Ken has worked in the healthcare and PBM industry for his entire career. He has watched as the industry coped with the entrance of MCOs, HMOs, PHOs, PPOs, and PBMs. He witnessed vertical integration at its best and at its worst; witnessing the industry cope and mature with these new pricing and valuation methodologies. He saw the entrance of capitation whereby physicians and hospitals were reimbursed not by the services they provided but rather by the number of patients which they agreed to own the responsibility of medical care. He began his formal career as a clinical social worker and was promoted through the healthcare arena numerous times over; always willing to accept new assignments and challenges. Ken was responsible for managing the PHO and the creation of the primary care operation at Cardinal Glennon Children’s Hospital. At Express Scripts, Ken operated in the player-coach model as he provided strategic and tactical leadership to his team who were managing day-to-day operations, selling/upselling new products, and assuring PBM contract compliance.
Currently Ken is a Partner with Experience On Demand. He understands trends and topics relating to the healthcare and PBM industry, including: Market Strategy Development, Product Development, & Subject Matter Expertise in the field of Pharmacy, Medical and Health Benefit Management areas. He can discuss the implications of employer public and private exchanges, growth of employers leveraging self-funding (as premiums are on the rise) with the advent of specific disease state stop loss coverage, and overall expertise in healthcare benefit programs. His knowledge spans the presence of specialty pharmaceuticals, compounding pharmacies, retail pharmacy, and M&A activity in the PBM industry. He truly understands the PBM sales cycles and is comfortable explaining the various value propositions of the key PBM’s in the marketplace.