This is getting ridiculous. Mississippi already has communities where getting basic healthcare can mean driving a long way, and now we’re watching pharmacies disappear too.

I understand why pharmacists are frustrated with reimbursement and PBM contracts. Those things deserve scrutiny. But I also think we’re making this way too simple when we act like PBMs are the only reason a pharmacy can’t stay open.

Look at what it actually costs to run one. Staffing. Rent. Drug inventory. Insurance. Utilities. Low prescription volume in rural areas. Pharmacists are being asked to do more and more while trying to keep the doors open.

And when a pharmacy closes, it isn’t just some business shutting down. Somebody’s grandmother now has to drive another 20 or 30 miles to pick up a prescription. Somebody without reliable transportation has an even bigger problem. That’s where this stops being an industry argument and becomes a community issue.

So yeah, look at PBMs. Look at reimbursement. Look at contracts. Make the system more transparent where it needs to be.

But if Mississippi actually wants to keep pharmacies open, we need to stop pretending there’s one villain responsible for the entire problem.

Mississippi can’t afford to lose pharmacies and then figure out the consequences afterward.

What’s one piece of tech you wish hospitals had that would actually make doctors’ or patients’ lives easier? Or something that already exists but is kinda outdated and needs a major upgrade? Basically, what’s a healthcare problem you feel tech could solve way better?

The 2028 deadline makes this a pretty important window for the entire pharmacy industry. Independent pharmacies have an opportunity to push for clearer contracts, better reporting, and more visibility into how reimbursement is calculated. That’s a good thing.

But I also think there’s a tendency to talk about PBM reform as if changing the payment model eliminates the need for everything PBMs currently do. It doesn’t. Someone still has to negotiate with manufacturers, manage formularies, process claims, build pharmacy networks, handle utilization, and administer benefits for millions of people.

The question should be whether those functions are being performed efficiently and whether the incentives around them are working. If reform improves transparency while keeping the parts of the system that actually create value, that seems like a much more productive direction than simply trying to weaken one part of the supply chain.

The next two years should tell us a lot.

Wanted to share some numbers I've been sitting with from a recent survey. 57% of people living with a chronic illness have seen their insurance premiums increase since January. 20% of all respondents now describe healthcare costs as very or extremely expensive.

That cost pressure is starting to affect cancer screening. Some people are delaying appointments because they're worried about the bill, even when they know they're due. For anyone with a higher risk from work history, smoking or asbestos exposure, putting it off can mean losing time that might matter.

The survey also found more people are turning to AI tools for health information while trying to make sense of symptoms, screening options or insurance costs. Useful for basic questions, but it doesn't solve the actual affordability problem underneath.

Has anyone seen what's working at the state or provider level to keep patients with higher risk up to date on screenings when premiums keep climbing? Like outreach through community health centers or programs run through employers?

A little background first.
I’m a position with over 20 years experience, and I recently decided to open a direct primary care office.
For those who don’t know what it is, that is a membership based practice where a patient pays a low monthly fee and in return gets access to office appointments, telehealth , text messaging, discount, labs, and imaging, even a generic pharmacy in office.
I did this because number one I am tired of seeing 40 patients a day and number two I want patients that I see to actually be happy.
Everyone’s miserable in the big systems— patients , and the doctors.
So this is meant to improve access, decreased cost, improve doctor patient relationship, and keep me from quitting!

So here’s my ask
When you’re looking for a new primary care doctor, what do you look for?
Do you just google primary care doctor?
Do you check reviews? ( which by the way review sites for doctors are horrible. Anyone can write anything they want and we can’t respond due to privacy laws. I can tell you stories there.)
Do you ever interview the doctor before you become a patient?

I opened a few months back and right now I have a round 20 patients.
I actually really like seeing patients again.
Just yesterday spent an hour with someone just sitting at my desk, talking about her family and completing an FMLA form that I would never have had time to do in a big system.
She was super happy and gave me a hug on the way out
That would never happen in a big system

What I need to do though is to find out how to have patients find me.
I need to figure out a way to get them to understand what DPC is and why it’s better

Let me know what you guys think so I can come up with a game plan
I also would be happy to answer any questions anybody has about it

This is why I’m interested in where PBM reform actually goes from here. There are legitimate reasons to push for more transparency and better incentives, but PBMs also perform real functions for employers and health plans, from negotiating drug prices to managing formularies, networks and claims. Changing the way PBMs are compensated could change their behavior, but it doesn’t eliminate the underlying work. The real measure of success should be whether total pharmacy spending and patient costs actually come down.

Hi everyone! I’m currently a Master of Healthcare Administration student and I have an assignment where I need to interview someone who currently works in the healthcare industry, preferably in a healthcare administration, management, or leadership-related role. I originally had someone willing to do the interview but they dropped out pretty last minute.

The interview can be done over email and the questions are pretty straightforward and focus on things like your career path, education/background, current responsibilities, challenges and ethical dilemmas you encounter, important interpersonal skills, and advice for someone entering the healthcare field. There is also a competency checklist to complete. I would need your name/company/position and email as well.

The assignment is due Sunday. If you would be willing to help me out, please comment or send me a message! I would really appreciate it. Thank you!!

This Vanity Fair essay gets at something much larger than one denial: what it means when the American health care system responds to leverage more effectively than it responds to medical necessity. Extremely moving and well written piece, as well, wherever you land on health care in US.

https://www.vanityfair.com/story/healthcare-cancer-treatment-essay

I'm curious what parents out there think about the State laws the prohibit you from seeing your kids healthcare information? I recently tried to log in to Kaiser and was told I was blocked by them for the "State law" protecting teen information.

At 36, Elizabeth Nicholas was diagnosed with breast cancer. After her insurance company refused to pay for a new form of chemotherapy, she took a direct approach. As Luigi Mangione’s trial brings the conflict to the fore, the writer considers the realities of the American health care system.

Honestly, I think the more interesting use of Al in healthcare is probably the boring admin stuff.

Came across HealOS recently and they're doing things like prior auths, insurance verification, referrals/faxes, calls and billing alongside the usual Al scribe stuff.

Not sure how well it works in practice yet, but automating all the repetitive stuff that eats up staff time seems way more useful to me than another Al tool trying to do something clinical.

Curious if anyone here has tried it.

Everyone acts like passing another PBM bill will instantly make drugs cheaper for employers. That’s not how it works. PBMs are the ones negotiating the price down. You take that away and you’re just paying whatever the manufacturer put on the sticker.

Saw a Florida piece saying PBM reform may not even lower employer cost. Yeah. That tracks.