Changing the game on consumer engagement

Exploring AI, analytics and the future of health care

Video Component

- Thank you.

- All right, good afternoon. Thanks for making the time for this session today. I hope you're comfortable. We have about three hours to talk through all of our suite of consumer engagement solutions, so let's talk a little bit about why are we here today to talk about consumer engagement? Why is it important? Over the last couple of days, you've heard a lot about our products, our services, our tools. In pharmacy, build it and they will come simply doesn't apply, right? They won't find their way to it. Maybe, just to frame why this is important, probably numbers you've seen a couple of times this week, but roughly half of consumers just simply don't understand how to navigate the current healthcare system. Let's put that in the context of pharmacy. What does that mean? It impacts everybody in this room. It impacts your constituents, so when you leave your physician's office and you have a prescription in your hand, it requires a prior authorization. Might make sense to you and I, how to navigate that process, does it make sense for a consumer? Right? Or, they show up at the pharmacy and the therapy happens to be off formulary, requires a switch. How does the consumer navigate that? So, we might say that this entire system is complex, but the reality is pharmacy can be equally complex. And we know that when these complexities come into play, it doubles the cost, right? Now some of these might be in readmissions. We've through some of that this week. Or gaps in care. Some of it is simply, are you on the most cost effective therapy, and how do we guide someone to the most cost effective therapy? We also know that roughly two-thirds of consumers have experienced some sort of barrier, right? In receiving quality care, and those barriers are especially prevalent in the pharmacy space. We're gonna talk through some of those today and our thinking about how we work around, or work through those barriers. And we know that a third of consumers have at some point in time decided not to take their prescription due to cost. So, we talk a lot about getting to lowest in that cost, but there's a point in time, and I hear this when I listen to phone calls that we might have the lowest cost on a particular therapy in the market, the reality is the consumer still can't afford that. So, how do we put strategies in place to one, make sure they're prescribed the most cost effective therapy. Two, that there's this understanding that they can fill that therapy. And three, when they still can't afford it, how do we meet them where they're at with programs to ensure they end up on therapy? So, part of, as I said before, the thinking is, from a consumer obsession perspective, build it and they will come simply doesn't apply. So, as you unpack this journey, it's really about meeting the consumer where they're at. Right? There's not a solution for engagement, it's a suite, it's a suite of solutions, and we're really having fun on this journey. Today, a couple folks will talk us through what we're first doing to meet the consumer where they're at, in this case, in the doctor's office. David Calabrese will talk us through some of the tools. Very encouraging results. And I will tell you this, it's a building block. It's a stepping stone. From there, Jacob Freshwater will talk us through strategies that we're putting in place to ensure that once that consumer leaves the physician's office, they're able to get their prescription filled, right? Navigating things like the prior authorization process. Very exciting set of strategies, and again, I will tell you these are building blocks. And then Lisa Smith will talk us through how we ensure that someone stays on therapy. How do we engage that consumer through the life cycle, so it's not just about filling a prescription, but how do we engage that consumer over the course of that journey to ensure they receive follow up care? We look for other gaps in care. We look at what the total picture's telling us in terms of what that consumer may need, and not know. And again, help them to navigate that. We'll have plenty of time for Q and As. Start thinking of questions. There's a bonus. I'm gonna see if we can work out some bonus points in the app, for the really tough clinical questions for David Calabrese. Hopefully you stored those up. The strategy earlier was to run the clock out, so that you couldn't get the questions, from what I understand. We've ensured , kind of put him in the middle today so we'll have ample time for the really tough questions for David Calabrese. So, with that, David.

- Thank you, sir. Nice, good choice. All right, so whether we appreciate it or not, I think all of us need to recognize, as a society, you and I, that we're very fortunate right now. We're fortunate to live in an era where we have, at our disposal, one of the most expansive, one of the most diverse, one of the most powerful array of pharmaceuticals ever amassed in the history of our country, in the history of our world. Each and every year, we continue to build upon that. Right? New innovations that are curing diseases that have in the past, not had cures. New innovations that are treating rare diseases. We talk a lot about orphan drugs, where patients had no options in the past. And so, as we continue down this road, we will continue to build on this armamentarium, but, we can have the best drugs in the world, but those drugs are only as good as how our doctors are prescribing and how we as consumers are utilizing those therapies. And if we look at some of the data, some of it John already talked about We still have a long way to go. We still have a number of gaps in terms of how our docs are prescribing, how we as consumers are utilizing these therapies. We have very poor adherence rates to chronic medications. If we look at the latest numbers, for chronic medications in key areas, particularly non-symptomatic areas like hypertension, hypercholesterolemia, diabetes, others, we're looking at adherence rates in the 50% range. That's abysmal. 40% of patients, sometimes we create these challenges for ourselves, right? So, as managed care organizations, we wanna make sure that docs are utilizing these medications appropriately, so what do we do? We build prior authorization, right? The problem with prior authorization is based on how it's traditionally been managed, the patient gets to the pharmacy, and that's the point in which they learn, well, my drug isn't covered, 'cause I have to get prior authorization. 40% of the time, what do they do? They walk. Walk away, they don't get anything, and that's unacceptable. 70% of the time, when a patient shows up in the emergency room due to a medication related event, it's due to non-adherence. They weren't taking their med the right way, wrong dose, they were only taking it intermittently, adding enormous cost to the system. And lastly, and I think most importantly, we're not supporting our physician community the way that we should be. 74% of docs are not getting the type of data that they need to make good, well rounded, high quality decisions when you and I are sitting in front of them in that doctor's office. So, in light of all these challenges, we've invested a significant amount of time, a significant amount of effort, and we continue to do so through group and others into a product called PreCheck MyScript. And I know you probably think, wow, these guys sound like a broken record. They keep bringing up this PreCheck MyScript tool, but for someone who's been in managed care pharmacy for 30 plus years, sort of that holy grail for us all along has been, how do we reach the doctor at the point of care? Everything that we've done historically has been retrospective in nature. Scripts already been written, patient's already fill it, and now we're trying to go back and we're trying to switch things. We're trying to correct things. How do we get to that doctor, again, at that point of care when that patient is in front of them? With PreCheck MyScript, we're finally there. We still have a long way to go, but we're finally there. So, now, when I'm in front of my doctor, in that exam room, that doctor not only has full access to my prescription drug history, which he prescribing has enabled, but through interface with the electronic medical record as part of that daily workflow, the doctor doesn't have to login to a separate system. Right within that electronic medical record that doctor will see my prescription drug history. That doctor will be able to determine, you know that hypertension med that I wrote for David, that hypercholesterolemia med that I wrote for David, is he taking it? Because he's not at goal. What would happen in the past, is the doctor would be blind. They don't know. They wrote the script. They assume I'm taking the script. I lied, I tell them I am taking the script the way I should be, and so, I'm not at goal. And in the past, what would happen? They'd jack up my dose, they'd add another med, now we create more problems, more side effects, polypharmacy issues, PreCheck MyScript is designed to avoid some of that. Secondly, doctors are blind with regard to cost, right? Half the time they don't know what insurance I have. Half the time, or the majority of the time when they write a prescription, they don't know how much that's going to cost me at the pharmacy when I get there. Through PreCheck MyScript, when they go to generate that prescription, it's gonna tell them exactly how much it's gonna cost me at my local pharmacy, on that day, based on where I am in my prescription drug plan on that day. Particularly if I'm in a deductible phase, if I have co-insurance, but not only that, whether it's a preferred, non-preferred, excluded, prior auth drug, it's also gonna provide the doctor with a list of alternatives, and it's also gonna provide the cost of those alternatives to me on that day, so the doctor can help me in terms of affordability, and know exactly what those alternatives could provide. Lastly, and the one I'm most excited about, is now we can communicate to the doctor in a clinical manner. We can provide clinical alerts. So, if I'm on a medication to treat anxiety, or panic disorder, or sleep disorder, like a benzodiazepine, drugs like Valium, and Ativan, and Xanax, and for whatever reason, I'm there because of a injury, a sports related injury, let's say. Doc goes to write an opioid prescription, we're alerting the doc that a mental health provider has issued a benzodiazepine in my profile. If they write a high enough potency opioid, what's that gonna do? Increases my risk of respiratory depression and overdose. Those of the types of alerts, smart alerts, that are gonna drive higher quality of care and improve that provider patient relationship and outcomes for those individuals. To date we've had over 170,000 physicians that have actively utilized, that are active on this particular tool. We're processing three million transactions and the results speak for themselves. This is the value this tool is providing. 80% of the time when a doctor is alerted to the fact that the patient, they're about to prescribe a tier three drug, 80% of the time, they're shifting to a lower cost product, a tier two, or tier one drug saving that patient a significant amount of out of pocket spend. 30% of the time, when the product is a subject to prior authorization, they are processing that PA right then and there 'cause the system allows that as well. Or, they're avoiding that drug and they're finding one that doesn't, that we're advising them is not subject to PA. Adherence rates are higher, four percentage points higher when they utilize this system for chronic medication prescribing. In terms of savings, $130 saved per prescription per consumer when this tool is utilized and we're advising docs on a lower cost alternative and to you the client, $415 saved per switch. So that's again, just scratching the surface. Where are we going with this product? First, is improving channel transparent pricing. Well, what does that mean? That means that right now we're providing low cost alternatives based on patient out of pocket spend, but we need to take that one step further. Let's say you have access to that product via your home delivery benefit and you can save even more money. We want to alert the doc to that as well. Let's say it's a medically infused product and there's a lower cost site of care. That's where we're headed with this product. To be able to advise the physician on things like that as well. Secondly, is increasing provider access. So, I said, 170,000 physicians, we continue routinely DN Team to work with these e-prescribing vendors to integrate into these different EMR platforms with a goal which remains that we've committed to before, that we'll continue to strive for, which is 80% adoption across all active physicians across the United States by the end of 2020. Thirdly, expanding low cost alternatives. If we're going to promote affordability, we need to continue to update our database, we need to continue to identify new generics, we continue to monitor price between products and ensure that we're constantly revising that. Expanding those opportunities for doctors to chose a lesser cost alternative. And lastly, it's engaging providers at a higher lever. How do we get them to want to utilize this tool? How do we get them to ensure that they want this as a key part of their day to day routine, well how do you do that? You need to understand how doctors work. You need to understand how their reimbursement now is transitioning. Many doctors are being reimbursed how? Pay per performance, right? Quality initiatives. How are they performing from a quality based perspective? If we can utilize a tool down the road to further enhance those quality clinical edits, we're gonna be able to do a much better job in helping them perform well in these contracts. Advising them when a diabetic patient isn't on a statin drug. When adherence have fallen below a certain level. So those are all the things from a clinical perspective we're working with the DM Team to try and get to as we continue to refine this tool down the road. So, with that, I'm gonna turn things over to my colleague, Jacob Freshwater, our Senior Vice President of Operations to take you to the next phase of the consumer engagement roadmap.

- Thank you.

- All right. ♪ I'm back in black, no one to hold my hand ♪

- All right. Good afternoon. So about a year ago, I sat down with David and John and Sumit, Doctor Dutta, and we talked about transforming prior authorization. We had a lot of feedback. Some positive feedback, some negative feed back. We had a lot of opinions and we decided to engage an external industry expert to help us get from the feedback and opinions to facts. So, we'll share a little bit about how we took those facts and what we're doing to transform the experience the consumers feel as part of a prior authorization process. So, abandoned therapies, we've talked a little bit about abandoned therapies. You heard about it a couple hours ago, David touched it briefly, he touched it again, we talked about 40% of medications that hit a prior auth, the patients are abandoning them. This is a problem. Particularly if you think about therapy conditions where if the patient doesn't have access to that medication within the next zero to 30 days, it's highly likely they will become more ill. Antirejection medication, antivirals, diabetic therapies, we are making an effort, through a pilot, to reach out to these consumers and understand what is it that's causing them to abandon these therapies? Can we conference in the prescriber? Can we get them access to that therapy or another therapy? Can we get a prior authorization submitted so we can make a clinical determination? And what we have found is that when we reach out, when we engage, there's confusion. They didn't understand they even had a PA. They didn't know why when they showed up they were able to get eight of their medications, but not the ninth, and so we look to invest with all of you as part of our processes to engage further in expanding our abandoned therapies program to make sure that these patients get access to the medications. They were diagnosed with a disease condition, they were prescribed medication, they need to get on to therapy, and we are investing in this now and in the future. Another fact we found is that we're not predictive. We were reactive. We were waiting for things to occur. We were waiting for a prior authorization to expire. We know in our data, that on the 11th month it's likely that they'll be going back to the prescriber to get their medication re-prescribed. What are we doing to enable that prescriber to know that that prior authorization is going to expire and make sure we get the patient on continuing therapy? So, we have an E-pro program, where we reach out proactively. We send a fax if they're not electronically enabled, if they are electronically enabled and to electronic prior authorization, we call it EPA, we actually put that PA on their dashboard, so when their medical assistant or their nurse comes in the next day they can reach out to the prescriber and they can get that PA renewed. We have a program called E-Pre. What E-Pre does is we work with our clinical organization, we work with David's team, and we say hey, here's a set of therapies that are about to expire. These are continuing disease conditions. Can we renew them based on the data we already have about this patient for another year? So, we're preventing the potential lack of access to the next set of medication to ensure continuity. We're automating. Our EPA adoption this time last year was somewhere in the 30ish range. Hopefully you folks know what EPA is. It's kind of like e-prescribing. It's a digital channel where people can submit their PA forms. Through advocacy with our regulators, advocacy with our providers, we have shifted this to 60% of all of our volume. So in one year we've moved 30%, 30 real percent in and we've taken 10% out of fax. Why is that important? Predominantly lack of information denials come through fax. Providers do not have to fully complete the form, answer all the questions in order to fax us a piece of information to move that patient onto completing a PA. Regulatorily, we have a certain time frame where we have to make a decision, and when we reach back out, it's not always that the prescriber's able to respond timely and an adverse coverage determination is made. So taking points out of fax helps us get patients on to care. Then, with that 60%, we've actually been on out automation journey. So we're looking at the reasons why doctors are providing diagnosis, other, so something that maybe isn't indicated on our initial form. We've taken those 'diagnosis other' free text fields, we've analyzed them for prevalence and we started to move diagnosis codes up into what you would call the dropdown or the radio button, so we can begin to automate even further. We've increased our automation 53ish percent year over year. What does that mean? That means within two minutes of submitting the form that approval is back, it's in the claim system, and they can get medication. We're continuing, as much as we can to advance that journey up. We'd like to get somewhere in the 80% range in the next year. And lastly, when a negative coverage determination is made and they are made, what we hadn't been doing is reaching out proactively. We've been sending a letter. A snail mail letter arrives two to three days later. They're still not on therapy, they don't know what to do, they're confused, so we've decided to make the investment to reach out to those consumers. Connect with them telephonically. We'll probably move into digital over time, and the feedback that we get is we explain to them the reason the coverage determination was made, what their alternatives are, conference in their prescriber to get them on to a therapy, and then if necessary, inform them of their appeals process. The feedback that we're getting as part of the experience is, thank you. I was so confused. I didn't know when I was gonna to get my medication. And so we look to take that journey and advance it over the next several years. And with that, I'd like to welcome to stage my colleague, Lisa Smith, Senior Vice President Consumer Marketing.

- Take this. All right. Hi everybody, I hope you guys are having a great conference. I am responsible for consumer marketing at OptumRX, and when I think about my role, it's really about driving engagement. Driving a patient's engagement so that they can be healthier. What we are going to talk about today is our offer management capability. Our offer management capability has 25 terabytes of data, and that's drawing off of about 100 million consumers. We have 33 million permintations of offers, and from that, we close well over a $100 million in care gap value. So, pretty incredible numbers, but when I think about my role, the most important number in all of that is one, because we all know that healthcare happens one person at a time. So, we're talking about your mom. We're talking about your child, your spouse, we're talking about you. And so it's really important that we get better as an industry in helping us engage people to be well, and that's really what gets me out of bed every morning. So, I'm excited to talk about our offer management capability. What it is really, at its core, is an engagement capability that helps us identify opportunities. Sometimes you'll hear it referred to as the next best action, or alerts for a member. And we do that through our customer service advocates, through clinicians, and pharmacists. We do that digitally. Through our websites and also our mobile applications, and we also do that through marketing material. So we might do that in a direct mail piece, or an email, or SMS Text. Often times we actually use a combination of those things, and I'll talk about that too. But the outcomes that we want are pretty clear. We want to maximize consumer engagement because that means that people are on a path to being healthier. We want to increase our care gap closure. That's really important. We gotta close those gaps in care to help ensure people are getting and staying healthier. And then the last thing is, and it's very important for everyone in this room, we want to reduce medical expenses as well. So, let's talk a little bit first, just basic engagement, how it works. So, traditionally, engagement would start with a product, and then you're looking for who might want that product or service, so you're doing outreach in that way. I like to call that spray and pray. You're just sort of guessing, right? And that works great for laundry detergent and cereal, and not so much for healthcare, because healthcare happens one person at a time. So, in our model, in our mindset, we're thinking about the consumer first. It all starts with the consumer. We need to identify those needs and offer management helps us do that. And then, we need to engage them in the right way at the right time, with the right message, and in the right channel. And that's not always been the easy thing to do, but I'll show you how we're building muscle in that space. So, how does it work? And this is maybe a geek alert here. I won't stay here for long, but I want to show you how the engine works together. The first thing is the data. It really all comes back to having the right data. And then what we need to do is prioritize those opportunities and messages. And then finally, like I said, we have to be effective in the way that we do our outreach. So, let's start with the data. Like I said, we have 25 terabytes of data and maybe the key message for you as you go back to your own teams is to think about the value of having data be on claims and clinical data. To me that's the key, most important thing. A person is more than their disease. So what we want to know is their health system utilization. We want to know about their health finances, of course medication adherence, and then we want to think about other things. Socioeconomic data can be helpful. Purchase history can be helpful. Channel preference is really important data. So, we really round out that view of the consumer. Then, when we're prioritizing the recommendations we do two things. One is, we segment the population a little bit because we want to narrow down to get to a cluster of one. We want to get to one person. So, the first thing we do is do some segmentation, and that just simply helps us narrow who we're targeting. We usually think about that, if you think about just a simple axis, we're thinking about it from how healthy is somebody? Are they relatively healthy or maybe polychronic? And then how engaged are they? Are they taking care of themselves and seeing their doctor, or do they have a lot of care gaps? So that helps us narrow the population a little bit. And then from there, what we do, is we apply a number of predictive models. Those predictive models really help us narrow down and become way more targeted. I'll give you just a couple of examples of predictive models, we've got a lot of them depending upon what kind of outreach and opportunities we're trying to deliver. Examples could be a social isolation model. We use social isolation to predict things like hospital readmissions or emergency room visits. People with weaker ties to family and friends have more readmission, so we really wanna look at that depending on the type of outreach. Another example, maybe a more simple example especially from a marketing lens would be a propensity to enroll. So, if I'm doing outreach, I wanna know that I'm pretty likely gonna get a response, and that the person is going to take action. We also have a model, it's called propensity to engage, but what that really is is, once we've engaged that person are they going to actually follow through with the action that we've recommended? So then, from there, like I said, it's all about delivering that in the right channel. Often times what we find is that it's really important to layer messaging. I'll just give you an example from your personal life that I'm pretty sure you can relate to. You know when you search for a video and then you're forced to watch a six second spot before you can actually see the video that you want, right? And then you're at home and maybe you're making dinner or just watching TV, and then you see basically a 30 second version of that same video. I like to call that surround sound, but layering and engaging those different channels and different touch points really helps people prompt into action. So part of our analytics also try to understand what's the optimal combination of these engagement techniques. All of this works together when we're talking about offer management. It might be fun for you guys to see what kinds of offers we have. I'll give you a few examples here. One is program referrals. This is really popular with our members and I'll show you the acceptance rates for these in just a minute. People really appreciate the program referrals. This is an opportunity usually to talk to a coach or a clinician, and in this case, it's a heart health benefit. Another example would be decision support and health education. Again, it's a great opportunity for us to show our value to the consumer. And in this case, it's really simple. It's just a flu shot. We're saying, hey, we noticed that you need to get your flu shot, here's some locations where you can do that. Another example is network. If we see a member has got an appointment to go out of network, we often want to intervene to make sure that they know that they've got lower cost options within their network as an option. And then near and dear to my heart, RX, here we've got a number of different offers and opportunities. People are pretty interested in knowing if there's a lower cost alternative, and we love to serve up the convenience of home delivery, is another example. Then finally, critical alerts. And this one, maybe is just worth a quick pause because this, where I talked about prioritizing the offers, and we do that based on the care gap value and what we can see within the modeling. Critical alerts, we actually will force in. So, if we somebody is in a hurricane affected area as an example, or some kind of a natural disaster, we wanna connect them right away with the resources that can help them, and so those critical alerts are also apart of this, and we can do that again, telephonically as well as digitally. So, I thought it might be fun for you guys to see what the advocate desktop looks like. For a customer service agent, when they are on the phone with a member, and they are serving up an offer, you can see, up top there where those offers are presented. There's hover-overs and they can click through if they want more information about what's available to that member. What I actually wanted to direct your attention to is that dotted red box down below. One thing that's really important for us to do is to keep track of whether a member has accepted, declined, or is thinking about an offer. There's two reasons for that. One, the obvious one, if they accepted an offer, we need to trigger the follow up. We actually have to engage and follow up with what we've suggested and recommended. If they've declined or they're considering an offer, we may want to do a rest period. We many not want to offer that particular recommendation again for three or six months, depending on what it is. We do put rest periods in place, but the other thing that that helps us with is sharpening our predictive models. So, let's talk about machine learning. I think this another area where again, when you think about what ideas could I bring back to my team, I cannot overstate the importance of machine learning for us and what we've learned. As we've applied machine learning to our predictive models, we've seen a pretty incredible increase in our affectiveness and our acceptance rate. So, it's actually right now, hovering around 61% and actually climbing. So that's a three times lift from when we started two and a half years ago and we're just doing basic predictive modeling without machine learning. So, I highly recommend you look for those opportunities within your business. I also wanted to share with you our offer acceptance rates by offer type, because I think it's helpful to see at least another level of detail and get a sense for what consumers value. So, for example, program enrollment is pretty popular with people. They like to respond to a place where they're getting one on one coaching with a coach or a clinician or a pharmacist. An opportunity for them to engage, that feels like you're getting a lot of value from your plan, and they tend to accept that offer and appreciate it quite a lot. Decision support. That's another place where people appreciate help. So, decision support can be two things. One is, a treatment path. Sometimes people are looking for, what are my options for treatment, and what are my options for provider? And again, that's got a very high average acceptance rate for those types of offers. And health education's another one. It's a lower acceptance rate, but it's still a third of the people are interested in that, and you think about it, there's a lot of health education opportunities through Google, through your provider, there's plenty of places you can get it, but I'm impressed. People still want to take advantage of learning from professionals within the system. Just to wrap up here with a few stats. What you're seeing on the screen now is our 2018 results from offer management. Last year we were able to impact our members in a pretty profound way. 930,000 people or offers were accepted, of that, 240,000 care gaps were closed. You have to remember, not every offer is a care gap. If I'm serving up home delivery as an option, for example, in pharmacy, that's not a care gap, it's an opportunity, and we certainly see great results from that as well. $165 million in care gap value. For me, I'm a real consumer advocate, and for me, that's just a proxy for people being healthier. It's an example of us starting to bend the cost curve because people are actually taking action one person at a time. And then finally, we're getting more creative as well. We've got over five offers for an average member, so what I get excited about with that is it's an opportunity for us to start being creative, start engaging people and helping them really feel the value when they engage with us about their plan and what resources they have available. And before I wrap up, I think I want to just tell you just a quick consumer story to maybe make this come to life just a little bit more. So, in the data, we found a consumer, his name is Eric, and Eric has diabetes. He's 47 years old. I'm sure what you're thinking is, all right, she's gonna tell me about how you got him enrolled in a diabetes program. That's actually not what it was. So, the data told us that Eric needed to reduce his out of pocket expenses. It was really putting a strain and we could see that there was some risk of nonadherence. The other thing that we could see in the data was that he was about to have a knee surgery, and was in need of some decision support because he needed a lower cost option for finding a provider. And so through a combination of engagement techniques we were able to help him transition to a lower cost therapy, and we were able to find him a surgeon that was in his network who had high quality and lower cost. As a result, Eric has now started to lead a healthier life. We can actually see that longitudinally in the data. So, that's how that can come to life for us. We're looking for more opportunities to impact more people each and everyday.


Improving the pharmacy consumer experience

35 min.

Learn about new strategies revolutionizing the pharmacy consumer experience and how machine learning and artificial intelligence (AI) guide better health care decisions. Hear from experts on what’s transforming at the point of prescribing and how consumer pain points can be eliminated.

Speakers include:

Jon Mahrt, Chief of Operations, OptumRx
David Calabrese, Chief Pharmacy Officer, OptumRx
Jacob Freshwater, VP of Prior Authorization, OptumRx
Lisa Smith, Senior VP of Consumer Marketing, OptumRx


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