In Focus

News & Insight from Chelko Consulting
Meeting Demand for Rx Benefit Services: Chelko Adds Another Pharmacist

Meeting Demand for Rx Benefit Services: Chelko Adds Another Pharmacist

Responding to client needs within its rapidly expanding drug benefits management practice, the Chelko Consulting Group recently welcomed Lucia Vescera, PharmD, RPh.

Before joining Chelko, Vescera was instrumental in the opening and URAC accreditation of the Cleveland Clinic Specialty Pharmacy where her clinical focus was hepatology, infectious disease, and preventative cardiology. Her role also involved clinical consulting for solid organ transplant patients.

Vescera’s professional experience includes handling insurance authorizations and appeals, benefits investigation and analysis for coverage determinations, and obtaining patient assistance, copay assistance, and foundation support for appropriate recipients.

As a key member of Chelko’s drug benefits management team, Vescera will help clients better manage the spend in their medical and prescription benefits programs. Her clinical experience, analytical skills, and passion for treatment efficacy ― especially as they relate to specialty drugs ― give clients confidence that their plan members receive the right medications, for the right conditions, in the right ways.

Established in 2001 to provide high value, conflict-free, and transparent medical, life, and disability benefits consulting services to medium- and large-size employers, Chelko has recently seen tremendous growth assisting clients in reducing costs on the specialty drug front.

Applying its typical data-driven management process known for producing actionable insight and impressive results, the firm works with a growing list of clients to reduce and avoid unnecessary costs in this area of rapidly rising health plan spend.

 

Chelko Strengthens Experience and Actuarial Expertise by Adding Parsons

Chelko Strengthens Experience and Actuarial Expertise by Adding Parsons

With the recent addition of benefits industry veteran Steve Parsons, the Chelko Consulting Group continues to expand its team of subject matter experts.

Throughout his career, Steve has focused on optimizing the value of clients’ employee benefits programs. His insights, creativity, and actuarial expertise have been key in building foundations for short- and long-term plan management success.
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Be Prepared: New Wave of Costly Rx Claims on the Horizon

Be Prepared: New Wave of Costly Rx Claims on the Horizon

If recent events have taught us anything, it is to be prepared for the unexpected. While none of us could have fully predicted the dramatic impact of COVID-19 on our families, organizations, and the world economy, hindsight reveals safeguards we might have put in place to lessen the damage.

Ironically, this is a subject I had been wrestling with well before the coronavirus was receiving any attention from the international media. Those of you who follow our firm’s work know we have long been concerned about the growing economic threat posed by rising specialty drug costs to employer-funded health plans and their members. It actually dates back to 2005, when I first learned about a $125,000 oncology drug that didn’t save lives. On average, it only extended life by less than two months of sub-optimal living. read more…

You’ve Been Warned: This is Not a Drill

You’ve Been Warned: This is Not a Drill

The COVID-19 pandemic has revealed any number of shortcomings in our readiness to face a healthcare-related crisis, and our handling of HIPAA privacy and security rules in the workplace is certainly one of them. Unfortunately, it didn’t require a global emergency to know that all too many organizations are falling woefully short when it comes to having adequate HIPAA plans and procedures in place. read more…

Necessity is the Mother of Invention… and Progress

Necessity is the Mother of Invention… and Progress

COVID-19 safety concerns have redefined “normal” for countless aspects of our lives and nowhere is that more apparent than healthcare. Some things, like discretionary testing and surgeries, will probably return to the pre-corona standard. But others (think telehealth visits) have achieved a new level of acceptance and may become the standard of care in many situations. read more…

What’s the Rush?

What’s the Rush?

 “The Food and Drug Administration (FDA) is responsible for protecting the public health by ensuring the safety, efficacy, and security of drugs, biological products, and medical devices.” It’s right there in their job description.

But with the release of new policies meant to promote innovation for patients with unmet clinical needs, the FDA is asking the American people to “accept some level of uncertainty” when it comes to a handful of gene therapies that have been fast-tracked through the approval process. read more…

In Search of Healthy Competition

In Search of Healthy Competition

There was a recent article in a North Carolina newspaper about a local surgeon, Dr. Gajendra Singh, who wanted to offer transparently priced, low-cost services to assist patients that are candidates for general or laparoscopic surgeries.

What was fascinating about the article wasn’t that the surgeon was still practicing independently (which seems very rare these days), or that he posts the cost of an x-ray on his front door (which is also rare, and admirable). The intriguing part was that he wanted to purchase an MRI machine and the State of North Carolina wouldn’t permit it. read more…

Keeping Score: Network Performance

Keeping Score: Network Performance

How well is your PPO network performing?

If we’re talking breadth of access and depth of discounts ― it probably looks pretty good! As far as helping you secure lower costs than their competitors ― it’s probably not making a big difference. read more…

CONTACT
Cleveland Office
24651 Center Ridge Rd, Suite 110
Westlake, Ohio 44145

Phone: 440.892.2600
Fax: 440.892.8920
Email: info@chelkogroup.com

Columbus Office
Phone: 614.869.4140

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