Pharmacy in Clinically Integrated Care with Debi Hueter

Debi Hueter 0:00

Clinically integrated networks really allows primary care physicians and specialists to work together collaboratively work at the top of their license and try to manage most everything for that patient. And I think patients really appreciate that so that they're not jumping from specialist to specialist with a co-pay, with a deductible and and all that, these primary care physicians are, like I said before, hardwired to really manage their patients as best they can.

Narration 0:36

Welcome to the Move to Value Podcast. In today’s episode, where we’re diving into the power of clinically integrated networks — and how they’re transforming patient care. We’re continuing the conversation between Debi Hueter of WakeMed Key Community Care and Rebecca Grandy from CHESS Health Solutions about how collaboration between primary care physicians, specialists, and pharmacy partners helps providers work at the top of their license. Together, they share insights on building trust, supporting independent practices, and keeping patients at the center of every decision.

Rebecca Grandy 1:10

Definitely. So I'm going to ask you to give some more advice. So for folks who are listening, who are considering a partnership with pharmacy as far as part of their ACO or CIN, what kind of advice would you have for them about where they should start, what they should prioritize, just any kind of next steps you would have for them?

Debi Hueter 1:27

Yeah.

Yeah, I've talked to a lot of, a lot of other ACOs around the country about this because typically they ACOs are are owned by the hospital system and so they have access to pharmacy and things like that, but, which is great, but it can, it can really stifle I think independent providers and and and things like that. So I think that by partnering with an outside company you really are getting the benefit of somebody who looks at all patients and all providers within the ACO and not just the hospital based pharmacy that looks at maybe the employed physicians pharmacy and and so what I would say first is what are your goals? What is your vision for for pharmacy? What do you want to accomplish? Is it just a stars rating? Is it better patient satisfaction? Is it provider satisfaction? And then look for the company that you feel matches your mission and vision and and maybe that is a sales company, maybe that is you know a another type of company that we looked for, but it's got to fit your model and it's got to fit your mission and vision and and a company that you feel comfortable working with.

Rebecca Grandy 3:03

I would agree with all that. And one thing I will say, you know, CHESS has been around for over 12 years now and I've been fortunate enough to be here for a few of those years. But they've really tried to make team-based care accessible, you know, to independent providers, to rural providers. And so I'm, I'm glad that that's, you know, showing through in the work that we do. So reflecting back then, what's the most valuable lesson that you've learned from implementing pharmacy-driven initiatives at WKCC?

Debi Hueter 3:32

I think the most valuable lesson that we learned and that we were hoping to learn was that patients come first, patients and providers come first. And again, whatever we can do to support our providers when it comes to great patient care and whatever we can do to support our patients. To make sure that they're getting everything they need. That's has been the most valuable lesson, which I I suspected we would have, but I I'm happy to say that the the lesson has been taught so well and learned so well that that's really our our our basis and and and why we implemented this program because we really felt like there was a need. We felt like there was a a hole kind of in what we offer and so that's why we that's why we did this.

Rebecca Grandy 4:31

Well, now I'm going to ask you to get out your magic ball. Or maybe, maybe it's actually your wand, your magic wand. So we did. Yeah, I'll give you your magic wand. So when you think about WKCC. Your ability to improve patient care, to to support providers even more than you're already doing. What would you prioritize? It could be pharmacy related or not, but you have a magic wand and you can advance patient care. You can support your providers. What would that look like? What would you wish for?

Debi Hueter 5:04

Well, I think some of the initiatives that we have coming down the Pike, I you know with you the pre-authorization pilot that we have going on. I think that I've heard so many practices say gosh, you know if someone could do a pre-authorization for for pharmaceuticals. Then that would be so helpful and we've got that going on and that's been very successful. You know, the other things in an in an accountable care organization that we look for are who else can we partner with? How can we do things better? What other ways can we support our providers? And so we're looking at things like like risk coding and HCC methodology and things like that. We've got a, we've got a great data platform with Arcadia, it's it's a really strong platform. And so I think that you know if you look at where we're going in the future, it's going to be better, even more better support for our providers, true programs that can offload some of the things that their practices are doing now and then also looking at growing, I mean you know obviously everybody wants to grow and so we're looking at growing also because we feel like what we have to offer providers is different than other CINs and ACOs, that we are a more hands-on kind of as you said, team-based care with a with a care management team, a pop health team and a data team that is right there to make sure that you have everything that you need. And so you know, priority wise, everything is a priority. Of course, especially with physicians, everybody, you know, they all want it now. But I would say that, you know, looking at ways that we can better support them and and continue to have them be successful is is the best priority we can do.

Rebecca Grandy 7:08

And I will say, you know, as our our collaboration on prior authorizations for medications, I mean that's really thinking outside the box on how can you support providers in a way that's not traditional of an ACO or a CIN. So yes, people have been so appreciative of that because the administrative burden is terrible. Well, Debbie, I have a few rapid-fire questions for you, but before I get to those, anything else that you would want to share with listeners or any other kind of advice about being in the space that you would want people to know?

Debi Hueter 7:39

I I say this to my peers, I say this to my friends and to people that I talk to all the time and that is healthcare is changing and and some of it is very good and some of it is is is tough and challenging. And but the most important thing to remember about healthcare is that your physicians are here to take care of you, take good care of you. You know, it's the old saying of no doctor ever woke up thinking he was going to kill somebody today and that's that always sticks with me. But you know, physicians are in tough situations right now, both from a financial perspective and a just a burnout perspective even from COVID. And so it's it's hard. I know people get frustrated when they it, you know when. They can't see a provider tomorrow and it takes a couple months to get in to see a specialist and things like that. But you know, it's unfortunately the way of the world now and I know everybody's trying to work on that, but healthcare is is changing and it's ever evolving. And like I said, some things are great and some things will always be a challenge.

Rebecca Grandy 8:56

Well, I think my first rapid fire question then is very appropriate. What keeps you optimistic?

Debi Hueter 9:02

What keeps me optimistic are my my providers. I love my providers. I absolutely think that these these physicians are top-notch. They just care for their patients. They do the right thing every time and they are are a pleasure to work with. And you know, they're interested in in value-based care. They're interested in different ways to do things. Sometimes it's a little bit harder to engage them than others, but you know, they they turn around, they get there. But that's really what keeps me optimistic are the primary care providers who are willing to do what it takes to take care of their patients.

Rebecca Grandy 9:51

OK, my next question then, what's the hardest leadership lesson that you've learned in this space?

Debi Hueter 9:57

integrated world since about: 2003

They they you, you should be respectful of them and they should be respectful of you, but but both sides have to earn it.

Rebecca Grandy: 11:17

I would agree. And just, you know, personally from practicing in team-based care and with physicians and providers, you know, APPS as well, they just want to make sure that you're going to take as good of care of their patient as they're going to. And once they see that and that you have sort of the right, the right mindset and that you just want to be helpful. Usually that's, in my experience, how you win them over from a clinical side.

Debi Hueter: 11:40

Right. Yeah. No, I I would, I would agree with that. I think that, you know, and once you do win them over, then sometimes you can't get rid of them. I mean, and so which is really kind of fun. It's kind of cute because, you know, then they start calling you for everything and and they become so reliant on you and so dependent on you, which is, which is great, you know, because that's that's what you want. You want to be there to help them. You want to be there to support them and and you know and and feel like like you are a part of their their practice and a part of their family.

Rebecca Grandy: 12:12

I know that's what you want. You want to beat them away with a stick and have to hide in your office. And I've had that happen before too, in my past life. It's a great place to be. Well, what about one book or resource that you feel like every leader should read?

Debi Hueter: 12:27

This is going to sound really corny, but I I've made my staff read Simon Sidek's book. Why? It really changed my life several years ago when I read it and it gave me such an aha moment of gosh, this is really why I do this. This is my passion. This is, this is, you know why I wake up every morning is to make the lives or help physicians and patients have better health care access, have, you know, better just just better lives and no matter what that is, how can we do that? How can we take care of our patients and and and really take care of our providers, our providers, you know it's it's been tough. It's been really hard for them the last several years and people think that that we're out of COVID and we are out of the pandemic, but it's still challenging. And so if you read that book and you really let it sink in and you think about what is your why? Why are you doing what you do? Not how, not when.

Not not who do you do things with, but deep down, why do you do this? I think that that's a book that everybody should read.

Rebecca Grandy: 13:49

Definitely makes keeping motivation easier when you know what your why is.

Debi Hueter: 13:54

And it it makes motivation easier and it makes a team stronger if everybody has that same vision.

Rebecca Grandy: 14:02

Yeah, supporting one another in addition to patients, cause you know, without the support of teammates and and staff and everyone on the team like it, it's so much harder than it has to be.

Debi Hueter: 14:14

It it is harder than it has to be and it shouldn't be hard. Working should be fun and should be interesting and a learning process. It should not be hard.

Rebecca Grandy: 14:25

And I love the fact that you said it may be a little corny. I think we all need a little more corny in our lives. I love a good dad joke. Try to throw in one of those to some of the meetings. You know, Debbie, we've talked about a lot today, but is there anything that you would like to share with the audience, especially about engagement, about CIN, about specialists that may be helpful for the audience?

Debi Hueter: 14:46

So I'm going to assume that it will be peers that will be listening to this and and you know, maybe employers or or physicians or whatever. And so I think you know. Maybe one of the one of the Um most important things that people should know about clinically integrated networks in healthcare is that is that it really allows primary care physicians and specialists to work together collaboratively for the care of their patients. And and the reason I say that is because we've got, we've got 580 primary care physicians in our network. We have about 1100 specialists that are referral sources to those 580 primary care physicians and so through the ACO you really garner conversation between primary care and specialists and some of the other tools that we have the referral management tool and and like you said the pharmacy tools and things like that, all of that generates conversations for the good of the patient and to make sure that primaries and specialties are are putting the patient in the forefront and that they're doing things collaboratively together in order to have that patient be as healthy as possible. I think that's one of the things that that maybe I missed that you know the basis of this is really because because we are just primary care physicians, where most ACOs are multi-specialty, um our primary care physicians really, really do work at the top of their license and try to manage most everything for that patient. And I think patients really appreciate that so that they're not jumping from specialist to specialist with a co-pay, with a deductible and and all that, these primary care physicians are, like I said before, hardwired to really manage their patients as best they can.

Rebecca Grandy: 17:04

Debbie, it's been a pleasure having you on the podcast today and a pleasure working with you. Um, couldn't say. Enough good things about WKCC and our partnership, so thank you for all of that.

Debi Hueter: 17:14

Well, thank you and and it's been my pleasure to speak with you and I can't say enough about the partnership that we have and the work that your team does. It's it's critical to our success and it's critical to the health and well-being of our community.