Chapter Next with Miriam Paramore || EP. 177

[00:00:00] When Kamala Harris, when Joe Biden made the, I think, remarkable decision to step down, I can't imagine a human, you know, doing that step away from the most powerful job in the world, literally, for the good of the country, that, that really energized me at a level when when Kamala was settled on and happened pretty quickly, energized me at a level that I hadn't expected. And it just catalyzed this, this enormous outflow of energy was like, man, I didn't know how depressed I was. Holy cow.

[00:00:30] And as I was sharing that enthusiasm, one of my colleagues, our colleagues encouraged me to marry me, you have to write about that. Like, put it out there and put it on LinkedIn. And I'm like, man, I've never, you know, crossed the streams of politics and business, because there's always been too much risk. And you try to stay apolitical and you don't want to offend a customer or whatever impact your business negatively. If you're public, you can't say anything if you're an officer. So generally, but at this point in my life, Laurie,

[00:01:00] chapter four, I'm now starting a new business. And so all that fear is going off like, oh, I can't say anything. Because what if you offend somebody that might be a customer involved? You know, this is your own money. And I was like, no, okay. This is actually more important than money. It's more important than my job. It's more important than my next business. This is an opportunity for us as a nation, in my view, to move forward.

[00:01:25] This is inspiring women. And I'm Laurie McGraw. And today we are speaking with Miriam Paramore. And Miriam is a friend. She is an outstanding executive leader. And she just started a new company called RX Utility. And today we're going to talk about RX Utility. But we're going to talk about a couple things. We're actually here in Nashville at the very awesome and cool Nashville Sessions Conference. And Miriam, in addition to the many things that she's done,

[00:02:00] she is from the inaugural class of the Nashville Healthcare Council Fellows. We're going to talk about that too. That was an early beginning. But she's one of the most connected people here in Nashville. Let me just tell you where it happens. About 18 people have stopped her just to get coffee this morning to say hello. Miriam, thank you for being on Inspiring Women.

[00:02:21] Laurie, thank you so much. This is a huge treat. I've been really excited and looking forward to doing this with you. And it was just such a treat that it came together here at Sessions. And I can do it in person with you. So thank you very much.

[00:02:35] I know. We're in a glass booth, everyone. It's very funky and cool. And there's a lot of people around who are looking at us like we're a little bit cuckoo. But that's okay.

[00:02:43] Though I'll tell you, I did a podcast here yesterday afternoon. And this is a glass for the you can't see us guys. So you can hear us. But the pod that we're inside of is a kind of a glass cube. Imagine that in your mind. And there's tall glass windows with the sun streaming in heating up this glass cube yesterday afternoon. And it was a little toasty in here.

[00:03:05] So it's like a sauna. It's much it's much cooler this podcast sauna. All right, Miriam, let's let's get started. So I know you we've known each other for a long time started at women business leaders, where we're both members of that. You're also a big advocate for innovation, investing as a woman investor, which is a fantastic thing that you do. But give us a little bit of your background. I know you but tell the world a little bit more about you.

[00:03:34] Okay, thank you, Laurie. I have been in healthcare professionally my whole career. And as I was thinking about this podcast with you and thought about, you know, what's my you know, what do I do? And what's my story? I thought a little bit about, like how I got here, sort of personally. So is that all right for me to just take a moment there, like pre professional?

[00:03:54] There are a couple of thoughts that I've been wanting to share that I think your listeners may resonate with. And, and one is that I have had a long and successful career. And I didn't go to a fancy school and I don't have a master's degree. And my parents were, you know, my dad was a preacher. So you can imagine the, you know, where we fell on the bell curve of, you know, sort of income.

[00:04:17] And the reason I share that is I used to think when I was younger, that, you know, only people that went to fancy schools and only people that had master's degrees or an MBA from Harvard, or, you know, went to Cornell or MIT or something like that. Those were sort of the smart people. And those are the people that could succeed in business.

[00:04:38] And that's really not true. And, and as I've sort of grown up as an adult, you know, my career path started. I have a degree in math and computer science. And I started out as a programmer right here in Nashville for HCA. That was my introduction to healthcare was just what you call go get a job right after you get from college.

[00:04:57] But I also started really young, I ended up going to college at 16. So I was only 20 when I graduated. So it kind of gave me a head start in the industry. But it sort of reinforced this feeling that I had that I don't quite really fit because I was always too young for whatever everybody else was doing when I was in college. And I felt like I didn't have the educational pedigree that I needed to be successful in business.

[00:05:25] And I found out that wasn't true, you know, either. And I want to encourage everyone who may feel like, like where I came from, you know, or who my parents were, or where I was able to go to school. Maybe I didn't go to school. I mean, some of our most successful in business terms, people, you know, college dropouts famously. So, you know, all of those things are origin stories, but they're not necessarily obstacles unless you sort of let it feel like one or sort of let it become one.

[00:05:53] For me, I think I sort of it felt like one, but it also gave me a fire. I'm very competitive and sort of ambitious. And I was like, I can, you know, I can probably do that. And then I would look up to people like you and people like our good friend, Glenn Tolman, who's been, you know, super successful and also a friend and mentor. And I would say, you know, be like Glenn.

[00:06:13] And I would wake up and I hate for him to hear that. But, but, you know, I would try to model after the behavior that I would see. So, you know, in my career, starting out as a programmer, I was just, you know, like I said, I just kind of had a job, but I kind of came up what I would call through sort of four chapters of my career.

[00:06:32] One would just be a baby worker, just have a job. But I learned healthcare and the data that drives a hospital system and a health plan and how they interact really early on.

[00:06:42] Then ended up getting into standards work when, you know, sort of HIPAA came out.

[00:06:46] But I got into management consulting, which is a great training ground, Ernst & Young, for young professionals who, that kind of help you up level and see a little bit more strategically around business processes.

[00:06:57] That's sort of where I got interested in using technology and information for business problems.

[00:07:05] I ended up being recruited into Anthem and my first sort of CEO job, I was only 30, but I was running a subsidiary of Anthem that was what we would call today a clearinghouse.

[00:07:17] It's like change the one that crashed, which I actually worked at when it was called Emdion, but it didn't crash during those days.

[00:07:24] No, but running that business got me into the revenue cycle of healthcare, which is sort of in the mid 90s, when healthcare really started to digitize claims, if you can believe it still a lot of it was paper.

[00:07:36] And so I remember Miriam, I remember.

[00:07:39] Well, you're, you know, I think of you as younger.

[00:07:43] So, so that sort of became, I guess, maybe the second chapter, which was I'm now an executive.

[00:07:49] What does that mean?

[00:07:49] What does it take to run a business unit or a PNL or that kind of thing?

[00:07:54] I was like, oh, this is pretty cool.

[00:07:56] So like companies that are just tech can be companies in healthcare.

[00:08:00] And somewhere along those lines, I really fell in love with the healthcare industry.

[00:08:05] I now had an exposure to providers, payers, you know, ambulatory providers as well as institutional.

[00:08:12] And I learned what used to be called medical billing, which is now called revenue cycle at the level of this is what it takes to post a payment.

[00:08:19] And how the technology sucks and things like that.

[00:08:21] And so, you know, we got all that off the ground.

[00:08:24] That was a subsidiary that we did, then did franchise for multiple blue plans and Medicare.

[00:08:29] So we really high volume data movement back before the cloud and so forth.

[00:08:34] And sort of the second chapter of my career was then becoming an executive at MDON.

[00:08:40] And MDON is now Change Healthcare.

[00:08:42] But when I was there, and this is a familiar story for you, maybe some of your listeners, Only Girl in the Room would be the title of the book, you know, if I ever write it.

[00:08:50] Yeah.

[00:08:51] So the only female executive on the executive team, a team of eight.

[00:08:55] And George Lazenby, who brought me in, I was the first executive hire after he became CEO of MDON, which was a derivative of WebMD, if you can believe that from way back in the day.

[00:09:07] Excuse me, I'll take a sip.

[00:09:08] We could do a little map of sort of like all the country or a company origins instead of like, you know, where they roll up to.

[00:09:16] It's funny.

[00:09:16] Yeah, it's funny.

[00:09:17] In fact, the name MDON, which I always thought was a terrible name because it's kind of hard to pronounce.

[00:09:21] Nobody knew how to spell it.

[00:09:23] It is the EON came from Healtheon.

[00:09:27] Yep.

[00:09:27] And the M, E-M in front of it, E-M-D-E-O-N, came from phonetic spelling of MD for WebMD.

[00:09:35] So they took WebMD and Healtheon and shoved it together and came up with this word, MDON, that, you know, nobody else had used so they could trade market.

[00:09:41] And this is why you and I don't have marketing degrees, because we know for a fact that that was not a good idea.

[00:09:47] But we would have had a better name, I'm sure.

[00:09:50] I think we would have.

[00:09:52] Without a marketing degree, we would have had a better name.

[00:09:54] Or at least T-shirts, yes.

[00:09:55] So that role for me was pivotal in my career.

[00:09:58] And the reason I kind of got that role was because I had just worked really hard in the industry and work that I didn't get paid for.

[00:10:07] For example, lots of volunteer work with HIMSS, lots of volunteer work with other trade associations that were in kind of the technical guts of trying to get standards developed and things like that.

[00:10:18] So I had relationships.

[00:10:19] George came in as CEO, brought me in as executive vice president of strategy.

[00:10:23] I ended up running product development for the entire business and was heavily involved with the corp dev.

[00:10:29] And we took the business from about $600 million to $1.2 billion in about six years, took it public.

[00:10:34] Largest health IT IPO in history at the time, 2009.

[00:10:38] Then we ended up taking the business back private.

[00:10:40] And that's when our executive team essentially left.

[00:10:42] So that was 2013.

[00:10:43] So that was like chapter two.

[00:10:44] And so chapter, that was a really successful period.

[00:10:47] I learned a ton.

[00:10:48] And now I feel like I can wear an executive suit.

[00:10:52] You know, I feel like a little less of an imposter with the imposter syndrome.

[00:10:56] It was also my first initiative or the first time I created what we now call a DEI group.

[00:11:03] And I'd love to tell that story.

[00:11:04] We can come back to it when we talk about help at the end, women's health care leaders, whenever you want to talk about it.

[00:11:10] So chapter three was like, well, okay, well, now what do I want to do?

[00:11:13] And I did a few things, but I ended up becoming president of a company called OptimizerX, which was a NASDAQ company.

[00:11:20] The first company I had worked on that joins the life sciences sector with the health care service delivery sector digitally.

[00:11:29] And I can tell you that that still really doesn't happen.

[00:11:33] And Optimizer was one of the few.

[00:11:35] And since my expertise had kind of evolved into multi-sided digital networks over the years, payers of all kinds, providers of all kinds, pharmacies of all kinds, including specialty.

[00:11:45] I was like, man, I don't know that much about these manufacturers.

[00:11:48] But there's a world of opportunity if we can bridge what I call this is like Australia and North America, lack of a digital bridge.

[00:11:57] And when we talk about interoperability so much in health IT, it's true.

[00:12:03] That's just within the service delivery ecosystem and payment.

[00:12:06] But you have this whole research, life sciences.

[00:12:09] They are two different continents for the lack of interoperability.

[00:12:13] So there's just a ton of opportunity.

[00:12:15] And that's kind of what takes me into after OptimizerX, I really kind of learned, that was chapter three, what that digital divide was and what the opportunities were.

[00:12:25] That was the seed of what became Rx Utility.

[00:12:28] Then I started into the fourth chapter of my career, which is where I always wanted to be, Lori.

[00:12:32] I was like, oh, my goodness.

[00:12:33] Who are these people that have money?

[00:12:35] Yeah.

[00:12:36] Because remember, I was like, you know, a person who kind of like, I don't know.

[00:12:39] You know, I'm just a programmer, right?

[00:12:40] And I was like, oh, I think I can run things and learn how to be an executive.

[00:12:45] But you always have a boss, even if you're in a publicly traded company, even if you're on the board.

[00:12:49] But you don't really know that when you're a young professional.

[00:12:52] You're kind of like, oh, if I could just be in that chair, I'd be sort of the boss.

[00:12:56] Yeah.

[00:12:56] But no.

[00:12:57] So, you know, you can be the CEO.

[00:12:59] The board is still your boss.

[00:13:00] If you're public or private, the shareholders are kind of your boss.

[00:13:03] And, you know, there's always so much to report to.

[00:13:06] Well, I want to get to chapter four because one of the things, and this sort of, you know, origin story and trajectory is a familiar one.

[00:13:13] Where a sort of like, you know, girl goes to work, works like crazy, works really hard, starts to show up in ways that, you know, larger and larger positions, becomes an executive, realizes that you can do something of magnitude.

[00:13:31] It's all about impact.

[00:13:32] It's not just about the paycheck.

[00:13:35] It's always about getting something done.

[00:13:37] Yes.

[00:13:38] And then comes chapter four.

[00:13:40] And I look at chapter four and I want to hear where we're going with RX Utility as the, okay, I've done things, I've made things.

[00:13:49] And now I'm thinking about what else am I going to do?

[00:13:52] I have a tremendous amount of energy.

[00:13:55] I have all this experience.

[00:13:56] I have smarts.

[00:13:58] I now fully appreciate to a large degree, you know, how complicated healthcare actually is.

[00:14:05] Yes.

[00:14:05] How upside down a lot of the metrics are.

[00:14:09] And as a woman executive, as an inspiring woman, you know that you've made it in places where others haven't and you're a role model for that.

[00:14:18] So what do you do with all that?

[00:14:20] Yeah.

[00:14:20] Sometimes women just sort of say it's time to take it easy.

[00:14:24] It's time to sort of like, you know, smell the roses.

[00:14:25] It's whatever.

[00:14:26] But you chose a different path.

[00:14:28] Your energy has led you to other things.

[00:14:31] And that path is innovation, doing something new, big vision.

[00:14:35] Yeah.

[00:14:36] What is it?

[00:14:36] Yeah.

[00:14:36] Thank you so much.

[00:14:37] Great setup.

[00:14:38] I thought I might not smell the roses, but take a little bit of a step back in the advisory work that I do with private equity and operating advisor for Goldman Sachs and others.

[00:14:49] And that's fun to do.

[00:14:51] Board work is fun to do.

[00:14:52] It isn't the same as creating something.

[00:14:55] And so work, in air quotes I'm saying here for your listeners, is my creative process.

[00:15:02] So I'm not a painter, musician, those types of – it feels very artistic to me.

[00:15:07] It's creative for me.

[00:15:08] And it's life-affirming and energy-giving.

[00:15:10] So as I grew up through my career, as we've discussed, by the time I get here, then you do have a level of confidence and, in fact, resources that you didn't otherwise have.

[00:15:19] Because there's relational resources.

[00:15:21] There's capital resources.

[00:15:23] There's skill and expertise.

[00:15:25] And what I hinted at earlier with what I saw, the opportunity in Optimizer X, is that I had just learned about the scale of copay coupons.

[00:15:34] So everybody is familiar with GoodRx because they're a fairly well-known brand.

[00:15:38] And those are cash coupons, and they're doing a great job.

[00:15:41] They help you comparison shop at pharmacies and so forth.

[00:15:44] But there's this treasure trove of things called pharmaceutical manufacturer copay coupons.

[00:15:50] And there's so many of them.

[00:15:52] This is a separate source of savings.

[00:15:55] It's $10 billion a year every single year.

[00:15:59] But only about 20% of it is used.

[00:16:01] And I was very motivated by that.

[00:16:03] And I looked at that hard.

[00:16:04] Why is that?

[00:16:05] What are the issues?

[00:16:06] Why is that?

[00:16:07] I mean, because it's confusing, I think, is the answer.

[00:16:09] Just like the cost of medications is everyone knows it's out of control.

[00:16:16] People are rationing their medications.

[00:16:18] And figuring it out in the moment when you're at the pharmacy or at the physician office, it's a mess.

[00:16:25] It is a mess.

[00:16:26] So I want to know why there is so little of $10 billion just sitting on the table.

[00:16:34] But what can be done about that?

[00:16:36] Because that's money that people need.

[00:16:38] It is.

[00:16:39] And medications are expensive.

[00:16:40] It is.

[00:16:41] And one of the things that emerged for me in using technology to improve health care was a personal health, personal mission statement that I developed for myself about 10 years ago.

[00:16:52] And my personal mission statement is to improve the U.S. health care system through the power of information.

[00:16:59] Because I've been a nerd to get things to be data instead of paper and standardized data.

[00:17:03] Now it's information.

[00:17:04] But if it doesn't move to people, if it's not distributed and actionable, it doesn't matter.

[00:17:12] And so that's the problem that we're solving.

[00:17:14] It's truly a lack of an awareness, a lack of awareness.

[00:17:18] And it's a lack of digital distribution.

[00:17:22] And so when I looked at that, I thought, oh, I know how to do those things.

[00:17:25] Yeah.

[00:17:25] I know how to make things digitally.

[00:17:27] And I know how to distribute things in a multi-sided network.

[00:17:31] Because what we have to have to get digital flow, digital liquidity, and not interoperability problems, but true digital equity or what I think of as digital data equity.

[00:17:43] The data has to move in a way that it can be consumed by applications and other pieces of software.

[00:17:51] And then it can get to providers and to patients.

[00:17:54] And I thought, man, here's how we do that.

[00:17:57] So how we do that is we created the only, it's the first time in my career, which is a long career, that I can use the word unique in a piece of software that I have developed.

[00:18:07] Yeah.

[00:18:08] And unique means there's only one of them.

[00:18:10] Like it's unique.

[00:18:11] So I've created the only database of all of these $10 billion of savings.

[00:18:17] And we've made that easily accessible through simple APIs.

[00:18:22] Yep.

[00:18:22] Because our path to putting this money in the wallet of the consumer, keeping it, improving their health and healthcare, is to use the health IT ecosystem that already exists.

[00:18:35] What if I wasn't using these digitally, you know, in terms of what you've created with RX utility, what was I doing before?

[00:18:44] Okay.

[00:18:44] You know, to access these $10 billion worth of coupons.

[00:18:47] Do you remember or you can think of any ad that you've seen?

[00:18:50] Yep.

[00:18:50] On TV.

[00:18:51] Yeah.

[00:18:51] Or radio.

[00:18:52] At the very end, they'll say, if you have problems affording this and blah, blah, blah, blah, blah.

[00:18:56] Yeah.

[00:18:56] Go to www.astrozenega.com.

[00:18:58] You know, it's, they talk real fast.

[00:19:00] And if you're looking at a print ad, it's very, very tiny print.

[00:19:03] Best point about the refrigerator not paying attention for sure.

[00:19:06] Absolutely.

[00:19:06] Yeah, absolutely.

[00:19:07] And so there was, there was, because there is no clear way to make money doing something, people won't do it.

[00:19:17] Yeah.

[00:19:17] And so we had a, I had a little bit of a, of a gift in that one of the product lines OptimizeRx had in its distribution of data from the life sciences sector to the healthcare services delivery sector.

[00:19:30] Remember Australia to, you know, the North American continent was some of these savings, but it was a very, very small scale.

[00:19:37] And I'll put that in real terms.

[00:19:39] We might do it for 50 brands.

[00:19:41] Yep.

[00:19:42] At Optimize.

[00:19:43] And we were one of the few that does it in the country.

[00:19:44] I have 1,215 brands in the database that I have in, and it's 10 billion dollars, this scale mover.

[00:19:52] Right.

[00:19:54] So if we digitize it and let it flow, that's where we're going.

[00:19:59] But if someone just hunted and tried to find it, first of all, a doctor is not going to do that, even if they know it's there.

[00:20:05] That's right.

[00:20:05] The pharmacist will actually try to do it.

[00:20:08] I have a lot of PharmDs I've worked with.

[00:20:09] They don't have the time to go behind.

[00:20:11] And now we've seen that people know GoodRx enough that a pharmacist might say, oh, look it up on GoodRx.

[00:20:17] Yeah.

[00:20:18] Well, there's no, quote, GoodRx for this $10 billion until now, which is called Rx Utility.

[00:20:25] Yeah.

[00:20:25] So I called it Utility because it's a tool that the existing health IT ecosystem can plug into.

[00:20:32] And who are you looking to get plugged to?

[00:20:35] So, like, who are your first, you know, target customers that you're going after?

[00:20:39] I'm going to answer that in terms of what patients and real people, I can say real people, we're all real people, but you know what I mean when I say.

[00:20:45] What real people do is we get sick and then we go to the doctor.

[00:20:48] Yeah.

[00:20:48] Almost every time we go to the doctor now, there's some kind of app on your phone that will help you check in.

[00:20:55] Right.

[00:20:55] Okay.

[00:20:56] Even if you're going to the hospital for some sort of procedure.

[00:20:59] Afreesia is a popular company that does this.

[00:21:01] It might not be.

[00:21:01] It might be something else.

[00:21:02] So you go in, you get to the doctor.

[00:21:05] A lot of then, you know, the prescribing that happens, those meds that happen when you're in the office.

[00:21:12] They go, well, you need this and this or you're in the hospital.

[00:21:15] That script is issued out of the EHR, out of the e-prescribing module.

[00:21:19] So right there, if we can be at the point of prescribe, that EHR or e-prescribing module can just plug in and it's a simple API.

[00:21:26] It's, is there a coupon?

[00:21:28] Yes or no.

[00:21:28] You know, and they can optimize that API however they want because my goal is to get them to innovate with the content.

[00:21:34] Yep.

[00:21:34] Move the content forward.

[00:21:36] If it's digital at that point, Lori, it gets embedded digitally into the script and flows directly to the pharmacy.

[00:21:42] Auto adjudicates as the secondary payer.

[00:21:44] That's the best case scenario.

[00:21:46] Yeah.

[00:21:46] But let's say that I'm not in every EHR, which I'm, which I probably never will be because, you know, there's some of them are, I won't let anyone in.

[00:21:56] There's a, there's another time.

[00:21:57] There's the point of dispense.

[00:21:58] Yeah.

[00:21:58] So we're, we do that with the pharmacy management systems, the things that the people are using behind the counter when they're keying in things.

[00:22:05] Yeah.

[00:22:06] So that it can pull up.

[00:22:07] So the meds there is their coupon.

[00:22:09] Yep.

[00:22:09] Okay.

[00:22:09] Auto adjudicate and go.

[00:22:12] Yeah.

[00:22:12] All right.

[00:22:13] Let's say that it's post dispense.

[00:22:16] Yeah.

[00:22:17] Well, if I'll take one more example, if you're on a discharge path, you have an ADT file that comes out of the system.

[00:22:22] Admit discharge transfer is what that stands for.

[00:22:24] And you have discharge meds.

[00:22:26] Yeah.

[00:22:26] And on that stream of data, you know, a lot of times, I think every time they print that stuff and hand it to you, there's some portals that are doing better now.

[00:22:34] But that can simply be appended and the consumer can have it in their hands.

[00:22:37] Well, I think that as you, as you work through all of these use cases, I mean, look, let's face it.

[00:22:43] I mean, the cost of medications is just too high for people to afford it.

[00:22:49] Right.

[00:22:49] And so anything that can be done that makes it easier for people to access these needed medications is important.

[00:22:57] I mean, I just learned recently that, you know, of the so many people who are on medications, 35% of them are non-adherent.

[00:23:07] Right.

[00:23:08] To medications that they need, whether it's a chronic condition, acute episode or whatnot.

[00:23:12] And a large portion of that 35% is due to affordability.

[00:23:18] Yes.

[00:23:18] It's not due to like, they don't want to take the medications.

[00:23:21] They've, you know, they're not paying attention to what they need.

[00:23:24] It's affordability.

[00:23:26] Right.

[00:23:26] So I have to say, Miriam, this is an exciting company that you're building.

[00:23:31] Thank you.

[00:23:31] With a big mission and I'm really hopeful that you are enormously successful.

[00:23:37] Thank you.

[00:23:37] So some of the things that I'm excited about is not just what you're doing, but also the energy that you bring to pretty much everything, Miriam, that you do.

[00:23:46] Like everything.

[00:23:47] And I wanted to pivot us just a little bit to another shared passion that we have that you have taken on steroids, you know, and just made even bigger.

[00:23:59] And that has to do with what's happening politically in this country.

[00:24:04] And we're in a very, I see the t-shirt.

[00:24:06] I see the t-shirt.

[00:24:07] We're in an important election cycle.

[00:24:09] You started an organization called Women Healthcare Leaders for Progress.

[00:24:14] And it's not about just a political, someone that you're supporting and asking us to support.

[00:24:21] It's an issue-based reason.

[00:24:24] And this started from, I remember, a conversation and something that you just had to put down on paper and wrote about that kind of went a bit viral, which is, I thought I was depressed or I didn't know how depressed I was.

[00:24:37] Yes.

[00:24:37] Until.

[00:24:37] So tell us a little bit about Women Healthcare Leaders for Progress.

[00:24:41] Well, thank you so much.

[00:24:42] And you, as a co-founding member, are a pivotal part of that.

[00:24:47] Riding on your coattails.

[00:24:48] Put that shout right back at you.

[00:24:49] But I was, when Kamala Harris, when Joe Biden made the, I think, remarkable decision to step down.

[00:24:57] I can't imagine a human doing that step away from the most powerful job in the world, literally, for the good of the country.

[00:25:04] That really energized me at a level, when Kamala was settled on and it happened pretty quickly, energized me at a level that I hadn't expected.

[00:25:13] And it just catalyzed this enormous outflow of energy was like, man, I didn't know how depressed I was.

[00:25:19] Holy cow.

[00:25:20] And as I was sharing that enthusiasm, one of my colleagues, our colleagues, encouraged me, maybe you have to write about that.

[00:25:27] Like, put it out there and put it on LinkedIn.

[00:25:29] And I'm like, man, I've never, you know, crossed the streams of politics and business because there's always been too much risk.

[00:25:37] And you try to stay apolitical and you don't want to offend a customer or whatever, impact your business negatively.

[00:25:42] If you're public, you can't say anything if you're an officer.

[00:25:45] So, generally.

[00:25:47] But at this point in my life, Lori, chapter four, I'm now starting a new business.

[00:25:54] And so, all that fear is going off like, oh, I can't say anything because what if you offend somebody that might be a customer involved?

[00:25:59] You know, this is your own money.

[00:26:00] And I was like, no.

[00:26:03] Okay.

[00:26:04] This is actually more important than money.

[00:26:06] It's more important than my job.

[00:26:08] It's more important than my next business.

[00:26:10] This is an opportunity for us as a nation, in my view, to move forward.

[00:26:15] Forward.

[00:26:16] So, progress.

[00:26:17] And having a diverse candidate, meaning a non-white male candidate by itself, is exciting.

[00:26:25] Okay.

[00:26:26] To have someone with her strength, poise, experience, and gravitas was double encouraging.

[00:26:37] So, I was on one of those early calls, the White Women for Kamala call.

[00:26:41] There were 160,000 women on that call.

[00:26:43] Mm-hmm.

[00:26:44] Celebrities on that call.

[00:26:46] Zoom broke.

[00:26:48] The DNC donation button broke.

[00:26:50] Mm-hmm.

[00:26:51] And it was a DIY.

[00:26:52] And it was so real.

[00:26:54] And I'd never been part of anything like that prior.

[00:26:57] All I had done politically was just I would donate, you know, support, maybe do a little bit of, you know, volunteer, but not much.

[00:27:03] And I really took to heart what Michelle Obama said.

[00:27:05] Do something.

[00:27:06] Mm-hmm.

[00:27:06] And I took Kamala's words to heart when she said her mom used to say, you know, and not half-assed.

[00:27:13] So, I was like, man, I just need.

[00:27:15] So, I broke that wall knowing that at this point in my life there's risk associated with it, but it's so important.

[00:27:23] I would rather do that.

[00:27:25] And the outpouring, the inbound response to it blew my mind from doing that.

[00:27:31] Yep.

[00:27:31] And it's got like 10,000, you know, posts and reposts and different things.

[00:27:36] And so, out of that, I said, well, you know what I'm going to do?

[00:27:38] I'm going to make a commitment to myself.

[00:27:40] Mm-hmm.

[00:27:41] I'm going to do something every week.

[00:27:43] Do something actual, a doing thing, not talking about it.

[00:27:47] Mm-hmm.

[00:27:47] I'm going to start that by get a call together.

[00:27:49] Who else feels this way?

[00:27:50] I just said DM me if you want.

[00:27:51] And we had that extraordinary call that you were part of.

[00:27:54] But out of that call, and here's innovation at work, out of that call came this idea of an open letter.

[00:28:01] Missy Krasner got on it.

[00:28:02] I didn't know until that call how active you were.

[00:28:05] I knew you were active, but I didn't really know what you were doing.

[00:28:08] I didn't know Lori Evans-Bernstein, our friend.

[00:28:10] I didn't know how active she was.

[00:28:11] I just didn't, you don't know because you don't have that conversation all the time.

[00:28:15] So, everyone had all these good ideas, strength, and they had resources and tools, and they wanted to get involved.

[00:28:21] Yeah.

[00:28:22] So, I was like, holy cow.

[00:28:23] Wow.

[00:28:23] So, this open letter emerged.

[00:28:25] I think now we have over 500 signatures.

[00:28:27] Yes.

[00:28:28] And you say, well, why do an open letter?

[00:28:29] What does it matter?

[00:28:30] It really does matter.

[00:28:32] And here's what's happened since then.

[00:28:33] So, you've got 500 people.

[00:28:35] Now, we've got our male allies coming along who are willing to take a stand and say, these are the issues that are important to me in terms of our nation.

[00:28:44] And I'll go back to your comment about issues.

[00:28:46] So, I believe and I think we believe that a woman's right to choose is a primary fundamental right.

[00:28:55] To me, that is a subset of our individual rights, our freedom of choice as American citizens, and our freedom to design and live our own lives unencumbered by other people's definition of things or who happens to be in power at a particular time.

[00:29:44] Yeah.

[00:29:46] What do they have to do with their own bodies?

[00:29:48] Yesterday, yesterday, I was reading that there are 210 crimes of pregnancy that have gone through courts since the overturning of Roe v. Wade.

[00:30:03] Crimes of pregnancy.

[00:30:04] Now, we don't know the details of that, but that can even be a thing.

[00:30:11] So, we are in a new world.

[00:30:13] And the level of security of the ground that we're working on in terms of walking on in terms of what is no longer available to women, it's very – there is no more important issue to me.

[00:30:28] I am ecstatic of the diversity of Kamala Harris as a candidate, but it is that reason of what that means for women specifically.

[00:30:38] The backward turning of the clock that I didn't think was possible has happened, and it is simply the most critical issue for me in terms of what's there.

[00:30:52] And there's a whole host of other things that I'm counting on, but I can't appreciate you enough, Miriam, for that getting out of the depression, taking the action, and then just clearing the way for others to come along with you.

[00:31:06] Well, thank you, and thank you for being on this journey and for letting us talk about it here because, you know, people use their time in different ways.

[00:31:14] And what you just discussed, you said the word backward, and what I want to say as it relates both to personal and business and sort of being inspired, if we look at where we've come from and where we're going, to me there's a civil rights issue broadly defined.

[00:31:33] There are certainly women's rights, and there's women's health care.

[00:31:36] And it's not even just health care.

[00:31:38] We had the two deaths in Georgia just recently.

[00:31:42] Like, people are – they're dead.

[00:31:46] And I use that word, you know, with some emphasis because it's not a theoretical thing, and I believe in the United States of America that it shouldn't be a geographical thing.

[00:31:56] And, you know, I don't believe that a state's rights approach is anything other than a smokescreen because I'm trying to think of a state's rights issue.

[00:32:04] Let me think back to – oh, I don't know – something that's not related to control and anti-democratic measures where we have, let's say, slavery was a state's rights issue.

[00:32:15] Civil rights – women's voting was a state's rights issue.

[00:32:19] Civil rights was a state's rights issue.

[00:32:21] Integration of schools was a state's rights issue.

[00:32:24] You can see where, you know, this sort of belongs if you want to use that smokescreen to believe it.

[00:32:31] But if you live on one side of the river and I live on the other, you can tell me we don't have equal rights in the United States of America as one state and one's another.

[00:32:39] One's Kentucky and one's Indiana.

[00:32:41] Well, now we're getting worked up.

[00:32:44] So now we're getting worked up, and we could talk about this, you know, a lot.

[00:32:49] But let's bring it back.

[00:32:52] So you and I share this passion and also the appreciation for 500 other, you know, women executives to put their name in print out loud for the world to see that these issues are that critical to them,

[00:33:07] that they're making this choice to stand up for women healthcare leaders for progress.

[00:33:12] But that energy, that passion, that sort of some of the defining characteristics of who you are, Miriam, as you think about closing out this Inspiring Women conversation,

[00:33:23] I'd love to bring it back to sort of like, you know, we're in Chapter 4.

[00:33:28] Yeah.

[00:33:28] Okay.

[00:33:29] What does sort of like Chapter 4.1 or next look like, you know, for you?

[00:33:35] I really love how you've sort of described this entire arc of what you're trying to accomplish.

[00:33:41] Thank you.

[00:33:41] I have learned through the different kind of businesses that I've run.

[00:33:45] And as I've seen, unfortunately, the Commonwealth Report came out last week, and the top 10 industrialized nations were last again in cost and quality.

[00:33:54] And I won't go on that ramp because I could.

[00:33:57] But I still believe that technology and information is a powerful lever to improve things.

[00:34:05] I've landed on for individual people, for the rights, you know, the rights and the health and the equality and affordability of people around their health.

[00:34:15] So Rx Utility gives me an opportunity to put my skills and resources to work in a way that tangibly touches people.

[00:34:24] And so it's sort of a micro change, maybe than a macro change.

[00:34:29] If you were talking about, you know, value-based care versus fee-for-service macro.

[00:34:33] This is something, it's a tool that already exists.

[00:34:35] We just need to mobilize it and get it moving.

[00:34:38] So that keeps me energized and inspired because I know that those people can experience the medication that they deserve, you know, through these affordability tools.

[00:34:51] And I'll give you an example of Zempic.

[00:34:53] I have it in my purse right there.

[00:34:54] But there's a manufacturer copay coupon for Zempic for $25 out of pocket per month.

[00:35:01] And that's a, you know, that's a thousand plus, you know, drug.

[00:35:05] If you're on a high deductible health plan, if you're in a, you know, high tier of your pharmacy, if you have a coinsurance scenario, these out of pocket things, 30% of the time will keep people from even getting it.

[00:35:18] Let alone the 35, 40% you mentioned about abandoning it.

[00:35:21] Yep.

[00:35:22] So people can't adhere to medicine that they can't afford to buy.

[00:35:25] Right, right.

[00:35:26] So 4.1 to me is the first phase of the business is we're going to get all this, all this 10 billion to every person that needs it, every dollar to every person that needs it.

[00:35:35] But then we want to break down these silliness, you know, sort of nonsense barriers that we have around forms that people have to fill out.

[00:35:44] So we can automate that so much more easily now than we used to.

[00:35:49] AI is truly powerful.

[00:35:50] We use it in product development.

[00:35:51] We use it in QA.

[00:35:53] We use it in the admin of the business.

[00:35:55] And these are exciting days.

[00:35:57] So technology has had a huge breakthrough with where AI is and it's not hype.

[00:36:03] It's real.

[00:36:04] You can tarnish it and use it.

[00:36:06] The industry is huge, but it has an IT ecosystem embedded in it.

[00:36:11] So let's just flow.

[00:36:12] So we don't have to blow anything up.

[00:36:13] Let's just flow stuff through it.

[00:36:15] You know, it's great.

[00:36:16] And then we'll move through kind of the nonsense part, you know, but we've gotten the money to the patients first.

[00:36:24] And that keeps me motivated because I've just seen people be sick.

[00:36:30] I've just lost my parents in the last two years.

[00:36:32] You know, people need help with access to health care.

[00:36:36] And this is one way.

[00:36:38] And their medication is just pivotal to getting and staying well.

[00:36:42] So that's 4.1 is just continuing to break down the barriers.

[00:36:46] Well, I think this 4.1 is actually sort of like, you know, the preview to what is going to be a Chapter 5, a Chapter 6, a Chapter 7.

[00:36:53] This has been an incredible Inspiring Women conversation.

[00:36:57] I've been speaking with Miriam Paramore, the founder and creator of Rx Utility.

[00:37:03] She's on Chapter 4, but everyone listening, she is just at the beginning.

[00:37:07] Miriam, thank you so much.

[00:37:09] Thank you so much, Lori.

[00:37:10] What a pleasure.

[00:37:11] I appreciate it.

[00:37:12] This has been an episode of Inspiring Women with Lori McGraw.

[00:37:16] Please subscribe, rate, and review.

[00:37:18] We are produced at Executive Podcast Solutions.

[00:37:21] More episodes can be found on inspiringwomen.show.

[00:37:25] I am Lori McGraw, and thank you for listening.