In this episode of Healthcare on Air by Verizon, the discussion emphasizes the need for flexible solutions in an increasingly complex specialty drug landscape. Joe Cardosi and Sarah Marche discuss how the FMH model has been gaining traction with partners like Highmark, outline priorities for scaling and improving outcomes, and identify potential future opportunities. We talk about how innovation in specialty pharmacy is being driven by necessity, with a strong focus on creating a more efficient system for patients, providers, and payers.
Here are six key themes from the conversation:
The discussion underscores how difficult it can be for patients on specialty medications to navigate the current system. Processes are often disconnected across payers, pharmacies, providers, and patients. FMH aims to introduce more transparency and competition into this space, making it easier to identify the best path to treatment while reducing administrative burden and unnecessary costs. The broader goal is to shift from a rigid, opaque system to one where value and outcomes are clearer and ensures the process is simplified for patients.
Innovative access and affordability models for specialty drugs are now more important than ever. The FMH model is resonating with payers—we're scaling within existing partnerships with payers like Highmark and expanding our reach. There's a demand for new solutions in this space as health plans actively seek better ways to manage specialty drug spend. In this favorable environment for growth, the FMH model has scaled exponentially in technology capabilities, lives serviced, and effectiveness of support services, delivering measurable value to payers in an industry that's ripe for change.
There are dedicated support teams at FMH that monitor a patient's progress during their specialty medication journey. The platform adds an extra layer of oversight into the process and quickly resolves any potential barriers to care, holding the system accountable to the patient and acting as a trusted intermediary when they need it most.
The specialty drug ecosystem is only becoming more complex, making flexibility essential. The FMH platform adapts to these changes, integrating new data sources, accommodating various care models, and supporting the process across all stakeholders. This flexibility and customization ensures the FMH model is meeting the needs of our partners as the landscape continues to evolve.
Early collaboration with risk-taking partners like Highmark helped to develop the FMH model, while a growing network of partners now provides broader input on emerging challenges in the ecosystem. It also reinforces the idea that solving healthcare complexity requires full coordination across the ecosystem, rather than siloed efforts.
At the core of the conversation is a focus on improving the patient experience. The ultimate goal isn’t just cost savings, it’s ensuring patients can access the therapies they need faster and with less friction. This includes reducing delays, improving drug adherence, and simplifying the patient journey. By aligning financial incentives with better patient outcomes, the model aims to create a system where better care and lower costs go hand in hand, resulting in:
FMH and Highmark are innovating in an area of healthcare that's undergoing rapid transformation, where traditional models are struggling to keep up with rising complexity, cost, and today's needs. Our partnership with an industry trailblazer like Highmark sets the standard for what modern specialty pharmacy should look like: transparent, clinically grounded, and customizable.
Listen to the full episode here: