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♪ Welcome to a special edition of "Direct Connection" with highlights of recent programs.

Coming up, we'll have some tips to save on auto insurance.

First, inside the complicated world of pharmacy pricing.

We asked Brian Hose, the owner of Sharpsburg Pharmacy, if ten people came in with prescriptions for the same antibiotic, how many different prices might they be charged?

>> Depends on which insurance company they have, whether they are cash paying.

Unfortunately, with the healthcare system in our country, it is very challenging To make sure that all ten of those people would get the same fair price based on what their coverage is.

>> All right then, so what is your best advice for our viewers on how they can be sure to get ,maybe not the perfect price ,but get a fair price on medications?

>> I think the best thing that they can do just know what their Benefit is.

Understand their insurance as best they can.

I know these challenging with the way things.

and then talk to your pharmacist.

If you have a good relationship with your pharmacy staff, or your pharmacist, ask them.

Is there a cheaper way for me to get this medication than through my insurance because unfortunately sometimes there is A cheaper way for them to get it.

>> Well, and maybe that is the coupon cards that I have actually seen at pharmacies, and I'm not sure that I totally understand why.

But something called GoodRX, A.A.R.P.

has a plan, and I think that they are free to use.

How does that work?

>> I would say as an independent pharmacy owner, I'm incentivized To just give you a fair price and not have to deal with the company like GoodRX for a couple reasons.

GoodRX is a company that collects data from consumers.

And then sells that data to get money in another stream.

So we also end up paying GoodRX an outside price to run a through the card.

They collect money from us that we take from the patient at the point of sale so we as an independent pharmacy own, we've incentivized to give the customer a fair price and not deal with a company like GoodRX wants to monopolize the market.

You see manufacturer discount cards for branded medications and these work differently.

Those are, you know, manufacturers agreeing to discount the price to help a customer take their product.

And those are usually to help to Pay your co-pay, come back from your insurance.

>> It seems like things have gotten more complicated in the last decade or two decades.

Is that your perspective from your side of the counter?

>> I would say that that's definitely the case.

Pharmacy owners used to be able to just help people and fill prescriptions and now there's a lot more business concerns in running a small pharmacy.

It is just we used to go we bought the store back in 2008, it would be strange we see a pharmacy claim come across where we were not reimbursed the cost of the medication.

Now, in the Medicare part d space, that rate is between 50 and 70% of the claims.

Especially on generic drugs, come back, especially brand drugs come back at a loss for Pharmacy It is not the way it was when we first started in 2008.

It was help as people as you can ,and you'll get reimbursed and get customers.

Now it is really a game that is controlled by the pharmacy benefit managers.

>> Let me remind viewers if you have a question about how to get a good deal at the pharmacy, send us an email.

Tell us a little bit about EPIC.

That name has been around for a while.

>> Yes, EPIC started as a buying group here in Maryland and Virginia, a couple of buying groups came together to join up to make EPIC pharmacies.

We also have what's called a PSAO, pharmacy service administrative, organization, big name, pretty simple.

We contract with big PBMs to Help pharmacies get contracts.

So we have buying groups that helps to collectively purchase drugs and we have contracts as well.

The footprint across the U.S. is around 1200 stores total.

>> Tell me more about the pharmacy benefit managers.

Is that an entity that consumers need to know about?

>> I think increasingly, it is.

We see they are being bought up and vertically integrated with health insurers so the big three PBMs, Caremark, Express Scripts and Optum RX occupy 80% of market of what consumers get on their drug benefit.

Those three companies control the vast majority of plans for consumers across the country.

>> Do they work differently?

Do the benefits that a customer might have work out differently if it is a big well-known chain pharmacy or independent shop.

>> The interesting thing about It really depends on the plan.

The thing about the PBM space is that, as an independent pharmacy, I'm contracting with a company like CVS Caremark has brick and mortar pharmacies that are my competition down the road.

And that company also gets to decide what they pay a CVS pharmacy for a medication and what they pay Sharpsburg pharmacy for a medication.

If it sounds like there might be an incentive there to manipulate that, there certainly is.

It has become a real challenge and I think that, for the consumers, they want to go to a pharmacy that provides them the best care and takes care of them and their community.

And it is not always the way as sometimes the PBM and way the plan is designed forces them to use a mail order pharmacy or one, and it takes the consumer choice away from folks.

>> I wanted to ask about the mail order pharmacies because if it is August and your drug is being shipped halfway across the country, and it is 100 degrees and it is going to be bouncing around in a hot mail truck all day, put your pharmacist hat on for a second.

Are there some risks affecting the quality of the medication?

>> Absolutely.

We actually in the pharmacy all of our product that comes in that needs to be refrigerated and be done in a coaching transportation, it comes to us that way.

We maintain it that way.

The boards of pharmacy require us to be very careful in how we handle those drugs and making sure that those temperature ranges are kept.

Your postal service employee is not able to do that.

If it is hot out and it is in a truck, we have customers all the time very concerned about this.

And I would be too if I was taking mid-occasions that were exposed to temperature.

I know some manufacturers have said that it is stable, at certain temperatures for certain periods of time but it is really hard to know how long or how hot that product got when it is in mailbox in the sun all day.

>> Back to the pharmacy benefit managers.

I believe that your organization is working with Congress, working with state legislatures, on reform ideas.

What do you have in mind?

>> I think that the main idea for pharmacy reform for us is simply a leveling of that playing field.

You can't have these big companies that are fortune 20 companies pushing small independent pharmacies out of business and trying to like try to grab all of that market share for themselves in the pharmacy space.

We can't allow them to push patients to use their own mail facilities and incentivize themselves with higher reimbursements at the facilities for drugs.

It is just simply level the playing field.

If these companies can't be owned by health insurers and vertically integrated and be fair players in the healthcare system, they need to be broken up.

>> This time of year, when people have been changing health plans and maybe different formularies are taking effect, are you busier trying to solve problems for your customers?

>> This time of year is always most challenging in a pharmacy because everyone's insurance either changed or if it stayed the same, the formulary changed.

I know that many of the farm hears that patients in Maryland are on have changed.

We've seen lots of instances already where they might have been on one particular product last year and this year that insurance company is negotiated a better deal with a different competing product and switch.

Or they have to go through a prior authorization process which is definitely challenging especially when you want to go and get your medication that you have been on and stable on for some period of time.

It is a challenging time for both customers, patients and the pharmacy staff.

>> Jeff: Viewer question about mail order.

Frank says, we were told to use mail order in lieu of retail pharmacy for particular prescription to save money.

Why is his question.

How do they save money by making you do that, normally, it is to get I think a 90-day supply?

>> Right, I mean, let's think for a second from the PBM that likely owns that mail order pharmacy.

If you get to get premium dollars for people for insurance benefits and you also have a pharmacy, you would love to both fill that prescription and have those dollars come to you on the mail order side as well.

If you can limit which drugs are filled in retail pharmacies, you can pay yourself better for those drugs that have to be forced to mail order and that's what we see a lot of times is that mail order prescriptions may be incentivized to be cheaper to the patient but they are a cash cow for PBM-owned pharmacies because they are able to set the reimbursement rates on those.

>> Jeff: Brian Hose joining us from Sharpsburg.

Now with Marylanders paying some of nation's highest auto insurance bills, what can drivers do to save money?

We spoke with Chris Schafer, senior editor at Insurify.

>> We're seeing rates climb across the country.

Now, different regions of the country have different increases, and in the Maryland area, for example, we're seeing very dramatic increases.

We have seen a 53% increase from December of 2023.

In 2024, Maryland became the most expensive state in the union for full coverage car insurance based on Insurify data.

>> Jeff: I seen other statistics that aren't quite that bad.

What are some of the factors that might go into how different organizations calculate this?

>> A lot of it is really based on the rent rates paying and the quotes that you're being offered.

And that's based on a number of different factors that can impact you.

For example, obviously Maryland has large population centers.

The Baltimore area, the proximity to Washington, D.C.

But, part of that too for Maryland is this push towards the enhanced uninsured motorist coverage which took effect July 1, 2024, it is a provision that allows policy holders to stack at fault driver liability insurance with personal uninsured or underinsured motorist coverage.

Insurers are taking this into account as they set new policy rates.

In addition to that, Maryland drivers also face some very traditional concerns that are heightened in the state.

For example, Maryland saw an 8.2% rise in motor vehicle crashes, deaths in 2023.

At the same time, the general U.S. population saw a 3.6% decrease.

So, more dangerous to drive in Maryland according to those statistics and those come from national highway traffic safety administration.

Car thefts are also up in Maryland 63% in 2023 ,and that's according to The National Insurance Crime Bureau.

So you are in insure retaking all of the things into account when set your rates and that's part of the reason that we're seeing the dramatic rate increase in Maryland.

>> Jeff: When you compare one state to another, you're looking at full coverage.

Is that the top of the line on an expensive car or what are you looking at when -- Because it is hard to compare apples to apples when you're looking at auto insurance bills.

>> Yeah, so we compare both liability cover about which meets the state's minimum required guidelines.

And then we compare full cover about rates as well.

And full coverage rates would be insurance coverage that includes comprehensive and collision coverage.

>> I got some data from the state motor vehicle administration on the number of points that are being assessed to drivers for various infractions.

And it is a surprising number.

The number of points given out in the last fiscal year was down by a third compared to pre-pandemic.

It doesn't look to me like anybody is driving any better but for whatever reason, fewer points are being given out, and that means that, that factors into cost of insurance too.

Are you seeing that either locally or nationally?

>> Tremendously, we're still seeing, it is not really having a very positive impact on insurance rates.

We're see something states where insurance rates are decreasing.

But obviously Maryland the rates are climbing.

We've seen dramatic increases in state likes Michigan, Florida.

We've seen rates climb, and part of that is because points indicate driving behavior but we're also seeing the increase just from the increased cost of labor to fix things, parts shortages.

All of that factors into your insurance rates as well as your driving record.

>> All right, let's get some advice for our viewer.

Say somebody watching has an average risk.

Let's say they have a clean record, they don't drive a super expensive vehicle, and the rates have gone up.

What do they do?

>> Well, you have a couple of options.

First, obviously one thing that you could do is shop around for car insurance.

Compare quotes from several different insurance providers.

A lot of people get into this idea that the insurance package is their insurance package and they don't really realize that there are unique risk factors present the same to different insurance companies but different insurance companies judge those risk factors differently.

Which is why you will get a different quote from one insurance agency to another.

It is all based on how they judge you based on your own driving history, your age, your gender and things like that.

So, that's one thing that you can do right away.

A second thing that you can do, let's say you go out there and get quotes and they are not any better or they are all similar.

The second thing that you can do, is look at your driving behavior and look, make sure that a, you're getting all of discounts that you qualify for.

If you have driven accident free for five years or more, you should be entitled to a discount in many cases.

If you're a military veteran, you should be entitled to a discount in many cases.

Make sure that you're getting discounts that you qualify for and also look at other ways that you can lower your car insurance.

Especially if you're driving a less valuable vehicle.

One of the main things, pay per mile insurer and look at something like that.

Maybe if you don't drive a lot, especially in this area where so many of us work from home, maybe that's your better case.

Instead of paying for essentially miles that you're not driving.

>> What if you have somebody on the other end of the spectrum.

They've got some.s, they have some bad driving history.

For whatever reason, they are driving expensive vehicles and on top of it, they have got teenaged drivers.

Anything that they can do to bring down their coverage and I'm thinking about.

I think you call it Telematic.

Would that make sense?

>> Yes, Telematics the same thing as we mentioned.

Telematics could do it for you.

Again, you should expect if you have those high risk factors, let's say you have a teenager, you have a DUI on your record, you're going to pay more.

There is not a magic genie in the bottle for that for example, if you have a DUI in Maryland, according to our data you can expect to pay about 53% more than someone who has clean driving record.

That's just going to happen.

Telematics can help you in many cases because you are given a chance to prove that you have improved your driving record.

Or if you have a teen that teen is driving with a clean record.

Another thing that you can look at doing too is increasing your deductible.

Many people have $500 deductible and you can see an increased savings if you go to a $1,000 deductible.

Just have to be ready for the fact that should you need to file a claim, your up front costs will be greater.

So, if you can afford that $1,000, then a $1,000 dollar deductible might make sense.

If it is something that you couldn't be able to, do then it probably doesn't make sense to increase your deductible.

>> Jeff: The Telematics thing, I think that, feels like I'm seeing less about this but, the idea is, basically letting your insurance company spy on you.

You plug a thing into your car that tracks your speed and heavy brakes that sort of thing.

Is that right?

>> That can be right, it depends.

Every program is a little bit different but that's definitely the hesitation that a lot of people have with it.

>> Our thanks to Chris Schafer of Insurify.

Now, Governor Moore's anti-child poverty effort has landed 100 million in philanthropic commitments.

We spoke about it with Carmel Martin, Special Secretary of the Governor's Office of Children, and Picket Slater Harrington, Director of the Enough Initiative.

>> Enough Initiative is first of its kind state-led place-based initiative designed to tackle child poverty.

We're focused on the communities across the state that have the highest concentrations of child poverty and unfortunately, we have got those all over state from western to Baltimore to the Eastern shore.

And what we're doing is partnering with people in those communities who would like to have a vision for how they would like to see their community revitalized to support the children and families in them.

And we're there to help to support them in executing against their plan as the Governor has often said, the communities have the people closest to the problems are closest to the solutions, have the best ideas, so, it is our job to help them think across issue areas, whether it is education, healthcare, workforce, and device a plan for how they're going to support the people in their communities, and it is our job to step for ward and help them to execute against that plan.

>> Mr. Slater Harrington, there was money in the state budget to get this started.

But, you recently announced a philanthropic commitment, a very big number.

Tell us about that.

>> Yes, you probably heard about it , it is called the Enough Alliance.

It is a coalition of local and national philanthropy and private sector organizations and they have come together to support the work of enough by investing in children and families to end poverty.

The goal of the alliance was to raise money over six years, and we're able to raise $100 million towards the effort to support children and families to end poverty.

So our local and national philanthropic partners did this work to support ending poverty in Maryland.

So we're super excited.

>> Jeff: Do you have in mind what communities are going to be served by this program, and exactly, what the fund will be used for?

>> Yes, so we're excited to have 27 inaugural communities throughout Maryland that will be doing the work and so we have 12 partnership communities for track one.

We have 12 communities that are developing neighborhood action plans, and we have three implementation communities.

Like I said, they are spread throughout the state and they'll be working on four core areas: So one is about children, cradle to career.

So there will be trying to figure out how do you support young people from birth all the way into college or career.

We're also be supporting families so making sure that families are healthy and economically secure.

And then last piece that they'll be working on is thriving communities so making sure that communities are safe, healthy, and they have housing, they have the supports that they need to be successful.

>> Jeff: Over the years, I guess, there have been plenty of attempts to break the cycle of poverty as they say.

What has been learned from that?

How can you most effectively deploy these funds, Madam Secretary, to positively affect the most people.

>> I think something that's really important about the Governor's Enough Initiative is the vision here, is a recognition that you have to meet people where they are.

That this is, to a certain extent, changing the government's relationship with individuals, with families and with communities and understanding their context.

And seeing how we can honestly, leverage existing programs and funding streams so they are more effectively meeting people where they are.

Just a little example that there is lots of programs that are designed, people to help people get good jobs, so there might be a great job training program.

But if the families in that community don't have child care in order to participate in those job training programs, job training programs are irrelevant to end this so part of what we're doing is helping communities meet the families in their community where they are and figure out how they can bring programs and services together to holistically support children, holistically support families and holistically support communities.

And then the other big piece of this is it is about being as Governor said we're heart led but data driven so really being driven by the data.

We've created data dashboards for each one of the communities so they can see where they have assets and where they have challenges.

And they can drive resources to their biggest challenges and tap into assets in the communities with creative fiscal maps for them so they can see where all of the existing programs are that support children and families and see where they can tap into existing resources.

So bringing things together around a strategy where again, strategy and the goals of strategy are coming from the people who are living in those communities, because they know their communities best.

>> Jeff: So you're saying this could be very different in an urban community versus a rural community.

>> Exactly ,and it could be different depending on even in an urban, two different urban communities could have different priorities.

You know, we're supporting Cherry Hill in Baltimore.

They are very focused on chronic absenteeism and their work is very driven by that.

And another one of our Baltimore grantees is Park Heights ,and they are focused on tackling vacant properties because the children have to walk through vacant properties to get to school.

They are less likely to get to school safely.

Hagerstown, they are very focused on substance use issues so they are focused on that so each of these plans do take a holistic approach to their community.

They are looking across as picket said, they are looking at the needs of children and education.

They are looking at healthcare.

They are looking at workforce issues and they are looking at community safety issues.

But each community is formulating a plan based on what's happening in their community not just in terms of what the challenges are but where the assets are.

How can they tap into the potential of the people and the community that is at issue.

>> I'll answer this as well.

That we often say that those closest to the problem are also closest to the solution.

So Enough really embodies this work.

So what you heard the secretary talk about was that each community, their issues are so unique to them, and what we have done is design a way to make sure that those communities are active and a part of that solution and we're connecting them to the resources in order to achieve their goals.

>> This is all about thinking big, so, I'll ask you to think big for a second.

Paint us a picture of 20 years from now, in cherry hill or somewhere else, where you have been able to make a difference.

What do you hope somebody's life who is, let's say they are an elementary school kid in Cherry Hill today.

Where do you want them to be in 20 years?

>> Yeah, I want you to think about this: We have the possibility of being the first state to end concentrated child poverty.

>> Remember, you can always see past editions of our programs at Videompt.tv and on the free PBS app.

You can also find us on social media at MPT news.

Now for all of us at MPT, thank you for watching, and