Adriana
Lynn Hughes
PharmD, RPh, CPh
A patient arrived with notice that her medication was covered. Her doctor was under pressure not to prescribe it. The benefit design was unsustainable. In that moment, I knew it was time to step into the role where benefit decisions are made.
That moment shaped everything that followed. I have spent five years on the provider side of a major health plan, watching how PBM and payer decisions land in the real world: on providers, on practices, and on the patients who trust both.
"Less is not always more. I measure success by total cost of care: not just what was saved, but what was preserved and prevented."