June 18, 2019

Accolade's Scott Cariello on the Best Job a Pharmacist Could Have

By Peggy Fischer

For Accolade Pharmacist Scott Cariello, the desire to help people began at a young age. Sometimes, when Scott's mother needed time to herself, she would drive him to the Staten Island health clinic pharmacy where his father worked among the tools of his trade—manual pill counters and bottles, typewriters and prescription pads. To Scott, it was a place of precision and care, where medicines were parceled out to those in need and where questions were answered about why, for example, that cholesterol medication had to be taken at night, or why there could be no after-dinner wine until the given course of therapy was complete.

Four-, five-, six-year-old Scott had a job to do when he was at the pharmacy. He'd climb up onto the counter and do it—handing out the bottles and bags that his father gave to him. Scott would remember, long after that, how good it felt to have an impact on people who relied on you.

Following in his father's footsteps

Scott followed in his father's footsteps, ultimately receiving his PharmD from the University of the Sciences in Philadelphia. He learned—and eventually taught, as an assistant—the chemistry. He even learned how to complete physical exams. It was a seven-year education, and Scott felt ready for the life he'd built. But just two hours before he was to graduate, his father, driving their car, turned his eyes to Scott and said: It is not too late to do something else with your life. Dad, Scott almost said, it is.

Some early jobs gave Scott a hint at what might have been behind his father's graduation-day caution. Scott's first job as a clinical pharmacist in a healthcare setting was deeply engaging, but it couldn't help Scott pay back his significant college loans. The next job, in retail pharmacy, showed him how hard it can be to work for your patients' best interests while also satisfying the economics of the business. By the time Scott was contacted by a recruiter for Accolade, he knew what he wanted to do with his life; he just didn't immediately realize that he was being interviewed for the possibility.

A new opportunity to help people stay healthy

Scott and Accolade worked together to define the position Scott would ultimately take as the company's first full-time pharmacist. As Accolade grew, Scott's job grew, too, and so did his team, which now includes several pharmacists and technicians located in Plymouth Meeting, PA and Scottsdale, AZ. Today, as the Scottsdale-based Director of Clinical Pharmacy Operations, Scott says his job is truly unique in the industry.

“We aren't at Accolade to dispense medications,” he says. “Our goal is to make sure that our Health Assistants and nurses can help our customers' employees and their family members get the most appropriate care within the framework of their benefits. We study our customers' benefits plans. We think about how to ensure that each member is being cared for in the best possible way. We maintain an in-house formulary management system that gives our Health Assistants a one-page view of all benefits related to a medication for each specific member. Ultimately, we are working to keep people as healthy as possible today, to avoid unnecessary health complications later.”

Factoring in each person's life context

To achieve that end, Accolade pharmacists pay careful attention to the circumstances and pressures of each member's life. “We're factoring in the reality that, for example, a woman with high blood pressure is also a mother without a car working two jobs to pay the bills. Perhaps she can't afford to take the most expensive drug on the market. Perhaps she can't stop to take her medication five times a day. Perhaps she would be helped by a combination pill. Perhaps she has had a few side effects and decided not to continue with the therapy. We listen. We think through options. We want to make compliance as easy as possible, because compliance is what will ultimately yield the best possible, and least costly, health outcome.”

Accolade pharmacists help members learn how best to take their medicines. They talk with prescribers—doctors and nurses—to help them gain a more holistic view and to join Accolade in a search for an optimal therapeutic approach. No one day is ever the same. In fact, says Scott, in seven years at Accolade he believes he's only ever been presented with five identical issues.

Finding answers together

In Scottsdale, where Scott moved with his wife and three children four years ago following three years in Plymouth Meeting, the work atmosphere has proven to be enormously conducive to collaborative decision making. “We're all sitting around tables, searching for the best solution,” he says. “We rely on each other. We find the answers.”

And when Scott heads home, he now has his mother and father nearby; following 40 years as a pharmacist, Scott's father has retired and is very glad that his son found the job that allows him to do what pharmacists really want to do: positively impact the lives of those who are in need of care and answers.

For more information on Accolade's clinical model, read Personalizing Population Health; Making Value Based Care Work for People and Employers. Download the paper today