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George Foley

George Foley

VP of Cost Strategy and Optimization at Crumdale Specialty, a registered nurse with 25+ years in healthcare and insurance; guest on the Aligned for Impact podcast.

Sep 21, 2026

17:31
What is case management?
17:33
So case management is typically a group of nurses that are gonna work with that member to look at that member holistically to make sure during their treatment journey that they're meeting the medical outcomes that they're going through, right? So an example would be, hey, it's a breast cancer patient, you're gonna get this treatment.
17:57
Well, that case manager is gonna get on the phone have a conversation with that member to help them understand, hey, you're gonna get this treatment, here are the side effects, they're normal, do this, do that.
18:10
So the case manager is kind of guiding that member, right? The worst possible thing can happen to this member if they get diagnosed with cancer.
18:20
So that case management group is typically gonna manage them through that process.
18:26
traditionally as i mentioned the signal isn't necessarily delivered to case management and then the pharmacy team right so there's there's another silo of pharmacy so you could have a drug matt that cost ten thousand dollars a month so real quick here's a statistic over the past Two years, 95% of cancer drugs approved by the FDA Food and Drug Administration, the floor is $100,000.
18:59
95%, the cost of those drugs annually are $100,000.

20 MINS LATER

38:55
And maybe you can talk about how our member advocacy team sort of makes that connection possible for all those solutions.

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