Rae McMahan on Choosing a Different Path || EP. 188

[00:00:00] Growing up, Rae McMahon's parents wanted nothing more for their precious daughter than to be a good girl, a good wife, have a great family, all of the things that were important. But something changed when, as a teenager, Rae got Hodgkin's disease and she had great care, access to care that allowed her to recover, lead a very, very productive life, and she values that. And something changed.

[00:00:27] And she wanted to dedicate her life, her career, to making a difference for others who didn't have all of the opportunities that she did when she was recovering. So being a good girl for Rae McMahon took a different turn. Her parents are super proud, as they should be. Rae is a leader. She is somebody who is making a difference in the world of health and care.

[00:00:50] Rae is looking to make it affordable for everyone to get access to life-saving medications. That's what her work at Prescriptive, her work of many years. And she is very excited about the future of personalized medicine and connecting diagnostics with prescriptions. So in this Inspiring Women episode, you're going to hear from Rae McMahon and what it really means to be a good girl.

[00:01:19] Because at the end of the day, there's a patient, a loved one, a friend, a family member that is getting this care. And when we think about the economics of that, how do we take that out of the mix and make sure that they're getting the best care at the appropriate cost? This is Inspiring Women. I'm Lori McGraw. I'm speaking with Rae McMahon. She is the Senior Vice President of Payer Solutions at Prescriptive.

[00:01:48] And we're here at the Transparent Voyages Conference. And Rae, thank you so much for being on Inspiring Women. So glad to be here, Lori. It's been an amazing meeting and wonderful to meet other women at the same time. And also talk about technology around health care and how others, men and women, and these employers can be empowered to think very differently, think about a new voyage overall.

[00:02:15] I feel like it's an important time for us all and what's more important than our health. Yep. You know, we have like, this is like the end of a really long day. Like we have been like since eight o'clock this morning, sort of like in all kinds of really energizing discussions. But I think everyone knows that, you know, after you're in a conference, but Rae, I am so excited to talk to you because, you know, here and at Transparent, just to disclose, like we are partners with Prescriptive.

[00:02:41] We do really important work together in the space of trying to provide low cost, the lowest cost medications in a transparent way to, um, to people. And so let's first start perhaps with Prescriptive. What do you do at Prescriptive? What does Prescriptive do? So a little bit about Prescriptive, um, I would say at a foundation level, we want to empower, um, members, patients, um, to get their medications that they need.

[00:03:08] Um, and we want them to feel empowered that they have the individualized information at their fingertips, um, at the time that they need it. And generally that time is not at the pharmacy counter, right? Um, that time is when you get your prescription or your physician is writing your prescription. And then you are able to receive your prescription via text message. We are all generally on our phones at this point in time.

[00:03:36] And that is, um, a large, um, a large age span, I would say on, on phones and ever growing. Um, but the important thing is that we, um, empower these members to have the information at the point of prescribing so that they can make, um, decisions around what pharmacy, um, to pick up their medication.

[00:03:56] If there is, um, an appropriate clinical alternative that they could utilize, um, for their medication, should they utilize a cash price or an insured price? And are there any coupons along with that medication that they should be thinking about utilizing as well? All to ensure that they can pick up the medication that they and, or their family members, friends need so that they can have better health and better care.

[00:04:25] Overall, we find that pharmacy benefits are the number one utilized benefit. A lot of times it's the first indicator to a potential chronic problem or even acute problem. And the system that we have today is broken. Yeah. There's not many items that we purchase and you actually go to the store and you don't know what you're going to pay for or what you're going to get.

[00:04:50] And you don't know the price until you actually get to the cash register. Yeah. And that is a fundamental problem. And that's why we're here talking and have the partnership to solve that. And we all know it. I mean, we've all been in, you know, the long lines, the pharmacy counters, and you hear, um, quite frankly, agonizing conversations, you know, in terms of people just like, how much does that cost?

[00:05:12] And it is really difficult to understand. You mentioned coupons and rebates and a whole number of other complexities there in pharmacy. I mean, Ray, you're an expert. I mean, you grew up in specialty pharmacy. You know a lot about, I thought you were a pharmacist. I mean, like just the level of expertise that you bring to the table. Was healthcare always sort of like top of mind when you started your career journey?

[00:05:34] It was absolutely top of mind. Um, when I was 17, I was diagnosed with Hodgkin's disease. Um, so in high school, um, and that was an interesting journey. Uh, my dad worked, my mom was a stay at home mom. Um, and we had to navigate insurance back then. And I remember getting to the hospital to, um, have, I believe it was an open biopsy done.

[00:06:01] And the person at the desk said, well, we don't have your prior authorization on file. And I remember my mom and I trying to remember. Oh my gosh. This is a huge component of what I remember back then on. I know that I have cancer. I know that I need to get something done, but there's a system that's broken. Unfortunately, insurance back then in the coverage of medications, um, was not what it is today. It was, uh, much more affordable. And our coverage, our insurance coverage was better than

[00:06:31] But the system was better than the system. Um, but the system was very broken. Um, so ever since that time, I felt very much a connection to be, um, in healthcare. Um, I went down the path of potentially being a, um, physician or a practitioner and ended up going down the business path. I had, um, uh, a cousin or close family member that, uh, worked in the health system and encouraged me to think about that path. Um, and then I, um, once I went through college, um,

[00:07:01] healthcare business, um, and a master's of business, um, I worked with a pharmacist, um, as my first, um, boss and mentor, and he really helped me understand, um, within the health system, uh, pharmacy. And from there, um, I just grew in, in the reason why I wanted to get into healthcare and, um, also do the work that I do now is to, um, help members,

[00:07:29] help patients get their medication. Um, and I've been in a number of different roles along my, um, career looking at, um, how do we increase revenue at a company? How do we save money at a company? And in healthcare, that's tough because at the end of the day, there's a patient, a loved one, a friend, a family member that is getting this care.

[00:07:54] And when we think about the economics of that, how do we take that out of the mix and make sure that they're getting the best care at the appropriate cost. Um, and that's not always done.

[00:08:05] Mm-hmm. Well, I almost have to, it's like, there's so much in what you just said, Ray. So first of all, you know, 17 years old, okay. And diagnosed with cancer. I mean, that is a very, that's life changing. That's life altering. And you're very healthy now. And that's wonderful. And, um, but at that time to actually recognize that some of the systems that you were dealing with were broken.

[00:08:32] And, you know, you're already dealing with a really challenging diagnosis. Um, and then to put your entire career energy on trying to solve some of these problems. I mean, it's kind of an amazing, um, arc. If we think about the problems that you're talking about, access to medications, affordable medications, and the complexities that are behind it. Um, how close or far are we from achieving something better for patients?

[00:09:01] It seems like things are actually just getting more confusing, quite frankly. I think there's a balance, um, overall. And when I think back to that time, um, my family dynamic, neither of my parents went to college. Um, and so navigating healthcare was very different. Neither of them had an issue. My dad, fortunately, um, had insurance at the time.

[00:09:25] Um, and, um, um, I think that from, uh, um, when we think about, um, the gamut of people that utilize insurance and don't know, um, there's a drastic difference, um, in that.

[00:09:39] And part of, uh, the journey when we think about, um, other industries, um, technology, for instance, outside of healthcare, um, our phones, uh, when I was growing up back then, uh, we had the dial phone. Yep. And it's funny, you don't know how to use a dial phone. Nobody does. Even I don't anymore. I was like, you try it again.

[00:10:01] And if we think about the progression of that technology and where we're at today, um, and the cost has generally gone down with, uh, a much better technology that we have. And when we think about that in healthcare, yes, our technology is better. We have a lot more, but the cost has gone exponentially up. So you have this, uh, reverse paradigm of what's happening and we haven't necessarily come up with the best way to, um, also have the right approach.

[00:10:30] Or the right algorithm on what do I need to use and what is appropriate for me individually at my time. And so I feel like we are finally getting there, um, because, um, there's folks like Glenn and Transkaren and, um, the founders of Prescriptive and utilizing the digital prescription and the technology that has come to pull these pieces, um, and put them together.

[00:10:57] And I feel like that is, um, making it, uh, much better and much easier, um, for people to access, but it's also a huge shift in thinking. Yep.

[00:11:08] And how do we, um, and how do we, um, learn from, uh, utilizing marketplaces like Amazon and online at Walmart or online at Target or Instacart shopping or Uber and Lyft and all of these different ways that we have transformed the way that we even buy auto insurance or buy cars.

[00:11:30] And how do we think about that in terms of our complex healthcare and utilize the technology and tools to have effective decisions, um, clinically and also financially at a level that we can also understand. Yep. Well, you're talking about breaking down barriers and you're talking about disrupting an industry that has been going in a direction of actually increased complexity, certainly increased costs.

[00:11:55] And for the average human being to figure out where medications are, may be such an important part of what they need for just like, you know, basic, reasonable, reasonably healthy living. Um, that's really important. If you were to think, Ray, just like with all the expertise that you have, um, and, um, perhaps, you know, what are the solutions?

[00:12:17] So, so if you could wave your magic wand and what would look different maybe five years from now than what is status quo today? Gosh, that's a really great question. Magic wand.

[00:12:30] Yeah, I think, um, it would be how do we connect, um, the lab blood tests that we do or saliva tests that we do with radiology exams that we know that the AI for those radiology exams within the expertise of a physician. How does that then determine for me individually what medication I should take? Mm-hmm.

[00:12:57] And I feel like with that technology to leverage those components to utilize, um, AI and utilize expertise in these, um, lab tests that have, have come out, whether they are, um, genetic testing or how a certain drug will work for, um, my blood type, for instance.

[00:13:17] Um, um, that should take out some of the noise and the messiness and over-utilization of specific pharmaceuticals, um, so that we are cutting out costs and really getting to the core drug that needs to be utilized and or the surgery or a combination there, um, of. And I think that's a really important component.

[00:13:40] And then that way we can start cutting out the unnecessary costs in the time so that my insurance can then cover what will work for me. So if I had a magic wand, it would be how do we connect all of these disparate companies that are out there with these new technologies to say individually for me, what will work? So I'm not wasting time, money, resources, and those things will then be covered. And I know they will work on me rather than test, fail, test, fail.

[00:14:10] You're talking about taking what is a complex web of diagnostics and really taking out the middleware of what is both time and complexity and bringing it to the end of one, the actual individual, whether it's their genetic makeup or whatever, in terms of what medications would actually work, um, for them. And that would be a really exciting place to be. So that is, um, a great vision. And I really want you to have that magic wand.

[00:14:36] Ray, as we close out on this inspiring women, um, conversation, you've talked about your journey, which started with a pretty heavy diagnosis at 17 to really a focus on a specialized area of a very important part of healthcare, removing barriers, making it easier.

[00:14:53] Um, and if you want to just like reflect a little bit for other, well, to say younger women who are starting their own career journeys, what do you want them to know from you to make it easier for them as they sort of ascend to their own leadership? Mm-hmm. Um, it's, it's, it's a hard one and certainly, um, a journey along the way. And, um, I feel one that, um, it's your journey.

[00:15:23] And, uh, when I was younger, I very much wanted to, um, please my parents and do what their expectations were of me back then. And, um, but that wasn't my journey. Um, and I feel at the same time I learned and had, um, the knowledge on how do I help other people?

[00:15:48] And, um, at the core of that, um, being able to help other people, um, was broadening into a career, um, rather than, um, my, my parents' expectation was to, um, get married, have kids and stay home. And although that is amazing, um, for a number of people, that wasn't my journey.

[00:16:08] And so I think really listening to yourself, um, and thinking about what's right for you as an individual, um, and making sure that you, um, also think and take care of yourself along the way. Um, I know a lot of, um, women that they're thinking about their family, their spouses, their parents, their kids, and, um, saying yes to a lot and not no probably enough.

[00:16:34] And focusing on their care, their health, um, from, uh, uh, emotional, mental, physical wellbeing is so incredibly important. And I feel like the rest of that will, will come along the way and surrounding yourself with, um, amazing people at the same time and learning, um, to really rely on a core group, um, as well.

[00:16:58] And for work, uh, many of us have been on the road, um, and, uh, on a plane and in hotels, um, and really relying on that, um, village of people has been incredibly important. So I think you have your own journey, um, or your own voyage, and it's all about, um, what feels right to you. I think at the end of the day, when we're helping out each other, that's a strong component. Um, and the other kind of comes along the way.

[00:17:29] Well, that is an incredibly inspiring journey for somebody who was, um, what a person who wanted to please their parents and did not meet their initial expectations, but chose your own journey. I'm certain they're incredibly proud of you now. And I really appreciate this conversation. I've been talking to Ray McMahon. Ray, thank you so much. Thank you, Lori. It's been wonderful. I appreciate it. This has been an episode of inspiring women with Lori McGraw.

[00:17:58] Please subscribe, rate and review. We are produced at executive podcast solutions. More episodes can be found on inspiringwomen.show. I am Lori McGraw, and thank you for listening. Thank you. Thank you.