Steve 0:09 The HRHappyHour Network is sponsored by Workhuman. Employees recognized for milestones, are three times more likely to believe their company actually cares about them, three times. So why are companies so bad at it? The stale bagels, the branded swag, the audacity. Workhuman believes milestones deserve their moment, the space for the people who know you best, your actual work circle to reflect on your journey, your wins, your impact, the inside jokes, the big moments, all of it. It's called service milestones. AI finds the right people. Automation handles the rest and employees choose their own reward from millions of options curated just for them. Milestone like you mean it with Workhuman, a proud supporter of the HRHappyHour network. Find out more at workhuman.com and thanks for joining us. Welcome back to the At Work in America show. My name is Steve Boese. I'm with Trish Steed. Trish, here we are again. Welcome. How are you? Trish 1:08 I'm fantastic. Yes, I love it. We're recording more than ever, so this has been fun. I'm ready for today. Steve 1:14 It's been a busy few weeks, and I'm excited for today's show. It's a great topic. We care more I think in our firm that about well being and health, mental health, physical health, financial health, all of it, I think we care more than most, right? We talk about it a lot, but today's topic, Women's Health specifically, is one where we spent some time on in the last couple of years, and I'm so excited to spend more time on it today with our guest who's way with us now, Susan Thomas. She's the Chief Commercial Officer of Lucy Rx. Susan, welcome to the show. How are you? Susan Thomas 1:57 Thank you so much. I'm great today. I'm really excited to be here. Steve 2:01 Yeah, thanks for joining us. Man, this is a great subject. I'm so intrigued and enthused about your passion for the subject as well, as well as what you guys are doing at Lucy Rx. But before we dive in to some of the issues around women's health and how organizations can stand up and step up a little bit more. Let's learn a little bit more about you, and then Lucy Rx. So tell us. Tell us a little bit about that. Susan Thomas 2:26 Sure. Well, I'll start with a shameless plug about my own background. I'm a registered nurse by training, really focused in the first part of my career in oncology, but kind of evolved into the PBM space about two decades ago. So now I lead sales and account management and clinical strategy for Lucy Rx, which is a newcomer to the PBM space, and we're trying to do something quite different for the next generation, and that is focusing on patient outcomes and care, not just a white bag at the pharmacy counter, but really improving the health of people you know, country wide. Trish 3:14 Yeah, we're so excited that you're here to talk about some of the issues and how not just individuals, you know, who might be listening to the show, but how we can impact our organizations and how they're supporting women and women's health in the workplace. You know, one of the shows we've done in the past really talked about the fact that women go into things like perimenopause, for example, even as early as their mid 30s, right? And these, these differences and hormonal changes and some of the other things go all the way into your 60s, and that's really the biggest chunk of your women in the workforce, for the most part, right? So it's always been a little bit surprising that we don't have more care in place specifically for women who are going through these different changes in their life and having support to match that. So maybe talk a little bit specifically about how Lucy RX is offering that as an option because the benefit, it's not just a niche benefit, right? This is something that impacts your entire workforce performance. How do you all think about that there? Susan Thomas 4:24 Yeah, I mean, well, when this really came to the forefront for me and for Lucy was when a woman came into my office and told me, this is not a woman on our plan. But a family member said her clinician had prescribed her hormone therapy for her perimenopausal symptoms, but her formulary was excluded, the excluding the hormone replacement product. And I scratched my head thinking, these aren't, you know, that expensive. Why would they be excluded? Why would women have to jump through hoops to get hormone replacement therapy? And I still don't have an answer to that, but I was determined that we were going to do something different and remove the friction for women that are trying to solve the symptoms that they have that are that are clearly under diagnosed most times. So we started out initially making sure that the formulary was robust enough to make sure women could get the medications they needed. But we we wanted to take women's health to another level by setting up a what we call care guides, a concierge type service to help women navigate these symptoms, because many physicians, frankly, aren't trained in menopause and perimenopause, and so that sometimes the symptoms are dismissed as with with maybe a sleep aid or an anti anxiety aid, when all of it could be hormonal or metabolic. So, you know, we fixed the formulary, we added a set of nurses that are trained in these metabolic changes that can help women with simple things like, know what to ask your doctor. We can mine the data to see women in that age range from 45 to 65 who aren't on HRT that you know, maybe just need some information about it. We're not prescribers, so we're not going to make sure that the woman gets on a drug, but we can give them information on it and help them understand how to approach it with their prescriber. And then finally, the whole GLP one conversation, because this is something everyone's talking about, we've created a new a new independent pathway for employers to think about GLP one coverage for the highest risk population in their cohort. So we know GLP ones are indicated for type two diabetes, and we know there are some indications for cardiovascular health and obesity, but it there's a gap there in the middle, mostly representing women in midlife who start to gain weight as a result of the lower estrogen levels and now increase their cardiovascular risk. So we've created a pathway to allow plan sponsors to add GLP one coverage for those women in high risk that keeps it affordable and allows for access to close that gap in care. So that's in a nutshell, what we've implemented around women's health, and it's iterating. We're continuing to see how can we touch or reach more women in in this population and help guide them through the next 20 years. Because, as you said, Trish, these the women in this cohort are at their peak of their careers, typically, and their symptoms are also potentially at the peak. And so they impact their ability to lead teams. They may impact their ability to be promoted. There are studies that say that they report the symptoms impact their ability to come to work in some in some cases, and lost productivity is real, and if you're in a kind of a career stepping phase, you want to make sure that your health is at its best so that you can deliver what your workforce and your work is asking of you. Steve 8:32 Yeah, and Susan, one of the other things we've we've highlighted here on the show and some other things we've done is often in the same years, many women have still have children at home, perhaps, and start running into elder care issues and caregiving issues at the same time. So all these things, and trying to manage a career, and trying to manage, as you said, meant often in the peak of your career and in your most stressful position and most responsibility type position and focus with leading teams at work and leading everybody at home, right? Like most women do, and then while taking care of everybody at the same time, while not feeling great, maybe yourself, because you're navigating some some issues here it's, it's a lot, right? And so I think employers have never really acknowledged this to the level at which it's required, right? And I think we're starting to see a change. But it takes, it takes some effort, I think as well. Susan Thomas 9:31 Well it does. And I think it just takes some creativity and maybe some very simple actions that employers can take that aren't necessarily super costly, but check the box in in attending to those, those multiple competing priorities, it could be as simple as flex time in order to be able to to go get your lab work, to get your blood pressure checked, to pick up prescriptions for your elderly parents, or, you know, take care of your kids. Because brain fog is real. Symptoms are real. They slow women down during this phase, in many cases, and just allowing flexible time, and then the education, you know, making sure women are supported with education and how to manage their symptoms. Because, I mean, frankly, it because it's been a gap for so long. I It's concerning, as a nurse, that women still just don't know that what they're feeling could be normal but could be treatable. Trish 10:35 Yeah, you know, Susan, I think you hit on so many important things that I relate to. I think often I'll just use myself. When I was in my 30s, I was in a very high stress position. I loved it. Moving up in my career, all those things, I wasn't sleeping more than three hours a night. For example, I talked to my doctor. It was a standalone symptom, right? And then I had brain fog in my early 40s, and that was a standalone symptom. And then I had vertigo in my mid to late 40s, and that was a standalone symptom. And it wasn't until another woman, who's a just barely older than me, said, I think this might all be related that it clicked. So to me, when you're talking about care guides being available to even help a woman connect those dots, I mean, I was the leader of HR. I didn't know it. So I think you're right. Education is so important here, and normalizing talking about it at work, because it's often through word of mouth. You know, you mentioned that doctors aren't really trained in menopause care or perimenopause care. I think my doctor, when I finally talked to her, it was like six hours, is all of the training she had in menopause care. And, you know, it's so I don't want anyone to feel like you know you're going through some symptoms. It might be perimenopause, it might be menopause. You're afraid to ask, because I went and asked my mother, and she said, I don't think I went through that. I don't think I so that's why we're not educated, right? The generation may be before us. They didn't know either. Steve 12:22 Yeah. Trish 12:23 What are you seeing when you're talking to whether it be your customers or your care providers, you know your care guides? Are they hearing these same kind of stories like that? There there's a disconnect between even linking symptoms together or? Susan Thomas 12:39 Oh, for sure, well, because they don't all bundle together. They don't all come at one time, as you mentioned, from perimenopause to post menopause there, there can be 10 or 20 years of symptoms coming and going. And you mentioned you were in a stressful position in your 30s, and so you may have attributed the the insomnia to the stress. Trish 13:01 Completely. Susan Thomas 13:02 When, in fact, it could be hormonal. And I think women just need to be able to ask, can we check my hormones? You know, let's, let's do blood work to make sure that this isn't metabolic. Maybe it is stress related. But and then meditation may help. But you know you have, you have to push for and advocate for yourself. So women do so that you can determine, are you in a metabolic change right now that can be treated? And the really key part about catching this or starting to to intervene early is that cardiovascular risk that can continue to rise into our 60s and 70s, and osteoporosis, so both of them very preventable if we know about what's happening early on, if we start to track waste measurements, if we start to track weight as women are going through, because you don't put on 10 pounds at once, you know it's it happens over a course of a decade where all of a sudden you're like, I'm 20 pounds heavier than I was in college. Trish 14:15 Yeah. Susan Thomas 14:15 And, and, and now your your risk is higher, and it's and you start to have symptoms, so now we start treating these more problematic symptoms than hormone replacement early. And I think that the stigma of hormone replacement, you know, from decades ago, also contributed to just women not automatically getting prescribed one when symptoms were suspect, and I think that's going to change because of the CDC and changing its its stance on hormone replacement therapy, but there's just so there's there's just education that needs to happen, and the more we can do. Which is why I'm so excited about having this conversation today, is the more we do this, the more light bulbs go on with HR benefit leaders and prescribers and nurses and women themselves to advocate for themselves. Steve 15:15 Susan, I'd love to get into just a little bit of the process that you guys, when you work with corporate clients or or health plans like, or even individual right members, like, I just tell me the nuts and bolts of this. Like, we know what PDMS are, right. We know who our health plan coverage provider is. We know, you know, I just love to see like, how, how you guys actually work in the process with your with your clients, and the folks that you support to actually, you know, help them with these issues. And, like you said, Make sure these, the appropriate treatments, are in the formulary. Make sure people have access to you working directly with the clients. Are you working through health plans? Is it both? I'm curious on that. Susan Thomas 16:01 Yeah, it's, it's both. It's, it's self funded employers and health plans. The formulary is, the formulary is a no brainer. It's, we've automatically updated the drug lists. It's really not costly to plans to add hormone replacement therapy as a general rule, and that just happens if you chose to opt out of updating the formulary and adding these hormone treatments. Okay, I don't think we've had any clients that have said oh we don't want that, that's that's the easy part. The the care guides piece is a clinical strategy and upsell program that we offer to clients, there's a return on that investment. The employers pay a fee to engage our nurses with their population. Steve 16:52 Right. Susan Thomas 16:53 And then we guarantee a return on that, whether it's through adherence on their medications, reduction in cardiovascular risk by reducing A1C improving their diabetes trend, getting patients cholesterol is under control, so we do a number of measures to show our ROI by how the nurse engages with the member and the prescriber. Because we don't just stop with engagement with the member. We will reach out to prescribers to make sure that they have a full picture on on the feedback that we might have received from a member. Steve 17:36 There could be some indirect ROI, too, right? Susan, in terms of, hey, employees really like this, and you know, they'll be more engaged. They'll be they hopefully won't get as sick or as often as sick, but certainly, just, hey, I'm gonna stick around, because my employer is invested in me, and part of that investment is my health, right? I gotta believe that's part of it. Susan Thomas 17:57 For sure, for sure. I mean, the employer can certainly measure employee engagement as a as a satisfaction metric. We also measure member satisfaction and report on that as well. And then we would encourage employers to measure productivity too, because they'll see improvements there as we help women improve their health? Trish 18:21 Yeah, I think one thing that I would have liked to have known because I was the person who was responsible for the benefit plans when I was still in that HR leader position, is I almost feel like we sometimes reward not just women, but all employees, if they are working through the night, right? You see those emails coming in, and I feel like I didn't see that is, like, maybe a red flag, like, oh, this could be a woman who might need information about care. So I would love to hear like, are you getting those kinds of questions? Are they that granular yet? Or or are people just trying to wrap their heads around like, oh, wow, we need to be thinking about this through the life time of the employee with us, because I feel like it was such a big miss that planning out benefit opportunities that we weren't including this. Susan Thomas 19:17 Yeah, yeah. It's a great it's a great insight and question. I don't know that we're seeing that granular of a question come through, but we're not waiting for folks to raise their hand and say, I think I have a problem. We're very deliberate on mining the data of our population, and I think that's what we're asking plans to do, employers to do is work with your PBM or your your health insurer to mine the data of the women in the population. Not many are in this age group not on a hormone replacement. Doesn't mean they need to be or must be, but if they're having symptoms, maybe they're on a sleep aid and an anti anxiety agent and then or an anti psychotic but no HRT, could we be treating the wrong symptoms? Possibly, that's worth a conversation with the prescriber. Or are they a type two diabetic? Should we be monitoring their weight more frequently and making sure that they're not continuing over the course of a decade to gain that belly fat weight that puts them at higher cardiovascular risk. And so that's the approach we've taken. Is mine the data. Know the population for the employers, so they can make educated decisions around support for that population. And that might be expanding coverage, pharmacy coverage. It could be adding care management, whether it's us, you know, as the care guide, or adding a women's health component like MIDI or, you know, there, there are many point solutions out there that can help employers to offer more support for the members. But you if you don't know what your population looks like, you don't know where to start, and so, so that's our approach, is help the employer understand the population. Trish 21:05 I like that starting point. Because I think that if you're not doing numerous things right to make people feel cared for and that valued, this is such a personal thing, it would really make me feel valued, like even working with Steve. You know, we may be a smaller company, but knowing that he values Women's Health helps me do a better job. And it also helps when your employees need to say, Okay, I've got something going on, right? They don't feel they don't feel like there's going to be punishment for it. In fact, they feel like they're going to have that extra support that they might not be getting from home. So I feel like it's a win win if you're using Lucy Rx as part of that program to offer your employees. Does it also cover the say, spouses or partners of the male employees, or is this just more targeted toward female employees in the organization? Susan Thomas 21:53 No, that's a that's a fantastic question, because we, I have had so many conversations with spouses of women going through metabolic changes and just feeling at a loss for how to help. And, you know, I don't have any studies, but I guess that that marital strife escalates during this time, you know, and so being able to our nurses can help guide that as well and help get partners or families into counseling if that's an appropriate, you know, Next step or just just awareness of this is a normal symptom of this period. Here's how to support it. Here's what to help with, asking the doctor, you know. Here are the medications that might be helpful. Here is the symptom control. Keep the temperature down in the house. Don't turn that, you know, don't turn the heat up. So absolutely, it's not restricted to you must be a female to use our nurses. It is a women's health and that's supporting them through the whole ecosystem. Steve 23:09 Susan, I think that's an excellent point, and because I do think Trish, you said, Oh, it's good to work with Steve, because Steve cares about this stuff. Look, I've always cared about it because I think I'm just a normal person. I'm not, you know, a psychopath, but I will say this before we started talking about these issues a couple years ago, we had MIDI on the show a couple years ago, and before we had Joanna came on the show, I didn't know anything, anything I knew nothing. Menopause, to me equaled hot flashes. That's just story I'd heard right as a man growing up in this country, and I'm not, I'm not trying to make a joke of this. What I think this probably still happens a lot, and I do think that there's a lot of folks who are making decisions in organizations who are guys just like me, maybe a little younger than me, maybe a little older, whatever, right? But equally uninformed or partly informed, or anecdotally informed, and not really super well informed, because, yeah, we're a small company, and I got confronted with it, you know, because folks in our company are, you know, we're going through things, and then we we talk about it on our show. But I could see a case where, you know, leaders and organizations who are who are like me don't know hardly much at all, and really that's a big education gap too I think. Susan Thomas 24:30 You know, I'm a registered nurse. I watched my cholesterol go up over the course of about 15 years, from a normal low 200 total cholesterol to almost 300 before I was like, hmm, I should probably do something about that. And fortunately, now on a very low dose statin, but it's back in normal range. But I didn't know that that post that menopause and post menopause put me at risk for that, until it was at such a point where I thought I really don't want to have a stroke. I don't want to leave my kids, you know, or my family taking care of a stroke victim, yeah, and I should do something about this. I should have known about that a decade ago. And I'm, I have no there. I've, you know, I'm a nurse. I should have known that. But I'm an I'm an oncology nurse by background, so I didn't, I didn't learn menopause in nursing school either, and it's just it became such a passion of mine as I watched my cholesterol go up, and finally said, you know, I better start taking a statin. That I said, How many other women are going through this risk? And we know heart disease is the number one killer of women. One in five women will die of a heart attack. Steve 25:47 Wow. Susan Thomas 25:48 So I it really just became this, this kind of life blood for me to spread the word and get women healthier in their last two to three decades of life, because that's that being vital up until your 80s and 90s is so much better than the alternative. Trish 26:10 I appreciate that you share that personally, because I think there's maybe a little bit of a fear you think you know you're a nurse, if you didn't know that that was related necessarily to menopause or post menopause, I didn't either, even when I figured out the whole vertigo thing or something like, I'm like, You, that that number went way up, and I was like, so what I love is that instead of being reactive, or having your employees be reactive, or their partners or spouses be reactive, this proactive approach. It not only helps them feel the care they get the care they need, it helps the bottom line too, because then you're not waiting until they have a heart attack that you're then covering, right? You're really helping everyone at the front end. So it's, it's really beneficial for both, I think, the employee, as well as the company. You know, both sides as I would feel comfortable making that argument to my CFO or a CEO, if I needed to, right, if I just had that little bit of information. But yeah, I had, like you, I had no idea that that was related to these other things at all. Susan Thomas 27:18 I mean, I exercise, I'm healthy, I eat fairly well. I don't eat processed food. So I was like, and it's not genetic, so I'm just kind of like, I don't know. I don't think I have to worry about that. I don't think I have to worry about that, until it was at such a point, and I think, you know, it just again. I was like, Okay, I'm on a I'm on a bandwagon here. Steve 27:39 Yeah, Trish 27:39 Yeah. It's hard to deal with things after the fact too, right? It's harder to correct something than to prevent it. Susan Thomas 27:46 It's it is, and so much more expensive. It is so much better for us to get in front of it and help women understand how to stay vital. Trish 27:56 Yeah. Susan Thomas 27:56 In their last two to three decades. Steve 27:58 And I think just yeah, talking about these issues too is what is going to help folks like me and even folks like in organization, but folks outside of the organization, right? You talked about, you know, married marital problems or problems with relationships, and some of that is just not knowing, right? And you know folks needing to be better educated and so that hopefully they can become more supportive and more understanding, which I think is really critical as well. But I do think, like there's, there's such a benefit to no pun intended for organizations to work with an organization like Lucy Rx, who's pushing and talking about these issues on the forefront, because I look, I'm not, I don't, I'm not subscribed to, you know, pharmacy benefit manager today magazine or anything. So I don't know what the other ones are talking about, but I suspect they're not talking about this. Maybe, right now, they're talking maybe talking about GLP ones, or maybe they're talking about, I don't know what they're talking about, but I feel like and some of that is probably because some of the PBMs, I don't know. I'm not trying to make put you on the spot, Susan, like calling out competitors, but my sense is there's like three or four massively big ones in the United States, and they're just giant, giant, giant companies, which is fine, right? Whatever. But I feel like you were talking about very human issues, very personal issues, very really down to the person issues, right? And I think working with a company like Lucy Rx is, is Could, could offer organizations much better way to support their employees down to love of the individual, right? A person can, can ring up or chat up one of one of the care guides, and get, get a person who knows what they're talking about to help them, I think is, that's a great, great opportunity and a great, great solution. And this is just me, just talk off top my head. But Susan, I, you know, again, I don't want you to have to call out competitors or anything like that. But maybe just, we'll kind of sort of start to wind up with that, just how you guys approach helping your members to really, you know, to thrive, quite frankly. Susan Thomas 29:58 Yeah, yeah. It just doesn't exist in the space. I've been in this space for 25 years, and it has, you know, PBMs were introduced to really be transactional, to replace the receipts in the shoe boxes that our parents sent into their indemnity plans. And it hasn't really evolved much beyond that transactional nature. And so the reason we came to market was patients deserve more. Patients prescriptions are much more expensive, three times more than any other comparable country in the world, and we have the worst health to show for it. So is it? Is it an affordability issue? Is it an access issue? Is it a knowledge issue? It's all of the above, and how do we fix that, but through education, through education so we can ignore it. We can put our head in the sand. We can continue to transact claims and process claims and dispense drugs. But if we're not talking to the people at the other end of the prescription and we treat it like a white bag at the pharmacy counter without context or without knowledge or education, then we're doing the same thing that the PBM industry has done for decades. That's our mission, is to be the next generation PBM care partner that can help employers improve the health of their employees. And when you improve the improve the health of your employees, you reduce your costs. Steve 31:32 You sure do. Trish 31:32 Absolutely, yeah, that's what I mean. It's a win. Win. There's no reason not to. I think again, it's just about informing as many people as we can reach, which is why we said yes to this interview. We want to be that partner to you all to help spread the word so that people can start making some really educated decisions, business decisions. It's not a benefits decision, it's a business decision on how to how to keep your people, keep them happy, keep them healthy, right? Susan Thomas 32:01 You invest in your employees, you know, to hire and recruit and train. You want the best from them. So I can't tell you how much I appreciate the conversation and your interest in the topic and giving us, you know, a platform to talk more about it. Steve 32:17 This was super fun. Yeah, no, it's our pleasure. We love this. This is really, I think, where we do our best stuff too, you know, I love, you know, payroll technology. But, you know, not sure that's really going to change anybody's life, you know, today listening to another conversation about that. So this is what, this is what we really like to do. So I want to encourage folks to go to Lucy, Rx, L, U, C, Y, R, X.com, that's the website. Loads of information there. Really cool website, actually, where's the Lucy name come from? By the way, that's an interesting name. Susan Thomas 32:50 Yeah, Lucy derives from Latin for light. So l, u x is Latin for light, and that means we're shining a light for members on better health, and also a light for plan sponsors on better ways to build a benefit. Steve 33:06 Awesome. Trish 33:07 I love it. Thank you for letting us be part of the light then. Steve 33:11 I dig it. Trish 33:11 That's what we want to do. Yeah, and please come back as things, as things evolve. This is something I know that is going to be changing rapidly in the next, you know, year, two years, five years. So yeah, please do stay in touch. And we'd love to have you back on as as there's new things that employers and employees should consider when they're, you know looking for what to air. Steve 33:33 Alright, Susan Thomas, She's the Chief Commercial Officer at Lucy Rx, a modern PBM. PBM for the modern world of work, I'll say, I'll make, I don't know if that's a tagline I made that. Feel free to use it. Susan Thomas 33:46 We'll use it. Thank you. Steve 33:47 Put it on link on the website, and thank you again. Trish, great stuff. Thank you. I know it's been a busy couple of days here for you, but thank you for driving force behind these kind of conversations on the show. I really appreciate that. Trish 34:00 I'm grateful. I learn every time we have these conversations, it just helps my it helps my well being Steve, so I can keep working with you. Steve 34:07 Good. Get back to work immediately. No, I'm kidding. Go to hrhappyhour.net for all the show archives as well. And my name is Steve Boese. Thank you so much for listening. Subscribe to the show, YouTube, wherever you get your podcast and we will see you next time and bye for now. Susan Thomas 34:24 Thank you. Transcribed by https://otter.ai