In this episode of The Pulse in 15, Mary sits down with Heather Sundar, CEO of Archimedes, to explore one of the largest and least understood opportunities in healthcare cost management: medications covered under the medical benefit. While many employers focus heavily on pharmacy benefit management, some of the most expensive specialty medications are administered and reimbursed through the medical plan, often with far less visibility into cost variation and utilization patterns.

Heather explains why medical benefit drug spending has become an increasing area of focus for employers, what organizations hope to accomplish through medical pharmacy carve-out strategies, and how improved transparency can help identify reimbursement variation, overpayments, and opportunities for greater spend efficiency. The discussion provides practical guidance for employers seeking to balance financial stewardship, appropriate clinical oversight, and member access to necessary therapies.

Key Takeaways

• Understand the difference between traditional pharmacy benefits and medications covered under the medical benefit.
• Learn why specialty medications administered through the medical plan have become a growing cost concern for employers.
• Explore the goals and potential benefits of medical pharmacy carve-out and specialty drug management strategies.
• Identify the reporting, transparency, and reimbursement insights employers should expect to effectively manage this category of spend.
• Understand how organizations can improve cost efficiency while maintaining appropriate member access to necessary therapies.

In this episode of The Pulse in 15, Mary reconnects with Dr. Sean Hashmi, a leader in Lifestyle and Obesity Medicine at Kaiser Permanente, to explore how obesity treatment has evolved since their first discussion in 2022. At that time, GLP-1 medications were just beginning to gain attention. Today, they have transformed conversations around obesity management, healthcare costs, long-term outcomes, and employer health plan strategy. Dr. Hashmi shares what real-world experience has taught us about sustainable success, long-term use, and medication discontinuation, while providing practical insights for employers evaluating obesity care programs.

Key Takeaways

• Understand how obesity treatment has evolved since GLP-1 medications entered mainstream clinical practice.
• Explore what providers are seeing regarding long-term outcomes, sustainability, and measures of success beyond weight loss.
• Gain insight into whether patients can successfully transition off GLP-1 medications and maintain their results.
• Identify the key elements employers should consider when developing an obesity management strategy that extends beyond medication coverage alone.

In this episode of The Pulse in 15, Mary Delaney sits down with Teri Weber to talk about the growing complexity of absence management—and why so many employers are feeling the impact across their organizations.

From FMLA and ADA to evolving state leave laws, rising mental health–related absences, and hybrid work challenges, absence is hitting organizations from every direction. What used to be a compliance exercise is now directly impacting productivity, cost, manager effectiveness, and employee trust.

In this quick 15-minute conversation, Teri focuses on what matters most right now:

• Where employers are most at risk
• What’s changed in the absence landscape
• Practical steps leaders should be thinking about this year

If you’re navigating absence across your workforce, this is a conversation worth 15 minutes of your time.