Tim Pafford, a drug rep with the international pharmaceutical company Novo Nordisk, was tired of not getting answers. In his job as a senior endocrinology diabetes care specialist, he talks with health care professionals every day about diabetes medications and getting patients access to them. Over and over, he said, he found a “convoluted mess.”
“My entire job is to educate and sell a clinician on the attributes of the medicine that Novo Nordisk makes,” he said. “In the course of doing my job, the clinical evidence was obvious. Doctors are like, ‘I want to use your medicine. Patients can benefit.’
“They’d go to use them and there would be roadblock after roadblock with managed care companies, deductible plans, employers. Why can Jane get it but Jill can’t? They work for the same company?”
Pafford said he went online “seeking to understand the market” and found the University of Lynchburg’s Master of Health Benefit Design and Health Informatics, the first master’s degree of its kind in the nation.
The program launched in March 2019 and new cohorts start every four months.
The online program, which can be completed in a year, gives human resources professionals and other in the health benefits arena the expertise necessary to improve the quality of health care available to employees, while also helping reduce employer and employee health care costs.
“There’s a need for cohesive education that shows corporations and benefits advisors how to tie together value-based approaches to health care that provide higher quality health care at significantly lower costs,” program director Dr. Tom Scott said.
“Health care is expensive and unnecessarily complex. This program not only makes health care understandable, but it shows the way to lower costs and better outcomes.”
The program has been praised by several national health benefits experts, including Harvard Law graduate Al Lewis, author or co-author of several books, among them “Surviving Workplace Wellness” and “Why Nobody Believes the Numbers.”
Lewis, who topped Managed Healthcare Executive’s list of the “Most Influential People” in disease management, said Lynchburg’s program “promises to provide an education that is desperately needed and currently not provided.”
The 30-to-33-credit-hour program has two available tracks: Benefit Advisor and Benefit Administrator. The tracks share several classes in the curriculum, resulting in what Scott described as a “great opportunity to provide perspectives to each other.”
Students on the Benefit Advisor track will develop a complete, integrated health plan design for a real corporation, and then present the overall plan to human resources executives and clients. The Benefit Administrator track focuses on evaluating requests for proposal from potential benefit advisors and learning to present and provide justification to stakeholders, such as a CEO or employees.
“These are effectively two sides of the same coin,” Scott said. “A benefits advisor, or broker, will help the benefits administrator — HR director, CFO, etc. — select a health insurance plan that makes sense for them.
“However, most benefits advisors do not have the knowledge, network, or desire to move clients to a lower-cost, higher-quality system. That means learning a new way of doing things and potentially taking a cut in revenue.
“Advisors in this program learn everything about value-based approaches to health care, how to tie them together in a comprehensive, cohesive document, and how best to approach benefits administrators.
“Benefits administrators also learn about value-based approaches to health care, so they can better position themselves to educate and communicate the message internally. They will be able to not only speak the same language as their advisor, but will probably be several steps ahead — which is new for most people in that position.”
Pafford chose the Benefit Advisor track. “I don’t see myself pursuing a career or working for a company in HR,” he said. “I would always see myself in the consulting role, helping multiple companies.”
He added that what he learns might also help in “future roles of negotiating patient access to medicine on a broader scale.”
Kellea Hogan, director of Total Rewards for Framatome’s North American headquarters in Lynchburg, is on the Benefit Administrator track. She first heard about the degree from her company’s CEO, and said she chose to enroll because “we are a company that prides itself on our innovation and our people.
“We are always pursuing the latest strategies in all of our practices.”
Pafford, who started the program in March 2019, is currently taking his fourth five-week course. So far, he said his experience has been “great” and he’s been made privy to lots of information that isn’t readily available to the general public — things like how health benefit plans are designed, who pays for them, and who benefits financially.
“Dr. Scott has done a very good job at looking behind the curtain and trying to expose all the moving parts. … It’s very beneficial to see all the moving parts when it comes to health care design and access. It’s been useful in my career because it has expanded my knowledge base when talking with health care providers and clinicians in the Virginia region.”
Hogan, who also started in the program in March, said she began using what she learned immediately. “One of the best aspects of the design of this program is the immediate application to my job,” she said. “We aren’t just talking theory, we are taking it down to direct, practical applications that I’m implementing throughout the duration of the program.”
As part of their classes, Pafford and Hogan learn from nationally known experts, the vast majority of which are CEOs, owners, or vice presidents of their own organizations. Among the dozens of experts involved in the program are Dave Chase, author and CEO/founder of Health Rosetta; Bill Hennessey, CEO of Pratter; and Katie Adamson, vice president for health partnerships and policy, government relations, and policy for YMCA of the USA.
“A great part of the program has been the connections with some of the real change agents in this field,” Hogan said. “I’ve read their books, follow them on social media, and now I’m interacting with them directly through the program.”
From these experts, Pafford said he’s learned about direct primary care, which he described as a “cost-saving option that would lower cost and increase quality” in health care, and about resources like Leapfrog and Pratter, which can help consumers better investigate the quality and cost of their health care providers and services.
“That was eye opening for me,” he said.