Pharmacy Benefit Insights

If your group is using a level-funded plan there are several ways to manage prescription drug costs while maintaining critical access.

Many stop-loss plans can set individual deductibles for high-risk members, and one pricey claim can impact cash flow and plan costs.

A primary issue frustrating health plan members in rural areas is restrictive pharmacy networks which limit options and drive up costs.

By not assessing prescription claims in detail, employers may be missing out on potential cost-saving and cost-containment strategies.

Increased transparency on PBM revenue streams has led to better handling of rebates but GPOs have added complexities to clear processes.

The importance of a cooperative PBM when implementing cost solutions for self-funded health plans.