Leslie Small is a senior reporter at AIS Health, writing about the payer industry in Health Plan Weekly, and the intersection of payers and pharma in RADAR on Drug Benefits, analyzing the most important topics impacting the market and talking with stakeholders about how current industry trends affect their future strategies. Small has been writing about the health care industry since 2015, joining AIS in 2018 from FierceHealthcare.
Q: Since AIS’s publications come out on a weekly schedule, can you walk us through a week in your life?
A: I write anywhere from two to four articles every week for Health Plan Weekly and RADAR on Drug Benefits. Monday is kind of a ‘get your ducks in a row’ day. I’ll figure out what I’m covering, set up interviews and start writing down what questions I want to ask. The week really varies a lot depending on whether I have one or two publications coming up, and when interviews get scheduled. Tuesday and Wednesday I’ll often do a lot of interviews, and Wednesday and Thursday I’ll do the bulk of my writing. Once Health Plan Weekly goes out on Friday afternoon, I like to think I’m once again on deadline for next week.
Q: What are some of the more challenging aspects of your job?
A: Every journalist has to be willing to be very flexible. You have to have a plan, but you also have to be willing to scrap that plan, because we do want to be able to cover what the industry is talking about within a reasonable amount of time. You have to work with what you’ve got. The hardest part is probably making sure you have a source who can talk about what you’re covering, because our journalism is so interview heavy. I might want to write about something, but if I can’t get anyone to comment on it, it’s not something I can write about at length.
Q: How has your understanding of the health care landscape changed since working at AIS?
A: I understand a lot more about drug pricing now, and in learning about our data, I understand all of the business lines of the industry in a more in-depth way. My coworkers here are people with decades of experience, so I’ve learned more about aspects of the industry that I hadn’t covered before, things like Medicare Advantage Special Needs Plans for dual eligibles (D-SNPs) and administrative services only (ASO) contracting.
Every time I do a story I learn a little bit more about the industry — everything changes so fast in health care, so having the knowledge base that AIS Health has really covers you if you feel like you don’t know as much as you should.
Q: What are some of your favorite topics to write about?
A: I’ve always enjoyed writing about the Affordable Care Act exchanges, as they’re always interesting and the ACA has faced so many challenges. I particularly enjoy writing about court cases and legal issues. I also love writing about mergers and acquisitions because everyone wants to read about them. It’s always interesting to see a lot of the drug pricing stuff that’s going on right now because the ideas coming from the Trump administration aren’t necessarily traditional Republican ideas. There’s a lot more willingness right now to take on the industry, and it’s really interesting to see that play out in real time. The best stories are the ones where you feel like you’ve learned something, because you can translate that into words, and you can take your readers along on that journey too.
Q: What challenges or shifts in the industry should MMIT clients be looking out for?
A: Everything is more integrated now — what do you even call CVS Health as a company now — is it a payer, is it a PBM, is it a retail pharmacy? Yes! There are so few, to borrow an industry term, ‘pure-play PBMs’ anymore, and the ones that do exist I think are kind of freaking out because they’re being pushed out by these 800-pound gorillas — CVS, Express Scripts, UnitedHealth. But as one source has pointed out to me, those big integrated entities, especially ones that have resulted from acquisitions, also need to prove to investors and the American public that they’re offering more than just scale — that they could really drive some innovation.
The focus on seniors is another big thing to watch. Medicare Advantage is such a huge money maker, and we’re talking about all of these changes like Medicare for All. I think a lot of the industry discounts that proposal, and no, I don’t think we’re going to have a single-payer industry in three, five, 10, maybe even 20 years. But I think the push toward it may bring something like a watered-down public option. There’s enough public support for it to bring something into the mix to at least placate people, so I still think that’s worth watching.
Q: If any of our clients are not reading AIS Health publications, why should they be?
A: We offer analyses that really are industry-targeted. There’s a million policy-focused newsletters and subscription services out here, but we are very strongly business focused, so we work to tell you what you need to know, not what consumers need to know, even though sometimes those two do intersect. It’s a good way to get business intelligence, and we do strive to make our graphics and our data journalism tell stories as well. We draw upon our really robust data to inform our journalism — we’re certainly not the only ones doing it, but we have this vast trove of health care data that we collect, so that differentiates us quite a bit.
Q: What’s your favorite part of your job?
A: I like seeing the publication come out and thinking, ‘that was a really good issue.’ I love reading the stuff that my colleagues write and learning from them. I learn something new most days, and that keeps my job interesting. At a lot of jobs, you reach a certain plateau of knowledge, but this is more intellectually rewarding.
Q: What do you like to do outside of work?
A: I have a 4-month-old, so I spend a lot of time with her! We like to go on walks around our neighborhood, and there’s a bike trail really close by. On rare occasions now, I like to go out to eat with my husband and see friends, go to happy hour with my coworkers, and I travel when I can. I probably won’t for a little while, until I can take the baby along.