

I think it helps some because then when you're trying to explain something to a legislator in Michigan, a year from now, instead of them having to understand eight [00:29:00] different levels of this puzzle, maybe it's down to three or something like that, they can understand it more. So that would be the good part about it.

And possibly some changes, but with our brothers and sisters that are still doing brand names, which we're not anymore at our pharmacy, but those doing brand names, they've got a little bit of a potential cash flow issue coming up. 

Doug Hoey: we've dubbed it just unofficially the d i r hangover, other people, just to call it d i r, mageddon. There's others, but this is a situation that pharmacies are looking at first, mostly. First quarter, even the first half of the year of

2024, where d i r will come due.

The d i r from the last quarter of 2023 will come due in the first quarter, first half of 2024. At the same time, the lower reimbursement rates for Medicare will kick in starting January [00:30:00] 1st, 2024. So you have a potential one-two punch. It's hopefully not net lower reimbursement, but that reimbursement in 2024 is, there's no d i r.

So it will look upfront lower, but it's actually more true to what you're actually getting paid. But at the same time, you've got this bill coming in, we've been out there for months and months. We've had webinars, we do the education programming at two of the three big wholesalers and we've certainly had programs just encouraging.

Advising members, having the Sykes family, come in and talk about from an accounting standpoint, from a financial standpoint steps to make. And I know the wholesalers have been doing some of the same sounding, the alarm of putting a little money aside, sometimes more than a little money aside.

And it's actually one of the programs we'll have at the convention and in October is to. Help people prepare for this d i r hangover.[00:31:00] It's something everyone needs to have on their mind, but it's going to impact some people more than others. Those who have a lot of c v s Caremark Aetna business, they're probably gonna be impacted the most because Aetna c v s is the poster child for d i r fees.

They're by far the worst offender. Not that the other two aren't. Aren't bad but c v s is the worst, at least from what I hear from our membership. So if you have a huge book of business, and of course, they're part of that oligopoly. So there's a lot of our members who have a lot of Aetna c v s business tho those are the people who are some of the most vulnerable going into 2024.

So hopefully they're they've already started to make Preparations, hopefully they're gonna come to the annual meeting to hear more, hear from experts on what to do. And you get through the first half of 2024 and, I think that could be some choppy seas. But after that, I don't know if there's ever smooth sailing in pharmacy but certainly fewer tidal waves [00:32:00] to upset the ship after that first six months.

Mike Koelzer, Host: Doug, we both agree that action is better than words. What action have we seen from.

Congress in the last year. Have we seen anything from them? Something we can hold onto.

Doug Hoey: We've seen an amazing amount of action. From Congress. Now, when we say action, I guess we need to define it that it's one thing to introduce legislation. It's a whole nother thing to pass legislation. But there's been more P B M or reform bills that have been introduced in the last nine months, then probably in the previous nine years.

It's been overwhelming. It's been gratifying to see. Because it's something n CPA's been working on for a couple decades and others have joined us along the way and we've appreciated them. Coming along and following our lead there are at least a couple of bills, so P B M reform is important.

We all wanna see P B M reform [00:33:00] 'cause it's better for patients, but we also need reform that's gonna result in predictable results. Reimbursement we need reform that's gonna result in better reimbursement for pharmacies so we can continue to take care of patients. And there, there's legislation in the house and legislation in the Senate that would reform Medicaid.

So in Medicaid it would be a naac plus a dispensing fee determined by the state. And those states that have already passed those individual states that have already passed. Similar state legislation. Those dispensing fees have generally been in the nine to $12 per prescription range, which when I ask my members about that, they say, if I'm getting $12 I can probably, cover my overhead and maybe, have, a couple shekels at the end for the risk that I take as a business owner.

So that's Medicaid . That could be big. Medicaid makes up on the average 18% of the [00:34:00] average independent pharmacies business almost 20%. Some a lot more, some a little less. The other one is Medicare reform, which is the even bigger fish 'cause that's 30 on average, 36% of the average independence business is Medicare.

And there's legislation that would do something similar where it would require that pharmacies be paid at least their cost. And the cost to dispense the prescription. So both of those, there's also some legislation that would improve the quality metrics, which desperately need to be overhauled so that true quality is being paid for versus, quality that is dependent on the doctor changing the prescription that the pharmacist has virtually no control over.

So there's some good. Substantive legislative legislation that could really help pharmacies to be able to be around, to continue to take care of, [00:35:00] constituents.

Mike Koelzer, Host: More so than if we were talking five years ago.

Doug Hoey: A hundred percent. hundred percent.

Mike Koelzer, Host: I know we have to give credit to the N C P A, I'm gonna say social media. I'm gonna say the F T C. did I miss?

Doug Hoey: I think we need to give some dubious credit to the PBMs for just continuing to get more greedy and more outrageous with their behavior that it's impossible to ignore., some people, want to v vilify the pharma companies and, they are not lily white with some of the prices they charge, but they produce something.

They produce lifesaving drugs. Covid vaccinations hepatitis C, practically a cure. On oncologic drugs. Thank God we've got such innovation. In that area. And in the last five years, maybe seven, eight years, that you wash my hand, all wash yours Relationship [00:36:00] between some of the pharma companies and PBMs has gone sour.

And so I think the pharma companies saying PBMs are not a good partner. In fact they're, they're a leach. I think that's also been an eye-opener for the public to have. Some of these incredibly important companies saying this, PBMs are bad. But that, that it has been gratifying because it's been N CPA's broken record message for decades that P B M reform is desperately

needed. 

Mike Koelzer, Host: Doug, I was talking to a guest a week or two ago and we were talking about the value in state legislation of just going and showing up at the capitol and maybe knocking on your legislator's door, and it might be that they live.

Six miles from you in town or something like that. And I was saying that has to be different on a national stage. And he brought up the fly in what is the fly in?[00:37:00] 

Doug Hoey: The fly-in is in CPA's, congressional fly-in or legislative fly-in that we have every year. It's in April almost every year. We understand how busy people are. So we've truncated it. So it's basically about 36 hours, 48 hours, where we get as many pharmacists and pharmacy owners as possible to come into the capitol to, to dc and we help schedule visits.

So we make it as seamless as possible to get in, talk with your legislator and tell 'em what's going on in your business. And, the legislator cares about it. They may or may not care about you as a small business owner, but they care about the patients that you serve. And so if you're able to tell a story about how you've been able to, because you exist, you've been able to help their constituents, your patients live longer, have a more productive life, those stories are what really resonate with legislators.

And, Mike, that's. Maybe the biggest reason why we're seeing some of the P B M [00:38:00] reform is because of the groundswell of messaging from mostly independent pharmacy owners about their patients and about how PBMs are harming them. And that has to continue . Even if Medicaid reform, even if Medicare reform is passed, pharmacy owners have to continue to tell the story about how PBMs are impacting them.

But that may be the single biggest difference. 

The first N C P A fly in was in 1968. So aside from a couple of, COVID interrupted years, I think we were probably the first pharmacy group to have these fly-ins all, 56 years ago, 57 years ago.

We encourage people we can never have enough people come to that meeting. So the more the merrier, and again, it's in April. In between, as I mentioned, we have our annual meeting in Orlando. And in addition to all the legislative work that N C P A does, we're also helping [00:39:00] pharmacy owners set the table for other ways to make revenue, additional ways to make revenue not besides, but in addition to the dispensing.

I know one of the programs we're gonna have, it's a pre-program. I think it starts a couple days, two or three days before the meeting starts. It is called Pharmacy Inside Out.

And I'm really excited about this one because it's got a group of the folks talking, the folks presenting at this meeting.

Most of them are pharmacy owners. If they're not pharmacy owners, they're working every day with pharmacy owners and they each have their own kind of specialty that they do. Amina Abba as one example, she's gonna be one of the speakers. And Amina, if you, if the listeners don't know her, she's in North Carolina.

She's an amazing pharmacy operator. Her and her team have traditional pharmacy but they also do one of the things they do, one of the many things, [00:40:00] they go into the partnership with the physician's office and they'll help the physician with some of their quality metrics. Things that pharmacists can do are trained well to do and help that physician recapture quality dollars.

And they'll share that with the pharmacy. She's gonna be one of the speakers. Jen Palazzo from Colorado does a lot of compounding, but also just, a great speaker. Very candid. Ben Jolly Ben's in Utah. He and his dad have a pharmacy out there.

Ben's this analytical guru.

You want to talk about an analytical mind. You talk to Ben Jolly. And that's really important. it's more important than ever. If you don't, if you're not doing analytics on your book of business, you're probably not, probably you're leaving money on the table.

You're, they're, you're leaving money behind the PBMs or laughing all the way to the bank for those pharmacies that aren't doing the type of analytics that are required. But anyway, it's gonna be this all star cast of speakers. [00:41:00] And so that's I think for pharmacies who go through that, it's gonna be.

For some of 'em, I think it'll be an eye-opening, life changing event. I guess I'm not really hyperbolic, but I think it might be life changing for some of 'em.

Mike Koelzer, Host: And the cool thing these days too is once you kinda latch onto somebody, you latch onto Benjamin or someone , and. Just like that. You can go back and read 10 of his blog posts and follow him in the future and this and that. So it's cool to latch onto somebody where in the past you saw their name on the flier and that that was about the end of it.

Doug Hoey: It's one thing to hear 'em on a podcast, and I think that the podcasts are very helpful to read something on paper. To hear someone's voice behind it, I think adds a lot of power to it. And I think the next level up from that is to be able to see that person, see that, that speaker in person.

So you're seeing the written word, you've heard the verbal words, and now you can see them in person, maybe even ask 'em a question or two afterwards. [00:42:00] But that's, one of the programs we've got something on pharmacogenetics pharmacogenetics have been around for a while, but this is application again from Amina and her team on, where they're actually doing pharmacogenetics, partnering with physicians, applying it in the real world.

There's a program on co-locating other health professionals, a doctor in your pharmacy. This is something C P SS n is involved with. And so that, that. Those kind of partnerships have been around for a while, but here's something very structured and organized at a time when there's a greater need for primary care and 

primary care 

access Than ever.

So we've got some really cool stuff for pharmacy owners who understand that, dispensing only. It is gonna be a tough road. Hopefully a little bit better with some, some reform to Medicaid and Medicare. But getting into these niches, for those who haven't already done that [00:43:00] that's going to be their pathway to future success.

 As I mentioned, the team puts this together. They run it by me a little bit. I have a little bit of input to it. But mostly they're putting it together and I get, unless it's just something that I 

say absolutely no, which is almost never I get excited, when they come in and tell me about some of the different programs that we're gonna be able to share with pharmacy owners, because I get excited for what it can do for pharmacy 

owners, 

That's what excites me.

Mike Koelzer, Host: And the thing about Amina, I these aren't theories. And then somebody who's trying to coach, she's really into this, with all of her new buildings and all that stuff, and it's really going.

Doug Hoey: That's one of the things I would kill something that was an ivory tower. That is something as my 20 plus years at N C P A when I came in I saw other places where Ivory Tower was the law building and that's, 

I can't stand that. That drives me insane. I, it's gotta be practical.

I want real [00:44:00] people doing real things in real pharmacies and the team is doing a really good job of finding those real people and putting it together and speaking in real language too. So it's not some, idiopathic methemoglobinemia stuff that we all got in pharmacy school, super important.

I'm sure in some research lab it doesn't really.

Make that much of a difference, eyeball to eyeball with a patient. 

Mike Koelzer, Host: Doug, you're very methodical in your position here, and you guys march forward with your tasks and that, and this question I'm gonna ask you is not the way you should manage, but I just have to ask you what in the last year or so, really pissed you off?

And I'm not talking about the bigger pisser offers, like the PBS and all that kind of stuff, but what's something that just. Really got under your skin in the pharmacy world.

Doug Hoey: Now that's a [00:45:00] dangerous question to ask. I know one thing that really got under my skin and I know that we've made a lot of efforts to clarified,

The government came out with a program, they announced a program a few months ago for covid for people who are under or uninsured for with 

covid. And the announcement and the reports in the media said that the government was partnering with large chains like Cvs and Walgreens. And, I'm thinking, hello, independent pharmacies we're here to help save America with our covid vaccinations. And in following up with them, to be fair we clarified that when they said chain pharmacies, that all along they were including independent pharmacies.

And sometimes when they talk about groups of pharmacies, like in a P S A O, Because that P S A O has single signature [00:46:00] authority. They call that a chain. But the examples were C V SS and Walgreens along with chains. So that's what got my blood pressure up. So momentarily yes, my blood pressure if I'd had a beta blocker to pop, I would've done so.

 But again, for any government officials we appreciate the clarification that came after. That independence will be included and are included as well in this bridge program for the under and uninsured. But we get pretty sensitive over here at N C P A when chains are mentioned and not independence because of the important role that independents play, the C M Ss secretary of Health and Human Services.

He's been going around the country to talk about the Inflation Reduction Act, and he's been going to independent pharmacies and, we've helped some with identifying the independent pharmacies. So he wants to showcase the government programs at independent pharmacies.

So it just seems logical to [00:47:00] us when there are government programs that independent pharmacies would naturally be included and usually they are, but every once in a while, That gets missed and that gets our dander up 

Mike Koelzer, Host: Part of that in. Letting people see independence. I know that N C P A, you put your time where your mouth is and you've got the show me series, right?

When you're actually there, you're getting people to know about independence and so on, and so that's what's needed. I think that flesh and blood stories.

Doug Hoey: Yeah, the show me series is some short videos that are online and you can go to, you do N C P A show me, and they'll pop up. But they're real pharmacies where we send a camera crew in. They're a little bit like, restaurant impossible or bar rescue.

 They're meant to be fun.

There are business tips in them and clinical tips in them that come along, but they're [00:48:00] done. So in the course of a real pharmacy owner talking to their real pharmacy technicians and real pharmacists interviewing them the first show me series is focused on immunizations.

There's some interesting billing tips, there's some interesting tips around travel vaccines, some interesting marketing tips. It's farm attainment Where it's meant to be. Interesting, and that's also how we try to do the programming at the annual meeting as well.

 One thing, Mike, I'm interested to see is our keynote speakers this year. One guy is named Peter Lovett and he's a, this British cognitive psychologist

I've heard amazing things about him. I've not met him personally, not quite yet, but. He's someone who believes in the importance of movement and the therapy of movement.

So I think I, and I don't know this, but I think he's gonna be, have people out of their seats at the program and

 It's certainly [00:49:00] not Lena Khan but I think people will be interested in that. And then the other speaker's, a guy named Marty McCarey, who's a physician. And I know one of my teammates recommended him to me, so I listened to his book.

And his book on healthcare reform and how we need to fix healthcare. He's a physician at Johns Hopkins and he had a whole chapter on PBMs and pharmacies and interviewed some of our pharmacy peeps that we've known for years. So excited to have the keynote speakers as well.

And last but not least, I'll leave a little teaser that I can't say much about, but we're hoping to have a. A special announcement at the convention as well. And that's about all I can say about that. But so maybe a few surprises that we can unveil at the annual meeting

this year in Orlando.

I 

Mike Koelzer, Host: Well, you're right on target. Doug, with the physicians and stuff. Because for this to work, for pharmacy to work and be part of this, that team's gotta grow. It not only has to be important in our eyes, but we gotta show bigger movement [00:50:00] than just pharmacy itself.

Doug Hoey: And, you know, and pharmacists because of the shortage of primary care and the desperate need for primary care in our country, pharmacists can, can help fill those gaps because we're trained for it. We're not gonna diagnose patients., that's not our expertise, but, We can certainly support the diagnosis that's been done by physicians and primary care providers 

and do that, you know, as patients come into our pharmacies 10, 20, 30 times a

year. And how do we get paid for that? How do we get part of what CPA's interest is, is and and, and also what we'll be talking about at the annual, in October. 

Mike Koelzer, Host: Sounds like you have a lot to do with this convention coming up, so you better get back to work.

Doug Hoey: Yeah. No, I appreciate the time to talk, Mike. I hope it did for you and for our listeners as well. Huge Chancey, our president from Georgia. We were in Florida. months ago and had a chance to visit pharmacies and, and, um, great to see pharmacies on their home turf. And we're hoping that there's a, you know, a, a [00:51:00] lot of folks that come into Orlando to come to the meeting. It's October the 14th through the 17th. you can register online and, um, get your hotel reserved before they run out. But, uh, we're looking for a big crowd and people who come, they're 

gonna, they're gonna benefit a 

a lot from it. 

Mike Koelzer, Host: Well, Doug, you have a busy schedule, a lot of people you could be talking to, so I appreciate you spending some time with us and, keep doing what you're 

Doug Hoey: Mike, appreciate it and look forward to talking again.