TRANSCRIPT: Episode 2 of The Front Porch: "Health on the Hill," Featuring Sloane Salzburg

The following is a transcript of "Health on the Hill," the second episode of ScriptDrop's podcast The Front Porch: Where Pharmacy and Healthcare Access Meet.

[LAUREN] Welcome to “Health on the Hill,” the second episode in ScriptDrop’s new podcast series. In this episode, we’ll discuss the possible impact of current legislation on healthcare. Today, Perry Lewis returns to speak with Sloane Salzburg.

As always, for those who don’t know us, a quick intro: ScriptDrop is the only healthcare IT company specializing in prescription access that serves patients in all 50 states. Since 2017, ScriptDrop has been improving drug adherence by delivering medication access opportunities through a robust platform, long-term data storage, multiple service levels, and first-class customer service.

I’m Lauren Carpenter, the Writer/Researcher here at ScriptDrop. In case you didn’t tune in to our first episode, “Health in the Heartland,” let me introduce our good friend and industry expert, Perry Lewis.

Perry is ScriptDrop’s industry relations consultant. Although he’s held a variety of positions in the pharmacy industry over the years, Perry’s claim to fame is that he was Chairperson of NCPDP for four years and has been on the NCPDP board for twelve years.

Today, Perry will be in conversation with Sloane Salzburg. Sloane is Vice President at Horizon Government Affairs, but also has a hand in a number of coalitions, councils, and campaigns. As if that weren’t enough, she is also a member of ScriptDrop’s Advisory Council. We’re so grateful that she’s here with us today to talk about healthcare policy, a subject we’re just starting to explore.

All right, Perry – take it away!

[PERRY] Thank you, Lauren, and I’ve been looking forward to this conversation with Sloane, um, she’s got such great background and, ah – before we get into the main topic of “Health on the Hill” and the related issues under consideration in D.C., could you provide some background as to who you work for?

[SLOANE] Sure Perry, and thank you both for that mahhvelous introduction! (A little Hocus Pocus reference because we’re coming up on Halloween here.) So hi y’all, I’m Sloane Salzburg, um, I’m in D.C.. I wear a few different hats: I’m Vice President of Horizon Government Affairs (HGA), which is a boutique health policy consulting firm in Washington, D.C. I also help run our managed coalition called the Council for Affordable Health Coverage (CAHC) and act as executive director of CAHC’s Campaign for Transformative Therapies.

I’m going to pause there because I used lots of acronyms and I’m going to try and define those acronyms but as they say in D.C., you know, it’s just kind of an alphabet soup. Um, so CAHC is the Council for Affordable Health Coverage.

Prior to my work at Horizon I worked on Capitol Hill for a member of Congress as a health policy fellow. I had a little bit of an unconventional background before I moved to D.C. for grad school more than a decade ago; my undergrad degree is actually in zoology, from the University of Florida (go Gators!); I was an emergency room technician and a science teacher down in Florida. So my interests started out in science and healthcare, and after working in the healthcare industry I realized how broken things were and really wanted to kind of move up to D.C. to change it. Which is what I do today – trying to make the health system work a little better. Um, and as I always say, I’ve got a long road ahead of me because it ain’t getting better anytime soon. [Laughs]

[PERRY] So thanks Sloane, and based upon your experience, I could see how zoology – such as maybe wrangling alligators – could be a benefit dealing with legislators and their staff at times, don’t you think?

[SLOANE] Oh yeah. I think my boss actually uses that a couple of times when he’s introducing me to others, um, and I definitely know ah, he – that was a, you know, a point of interest on my resume when he was hiring me.

[PERRY] [Laughs] I’d like to point out for our audience for full disclosure that in my previous life, while working with CoverMyMeds, the firm HGA was retained to pursue electronic prior authorization legislation, so I have first-hand experience on how well you and the entire team operate and are engaged in D.C.

I find the political landscape interesting but also very frustrating at the same time, so, let’s begin with the lay of the land, per se, on what is going on in D.C. with proposed bills that could impact health. Can you provide a high-level perspective, if you can, on the infrastructure and reconciliation bills being vetted? And I know that it’s probably changing by the minute.

[SLOANE] [Laughs] Yes, um, so funny story, when we were doing a little prep for the podcast, I wrote out the script and I was working on it yesterday, um, and then this morning everything changed! So I’m going to start out with a big level-set that it is very complicated right now, and literally changing by the hour, if not by the day, so chances are that things I’m going to talk about today will change by the time the podcast is published. So just take everything I am saying and, um, you know, maybe I’m kidding or maybe I’m telling the truth! Um, so I really wanted to kind of level-set there.

Um, another level-set, because I know – I think the audience will be folks kind of outside of the D.C. space… talking about Congress. So even though Democrats right now hold power across both the House and the Senate, um, and the administration at the White House, the margins are very, very slim. So the Senate right now is split 50/50, and Vice President Harris has to come in for that tie-breaking vote for the 51/50. The House is also very narrowly split with 220 Democrats and 212 Republicans with 3 vacancies – if you split the House down the middle you only need 218 votes for a majority, so Democrats cannot lose more than 2 votes if they want to pass something. So bipartisanship has been pretty tough lately if you’ve been following the news. Compounding these very slim majorities you’ve got the January 6th Capitol riot and all of the recent happenings around that, you have the ongoing COVID pandemic, next year’s looming election where each party is trying to either gain or maintain the majority… Politics are at the forefront, and policy has gone by the wayside. So I’m going to say that again, because some folks don’t quite understand that. Policy, right, are the ideas, the laws, the legislation that we’re working on. Politics is really how you get those things passed. Um, and so even if a policy or idea makes the most sense, is bipartisan, supported by a majority of Americans, passing that bill or that piece of legislation has become a real political game. And so depending on the calendar, depending on who can claim credit, who it affects, etc. etc. etc., what’s going to happen this year is so up in the air, and a lot will ultimately depend on that calendar that I was talking about, and various important dates.

So talking about the dates, we’ve got some deadlines coming up with what we call in D.C. “must-pass” legislation. So those are the funding bills to keep the government running or to keep certain programs running. And that – those dates where that must-pass legislation, um, you know, where funding could basically run up, those can serve as a rallying point for other pieces of legislation, what we’re calling a vehicle – you can tack other things on. However, with bipartisanship becoming less and less popular, there are a lot of question marks. So the biggest date right now in my opinion is December 3, which is right around the corner. That’s when we’re going to hit the continuing resolution deadline. So the CR, or continuing resolution, was basically a stop-gap measure to continue funding the government at current levels. You didn’t update funding, um, for the next year, for federal – for fiscal year of 2022. We passed a CR in September up until December 3, that runs out. You also have the debt limit. If folks were following that debate, again early – er, late September, early October – they punted the debt limit until December 3. You have to – we have to – deal with the debt limit or the country defaults. And so there are two viable options to dealing with that debt limit on December 3 by my reckoning.

One, the Senate Democrats amend the filibuster so you only need a simple majority. That has some longer-term repercussions in case another party – not in case, when another party takes over – I don’t know when, I’m just saying eventually Republicans will take over. Um, the filibuster means you don’t need that 60 vote threshold, you only need 51 votes, and then you can do whatever you want. The other option to fixing the debt limit is you do it through reconciliation, which is a partisan effort that only requires a majority vote. So only 51 votes in the Senate. But it must be directly related to budget impact, and it has lots and lots of rules around what can and cannot be included. Um, so the timeline for that December 3 date is getting shorter and shorter.

Speaking of reconciliation, folks may have been following the news recently with President Biden’s Build Back Better package. Um, so Democrats are relying on reconciliation to pass this. And this Build Back Better package has climate change, immigration, child care, some healthcare provisions in it, and it’s taking up all of the air on the news right now. The latest as of this morning is that the White House released an updated framework that took out a lot of the more controversial provisions, um, and they’re supposed to be going to the Rules Committee today to kind of pass legislation to keep this moving forward, but we can get into more details on that later.

Um, and the last thing I really wanted to cover in this overview is that – the infrastructure package. So this was actually a bipartisan effort, it has already passed the Senate, and so we’re waiting on the House to vote on it. The original deadline for passing this was in September but that got passed over and Speaker Pelosi now set a new deadline for the end of October, which is this weekend. But TBD on whether or not this actually happens, because the Progressives in the House have said they do not want to pass infrastructure unless they pass this Build Back Better package. So they’re tying those two together. Um, so there’s, you know, a lot of differing opinions on do you separate them, do you keep them together, how does this move forward, again as of right now, there has not been a vote, but there could be a vote on that later today.

So: lots going on, but more activity rather than actual movement right now. There’s a lot of news headlines, a lot of folks saying this is gonna happen, this is gonna happen, but there’s just this flurry of activity and we don’t actually know whether or not anything’s going to happen.

[PERRY] So I would think right now, um… [Laughs] You’re not getting an awful lot of one-on-one legislative meetings, because they’re so absorbed with everything going on with these two bills. Um, I’m sure you’re reaching out but man, this is a lot – a lot to take in.

[SLOANE] Yeah, yeah. I can comment on that real quick. So depending on who you talk to, well actually you can chat with a lot of the, you know, legislators and their staff. A lot of the rank and file members, so those that aren’t in necessarily leadership, don’t know a lot. And there’s a lot of anger right now, because they’re expected to vote on this package that’s going to come to the floor eventually, that’s, you know, almost two thousand pages long. And they haven’t been part of the negotiation process. The two members right now that are really in the news media and that have the most leverage are Senators Manchin from West Virginia and Sinema, um, because they’re the moderate Dems and they’re the holdouts, and they need all 50 Democrats in the Senate to get this forward. So they’re the ones who are negotiating, um, with President Biden, and they’re keeping a pretty close lip on, um, what they’re asking for when you talk – when I go in and talk with them, but we’ll see. [Laughs]

[PERRY] Yeah, that’s an awful lot of pages to go through to see what could be stricken or what needs to stay. So good luck with all that, Sloane.

[SLOANE] [Laughs] Thanks. I think my shorthand answer when folks ask me what’s going on is “Chaos.”

[PERRY] [Laughs] So – I’m going to change gears just a little bit. So as you know, Sloane, I’ve been a caregiver in the past, and there are a few proposed measures that certainly would have been a good step in these bills that are being proposed to improve healthcare, not only for my family members but also for thousands of others and into the future. Can you highlight a few of the proposed policies included in the Build Back Better in regards to healthcare?

[SLOANE] Sure Perry, although again I’m going to caveat this with, “Everything changed this morning.”

[PERRY] Right.

[SLOANE] So originally there were policies that spanned from free childcare, free community college for two years, there were efforts to combat climate change, lots of new taxes like an increased corporate tax, additional taxes on the super wealthy, um, there was additional funding for IRS police, um, and on the healthcare side, there was an effort to expand Medicare to include dental, hearing, and vision benefits. Um, there were additional ACA subsidies for the non-expansion states to help with the Medicaid coverage gap, um, there was some maternal coverage policy updates, and then there was a big chunk of prescription drug policies that were pretty controversial. They were using those as “pay-fors” to help fund this, you know, originally $3 trillion bill.

[PERRY] Mmhm.

[SLOANE] As of this morning we’re hearing that some of these more controversial policies are out. I don’t want to get into too much detail because like I said, everything is changing. What I say now is probably going to be wrong tomorrow and the next day and the next day. I will cover, kind of at a high level, um, some of the prescription drug policies that they were considering including, um, just because of the audience.

So originally they included, um, policies from H.R. bill 3, which was a controversial kind of Democrat-only drug pricing bill which aimed to cut drug prices by, uh, importing price controls from abroad by, uh, you know, basically saying that Medicare was going to directly negotiate for drug prices because they were claiming that Medicare does not negotiate now, even though the Part D program actually allows for negotiation. The individual Part D plans do a really good job of negotiating.

And then it included some good things, like an out of pocket cap in Medicare Part D. And so that would cap, you know if you’re in, um, if you’re a Medicare Part D beneficiary and you had catastrophic coverage or you had catastrophic prescription drug costs, you would cap that. So you’d only had to pay up to $2000 a year, and if your drugs cost more than that, you wouldn’t have to pay and the government – a combination of the government – and when I say the government, I mean CMS or taxpayers – plus the individual Part D plan, plus the manufacturer would pay a proportion of those costs, over that cap.

Um, and then there were inflation caps on, um, you know, if drugs rose – if the drug prices rose faster than inflation, there was a cap on what was allowed. And those were kind of some of the more controversial pieces in that. But again, this has all changed as of this morning. The Medicare – you know, one of the things that was included – er, actually excluded – was the Medicare dental and vision, they kept in hearing [benefits] as of this morning. One of the main points against expanding these – this Medicare coverage was Medicare is supposed to be insolvent in just a few years. Which means we don’t have enough money to continue funding it, so if we don’t have an answer to how to continue funding Medicare, how can we talk about expanding Medicare? And so that was another kind of interesting point.

[PERRY] So Sloane, you’ve given us an awful lot to think about, and – what is today, October 27 – so October 28, it could be entirely different. But, um, basically we’re asking your advice and what you’re hearing. Outside of reconciliation, are there other opportunities to pass healthcare legislation this year?

[SLOANE] Great question, Perry. Um. [Laughs] The short answer is yes, there are opportunities...

[PERRY] [Laughs]

[SLOANE] The long answer is, you know, do I think that it will happen? Maybe, maybe not. There’s still a big question on if reconciliation goes and if it doesn’t go. Um, but outside of this reconciliation process, there is another opportunity that’s coming up. You’ve got that continuing resolution deadline that I covered on December 3, but they could also punt that and really do – ah, package all of the, you know, end of year spending bills into one package. Oftentimes they’re called an omnibus, if you do it at the end of the year in D.C. we like to call them “Christmastreebuses.” Um, so if you are able to pass that new appropriations level, which is the new levels for government spending for the various programs, um, that could be an attachment point for other healthcare policies. Especially if they are non-controversial and, honestly, if they’re cheap, that’s an opportunity.

So for example, last year our coalition, the Council for Affordable Health Coverage, was working on a real-time benefits bill that would mandate Part D plans to utilize these tools, the real-time benefit tools, to help patients understand or know their out of pocket costs before they get to the pharmacy. This ended up passing in last year’s omnibus bill, so something like that could happen again. A technical fix, something again that’s bipartisan, non-controversial, and doesn’t cost a lot of money.

[PERRY] Well, you know how I feel about real-time benefit checks and transactions. I think it’s imperative that we have those tools. And, you know, another hat that I’ve worn was with NCPDP, that have worked on standards around that, so I think any tools like that – that providers and pharmacists can use – is just vital, so I’m really hoping that moves forward.

So: let’s continue along the lines of long-term care and consider what options may be available in the future, pertaining to home- and community-based services. Let’s face it, Baby Boomers are aging – I will admit, I fall into that category – and this is a large group that will require more at-home and community services. Don’t you think for this age group (or nearly anyone) adherence plays a prominent role in the success of one’s health? And if so, what are you seeing or hearing in regards to programs and measures that states and plans can design to improve adherence? Because I know adherence is a big focus of you, especially with your coalition, so what are you hearing in regards to some of these services?

[SLOANE] Yeah, no, thanks Perry. I, as you know, am a big proponent of medication adherence programs. Unfortunately, adherence programs have kind of died down. When I say that, I mean policies, federal policies to help improve adherence programs, have died down. Um, and so I do think that adherence and appropriate utilization is such an important issue, but it’s not at the forefront of healthcare thinking right now. And there’s a couple of reasons for that. One is obviously that there’s a pandemic going on, so we’re really putting out the fires that are coming up first. The second, um, is that costs – costs are just in this big – they’re kind of the big thing that everybody’s focused on, and again, it’s the pandemic, it’s just the continued rise in health costs. And so when you talk about programs that may cost money up front, even though they’re going to save money down the line, they’re not the most popular. So CBO, which is the Congressional Budget Office, they’re the congressional entity that scores bills and tells us how much something will cost, like a policy will cost. They only score bills in a ten year window for savings. So if you’re going to get savings outside of that ten years, you don’t – you’re not going to get the savings on the bill, and the bill’s ultimately going to cost money. A lot of medication adherence programs, when they’re looking at the data, save money down the line, right? You’re adhering to your heart medication today and you’re not going to have the heart attack. But that heart attack might’ve occurred ten, eleven, twelve years down the line.

[PERRY] Mhm.

[SLOANE] And so that’s something you kind of need to keep in mind. This invest-now-to-save-later kind of approach, um, is hard. And you know, it’s that old marshmallow example, when you give the kid a marshmallow now and they can eat one now, or they can wait and have two later… Human being just aren’t great about that, you know, um, delayed gratification. And so with regards to that and medication adherence or any kind of these policies that are going to save money down the line, it’s hard to do. One of the things though that I do think med adherence has some viability in is CMMI, which is the innovation center at the Centers for Medicare and Medicaid Services, at CMS. They are the guys who do the demonstration projects. They are likely to do some more interesting things down the road, because, you know, as we’re seeing and as I’ve discussed, Congress can’t get out of its own way and they can’t pass very many policies or very many bills. So that’s going to leave CMMI to do some more interesting things. We’re hearing that they’re considering large, value-based, total cost of care initiatives for next year and beyond, and so I think that there is an opportunity for medication adherence programs to play a part in those demonstration projects.

[PERRY] Well great, I won’t hold you to the fire on that, but um, we’ll have to recircle about that in a year and see what happens. So… Man, there have been so many lessons learned during the past few years, especially within this environment of COVID. Healthcare has also been impacted in how services are provided. In regards to adherence, what programs or services have been proven as successful as a result of pivoting within the pandemic?

[SLOANE] First off, I’m going to do a plug for my coalition’s event, “The Price of Good Health.” We are featuring experts on a three-part series in November, it’s November 3, 10, and 17, and those will be available after the fact on-demand on our website. And we’re going to discuss just that. How has COVID affected the healthcare space, what did we learn, what’s here to stay, what’s going to go back to normal. So learn more by visiting cahc.net!

So secondly I’ll get into answering your question, Perry. [Both laugh] I think COVID really put a spotlight on sites of service, so where patients can get their care. Telehealth certainly exploded; I’m hearing about employers starting to offer more on-site or near-site are options so employees don’t have to take a half-day off work to go to a doctor’s appointment, so that they’re more productive.

On the telehealth front, COVID forced remote care, and Medicare waived old rules to allow beneficiaries to access their care from telehealth. So before COVID, telehealth was not allowed in Medicare. Unfortunately this is tied – these telehealth waivers are tied to the public health emergency, and they’ll go away once that ends. So there’s a bunch of bills to permanently expand telehealth in Medicare right now. Unfortunately, this is where the politics come in, even though these have bipartisan support, they’re, you know, broad support from Americans, they’re not likely to happen this year. It’s probably going to be punted to next year. And the main reason for that is because of the cost. They’re pretty costly.

Um, and so, on the adherence front, there was some interest pre-COVID around creating a safe harbor to the anti-kickback statute for certain medication adherence programs. Again, this has stalled out because all the air is being taken up by reconciliation and infrastructure, but I think if we can get some good data that ties COVID and nonadherence and exacerbated conditions together with that declining health, you may be able to get some good policy ideas into moving vehicles.

Another interesting drug policy that has an adherence angle that has some legs – and I’ve been working on – are these ideas around value-based payment arrangements, which tie reimbursement for a drug to outcomes. Did the drug work or not? These are happening in some state Medicaid programs, like Michigan, Washington, Oklahoma, and in the private sector, they’re fairly popular among gene therapies, although there’s only a few gene therapies on the market right now, but more are coming down the pipeline. There’s however some laws on the books that need to be modified to enable these. And so I think that has some legs for maybe this year/next year, and adherence programs are a big part of that. Particularly if it’s not a gene therapy, if it’s a therapy you have to take more than one time – obviously if you’re going to be testing outcomes, whether or not the therapy worked, the patient needs to take that therapy. And so having adherence programs be part of these value-based arrangements I think is a really, um, viable option for some policy – for some policies down the line.

And then I said earlier, you know with CMMI, I think the total cost of care initiatives and some of the disease management programs – there’s some diabetes management programs – those are some other areas that you can look at and develop some policies that you can help improve adherence.

[PERRY] Interesting, and I will say I’ve heard an awful lot about the value-based arrangements – payment arrangements – lately, throughout the – especially in the pharmacy world, because I know that there’s been some meetings designed and some stakeholder action groups around that. So it’s going to be interesting to see how those play out over the next year or so.

[SLOANE] Yeah, yeah, for sure, there’s more and more folks getting involved. There’s a myriad of reasons for that: one is, um, you know manufacturers, they’ve been kind of put on the spotlight recently with regards to drug prices, so value-based payment arrangements – or sometimes they’re called outcomes-based contracts – are one of those areas where they’re saying, “Hey, we believe our drug works, and if it doesn’t, you’re going to get a refund.” They’re putting their money where their mouth is. So they, you know, it’s – it was relatively new I think four, five years ago, but they’re becoming more and more popular as the years go by and I think more and more payers are looking at these and hoping manufacturers will come to the table to negotiate around their prescription drugs.

[PERRY] Well, I would say that, you know, the pandemic has created a lot of diversity and a lot of new services and technology have come out it as well, and I do think also that ScriptDrop, with their pharmacy delivery services – the timing of the pandemic really brought to the forefront that people needed options on getting their prescriptions, and one of those is home delivery. And that seems to be really having an impact within the system of pharmacy, uh, but also in improving adherence.

So Sloane, this is great information, but what is the trick on getting a lot of these initiatives moving and getting members to say yes? Because as you know, pharmacies operate on razor-thin margins, and we keep hearing about potential government price scenarios – how do these connect? And I’m not going to hold you to it, I know you’re not a genie, but your perspective would really be important.

[SLOANE] It’s tricky. The trick is getting the right kind of broad support, in my opinion. So we can make it as easy as possible for a member of Congress to say, “Yes, we will support, we will sponsor this piece of legislation.” And then the next piece that you really need to work on and that actually we’re pretty good at, at Horizon, is mapping out the road forward so you get that bill turned into law. So you know as I was talking about earlier, what is the attachment point, what is – what’s a must-pass piece of legislation that is going to be moving this year that you can tack this bill on, whether or not it makes sense or it doesn’t make sense? And then getting that across the finish line. Because as we know, these days, even though if you get a bill introduced, that is a long way from actually passing it into law.

And then on the pharmacy side, in the government price setting – [Laughs] I will just state this at the front. I believe in market forces and competition. Unfortunately, healthcare is a bit of a black box when it comes to pricing and quality information. So we need to do a better job of getting the right kind of transparency in front of patients so that they can make the best health decision based on their needs. Government price setting is not a sustainable option for improving the affordability crisis. I think we need to look at specific problems and then find solutions for those problems that affect real patients rather than play political games with various industries. So making – one of those examples is making sure patients know the cost of a drug before they get to the pharmacy or get it delivered by ScriptDrop. That’s important. But not all prescribers know or can easily get this information, and so this needs to change.

Another example is patients that have catastrophic health costs, like I discussed earlier. There should be an out of pocket cap for patients so that they don’t hit that and so they’re not held responsible for health costs beyond a threshold that they cannot afford. Value-based payment arrangements, as I talked about earlier: that’s another market-based policy. If it works, you pay, and if it doesn’t, you get a refund. Adherence policies are another one, like medication synchronization, where you synchronize all of the fills up to one day a month; this is particularly relevant for patients in rural areas. Comprehensive medication management, where you’re making sure that all parts of the healthcare team know the drugs that the patient’s on and how they take those drugs, so a patient’s not prescribed a drug from their pulmonologist and then another drug prescribed by their, um, nephrologist – you’ve got kind of that total, holistic view of the patient, and you can make sure that they are on the right drug, at the right time, and that they know how to take the drug.

So those are just a few of market-based options that I think are better alternatives than some of the draconian, you know, price control metrics that the government right now is currently considering.

[PERRY] So I, I could resurface with you in a couple months to make sure you’ve got all of this taken care of?

[SLOANE] [Laughs] Sure, sure.

[PERRY] [Laughs] Ok, so let’s switch gears just a little bit. I know there’s a lot of attention in the media about funding the government. It’s front and center on legislators’ minds, and one of the most contentious issues across all media these past few weeks. So, simply: what happens to healthcare for recipients of Medicaid and Medicare?

[SLOANE] That’s a great question, because I think a lot of folks get confused when you’re talking about the government and the government shut-down and who gets paid and who doesn’t get paid. Medicare and Medicaid and Social Security is considered non-discretionary, so it’s mandatory spending. They’re also called entitlement programs, which means that they’re not affected by the annual appropriations process. So my parents don’t have to worry about not getting their Medicare coverage if the government ends up not able, um, to pass some kind of continuing resolution or the funding bills for federal year – er, for fiscal year 2022.

However, regarding Medicare and spending, Medicare is expected to be insolvent by 2026. I’m going to say that again: 2026. That’s four years away. Um, and this is according to the Medicare board of trustees annual report to Congress. This is one of the big reasons that opponents of expanding Medicare services cite. Letting that trust fund run dry isn’t likely, but it does mean that addressing the finances with some kind of legislation are required sooner than later.

[PERRY] Wow, I’m kinda torn. Eventually, being a Baby Boomer, I want all those additional services. But on the other hand, I don’t, you know, want it to become insolvent before I have the opportunity for that to happen! So… Man, you’ve given us a ton to think about. My head is swirling around everything that’s going on. I want to thank you, Sloane, for really preparing an awful lot of information for this podcast, I think it’s been very rewarding to me, I hope for our listeners as well. And, you know, I would have to say maybe at the beginning of the year we may want to have another podcast as to what’s actually happened and where are things going, if you’re up for that.

[SLOANE] Yeah no sure, this was a pleasure. [Laughing] Caveating again, a lot of the things I’ve said may change by the time that this is published. Um, and happy to do an update, happy to chat with anybody about the complicated process that is Washington, D.C. And, you know, I think I’ll end this on a positive note. I think healthcare is exciting right now. We’ve got all these new innovations, you know, hopefully we’re approaching the end of the pandemic, although maybe it’s going to be here with us to stay, like the flu… But weren’t we able to get incredible treatments in an incredible amount of time? And so, you know, while I’m kind of talking about politics being, um, you know, this, this hurricane of inactivity, it’s necessary.

We’ve got elections coming up, so you know, if you believe in something, I really encourage you to look up your member of Congress and see what they are voting on, to engage with Congress. And go vote! At the end of the day, that’s what this democracy is built off of.

[PERRY] Point well taken, I totally agree. So this has been a lot of fun; I wish we could’ve done this in person. Maybe next time we can, over a cup of coffee.

And now I’d like to turn it back over to Lauren.

[LAUREN] Thank you so much, Perry and Sloane. That was a great conversation; so much information. But before we go, I would like to reiterate Sloane’s caveat. The legislative landscape is really chaotic right now, so if you are listening to this podcast any time after October 28, it’s very likely that things have changed. Nevertheless, I think it’s important to remember that policy has a major impact on what we do as healthcare companies – and patients.

But regardless of what the future holds for healthcare companies, providers, health systems, hospitals, and patients, ScriptDrop will be there to help.

Now thank you to all of you for catching “Health on the Hill!” We hope you’ll join us for future episodes with guests like Lee Ann Stember of NCPDP.

If you’re a member of the healthcare industry and would like to learn more about ScriptDrop’s healthcare access solutions, please reach out to us at info@scriptdrop.co

If you’d like to learn more about prescription delivery and its impact on patients, check out our 2021 industry report at report.scriptdrop.co.

And finally, if you liked what you heard today, please click “like” and “subscribe” so you’ll be sure to catch our next podcast episode coming this winter.