5 Things Utah: Q&A w/ Tracy Gruber, Formulary redesign, LGBTQIA+ health


Eli Kirshbaum


With the long-anticipated health department merger now finalized, this newsletter features a Q&A with the leader at the helm of Utah’s new Department of Health and Human Services, Tracy Gruber.

Also in this month’s edition are recommendations for redesigning Utah’s Rx formulary to lower medication costs, details on how U of U Health Plans is preparing for the end of the public health emergency, and insight on how to improve the LGBTQIA+ population’s access to care.

Thanks for reading!

Eli Kirshbaum
State of Reform 


1. Q&A: Tracy Gruber discusses new DHHS

Following the operationalization of the Department of Health and Human Services at the beginning of this month, DHHS’s Executive Director Tracy Gruber says she’s proud the state made the July 1st implementation deadline and affirmed that the consolidated services provided by the merged department will make accessing care easier for Utahns. In this Q&A, Gruber discusses the impact of the new department and the administrative work still to be done.

While emphasizing that the department is fully ready to serve Utahns, Gruber said remaining work includes consolidating contracts the two former departments had with community entities and establishing a Division of Customer Experience. The latter will help Utahns “navigate the complexities of government.” Gruber also said DHHS plans to pursue innovative health payment models through its Office of Innovation, which will complement the governor’s One Utah Health Collaborative in pursuit of value-based payment structures.


2. Advocates say Utah needs formulary redesign to lower Rx costs

Utah could save $250 million per year on pharmaceuticals by utilizing biosimilars and therapeutically equivalent medications, according to Dr. Bruce Wolf, CEO and Founder of the Rx cost advocacy organization Milligram. Wolf testified at a recent Health and Human Services Interim Committee meeting on lowering Rx prices. As an example, Wolf said the commonly used COPD medication Advair costs the state $15.30 per patient per day, while Breo—an alternative COPD medication that’s just as effective—costs the state $10.41 per patient per day.

“If you do the math, if you just switched Advair to Breo, you would save a third of the expense of [the medication] with just that one switch,” Wolf said. “That would probably entail just pushing a button.” Wolf urged state officials to enlist Milligram to identify the most costly drugs on the state’s formulary and design an updated formulary with alternative, lower-cost drugs. He said Milligram would provide ongoing quarterly updates to the formulary design.


3. What They’re Watching: Dulce Diez, Department of Health and Human Services

The Department of Health and Human Services Office of Health Equity Director, Dulce Diez, said lowering the cost of primary care is the most important way to bridge the equity gap for underserved Utahns. She said her office’s main goal is to listen to the community and create programs based on what they hear from stakeholders.

“The key for us is to involve the community from the beginning and work with the community all the way,” Diez said. “It’s not about what we think, it’s about what they think. It’s not about what we want, it’s what they want. It’s not about what the quantitative data shows as a priority, it’s also the qualitative data and the life experiences of the community working together.” She cited her office’s COVID Community Partnership project as an example of this, in which community health workers connect with underserved communities to help with the COVID response.



4. U of U Health Plans continues preparation for end of PHE

The CDC recently extended the COVID-19 Public Health Emergency until October, but preparations for inevitable Medicaid redeterminations haven’t slowed down. As one of Utah’s biggest Medicaid plans, University of Utah Health Plans is using various mediums to communicate with its members about checking their eligibility status. They’re also asking patients to update their contact information and are partnering with Take Care Utah to send health access assisters to help underserved Medicaid members prepare for redeterminations.

Randal Serr, Health Plans Community Outreach Manager at University of Utah Health Plans, said the PHE flexibilities that allowed so many more Utahns to receive Medicaid coverage presented opportunities to expand the program. “If there is one silver lining, we would not have anywhere near this amount of people on Medicaid right now [without PHE flexibilities],” Serr said. “This is a huge opportunity for us to retain as many people as possible and end up with more people on Medicaid than we would have without COVID.”


5. Recommendations for improving care access for LGBTQIA+ individuals

LGBTQIA+ adults are twice as likely as heterosexual adults to experience mental health issues, and transgender individuals are almost 4 times as likely as cisgender individuals to struggle with mental health. To address this, advocates encourage increased competency trainings on LGBTQIA+ health issues for Utah providers.

“We need to take the initiative to learn these things for ourselves, become competent, and advocate for people in our communities,” said Anna Docherty, PhD, of the Huntsman Mental Health Institute at a recent panel discussion. U of U Health has implemented a search tool for LGBTQIA+ patients to find providers who are trained on their specific health issues, as well as a Sexual Orientation and Gender Identity Committee that measures health disparities among the LGBTQIA+ community.