Matt Shiraki doesn’t shy away from tough conversations. In fact, he has them for a living. As director of public policy, he speaks with our customers about the opportunities and challenges they face, and looks for public policy solutions. Whether he’s talking to customers about direct and indirect remuneration (DIR) fees, or working to shape public policy on drug pricing, he takes pride in working to effect high-level change.

In this edition of Expert Spotlight, we sat down with him to discuss some of the biggest public health policy issues of today and what he envisions for the future of healthcare.

How would you describe your role?

Shiraki: As part of our Public Affairs team, I help establish McKesson’s positions and recommendations on important health policy issues like drug pricing or DIR fees. My team and I then advocate for these recommendations. We do this by speaking with lawmakers, weighing in on regulatory considerations when we can, and partnering with trade groups and other customers to advance policy change.

What is your favorite part of your work? What are you most proud of?

Shiraki: I love getting to work within the intersection of business, policy and politics. In order for a company like ours to operate, we have to understand all three. So I really enjoy that challenge. Even though I’m not interacting with patients on a daily basis, I get to try to effect change that could improve health outcomes for a lot of people.

I’m proud of being a part of a company that is proactive about addressing big public health policy issues. One example would be the opioid epidemic that has affected so many people. It was crucial for us to put forward policy positions that included sensible ways to address the epidemic, including technology solutions and strategies that empower pharmacists. I appreciate the opportunity to have worked on our company’s recommendations since my own family and relatives have been impacted by addiction.

Is there anything you’re working on right now that you’re particularly excited about?

Shiraki: Right now, all eyes are on drug pricing and lowering patient out-of-pocket costs. So for the past few months, we’ve been working really hard to put forth our view on drug pricing. With the Trump administration laser-focused on that right now, it’s important for McKesson to be a part of the discussion.

The other situation I’ve been working on over the past two years is the issue of pharmacy DIR fees. That’s a complex challenge and the biggest pain point for our independent pharmacy customers. We’ve been asking the administration to address DIR fees through rulemaking and to make sure any price concessions are completed at the point of sale so pharmacists can continue to care for their patients with more certainty.

Is there a question you’re asked most often by government officials? What do you tell them?

Shiraki: It typically revolves around the public health policy issue that’s most important for their state. Many times, it comes down to opioids and drug pricing. And every lawmaker wants to know: What’s your position? What do you propose as a solution? It’s very important to have the team that we have in place, because we need to be able to succinctly express our views and recommendations on these issues.

We want to know what these government officials think of issues, too, so we’re there to listen as much as we are to share. But when we are sharing, we discuss how we’re thinking about different business and policy solutions that may help. Overall, we want to communicate our position, provide potential solutions, seek ways to partner, and offer ourselves as a resource.

Since we’re all about better health, I’d love to know how you stay on top of your own health and wellness?

Shiraki: Since joining McKesson, I’ve started running more. I’ve run two half-marathons over the past few years. And I love playing sports—particularly basketball and tennis. My wife and I like to swim and go to the gym. Something I’d like to do more of is biking to and from work. It’s a great way to clear your mind after a busy day at work.

Can you describe a recent experience you've had with the healthcare system? It could be positive, negative, eye-opening—anything that really stuck with you.

Shiraki: I was diagnosed with a MCL (medial collateral ligament) sprain last February. What I found most frustrating was the lack of coordinated care. Every time I went to see a different doctor, I had to explain the whole situation all over again. They couldn’t find my X-rays or MRIs. The system definitely wasn’t interoperable. This contributed to the length of my recovery, because it took six weeks to even get a diagnosis. I felt like the lack of coordinated care and interoperability was frustrating and prolonged my recovery time.

What do you hope the future of healthcare will bring?

Shiraki: I’m a big fan of telehealth and telemedicine. For patients and providers in rural areas, they could be especially impactful. I was encouraged to see them addressed in the latest Medicare payment rules; the administration is definitely focused on expanding reimbursement for telehealth services. We’re the most technologically advanced country on the planet, but we tend to lag behind on using technology to coordinate care. I think that has to change.

What else do you hope to see change from a policy perspective?

Shiraki: Our healthcare system is great at treating patients once they get sick. But I would love to see an even greater shift towards prevention. Let’s look at a patient’s family history and other factors and when appropriate, screen for potential health problems earlier on. For example, there’s a policy movement underway to encourage pediatricians to screen for adverse childhood experiences, which studies show contribute to poorer lifelong health outcomes. The sooner patients understand potential problems, the sooner they can be empowered to change behaviors to improve their health.

Policies that promote the role of nutrition in fighting disease should also be further examined. I served on the board of Project Open Hand, a nonprofit that provides nutritious meals to seniors and critically ill neighbors. They provide, and advocate for the reimbursement of, medically tailored meals for people with chronic conditions such as cancer and diabetes. Their data shows that food really does equate to medicine for patients. So I’m hopeful that, as a society, we will start to understand and better employ such tools to prevent and combat disease.

To read about our reform efforts on reducing DIR fees for pharmacies, visit our blog.

Related: Learn more about McKesson’s public affairs efforts

Unable to cast object of type 'System.DBNull' to type 'System.String'.   at McKesson.ImageHelper.getImageDesc(String URL)

About the author

McKesson editorial staff is committed to sharing innovative approaches and insights so our customers can get the most out of their business solutions and identify areas for operational improvement and revenue growth.