Companies of all sizes continue to struggle with the increasing cost of healthcare. Many organizations utilize pharmacy-benefit managers (PBM) to negotiate prescription drug prices. These PBM contracts are often intentionally vague and tend to favor the PBM who are able to keep a large portion, if not all, of the rebates negotiated within their employer contracts. Additionally, the availability of strong data analytics, predictive modeling and reporting have been at a premium.
Recently a corporate alliance was formed in an attempt to lower the companies’ total healthcare spending. The alliance includes American Express, Johnson & Johnson, Macy’s Inc. and more than three dozen other corporations. Included in this initiative are strategies geared toward addressing prescription drug spending, the creation of specialized physician networks and greater analysis of healthcare data.
While corporate alliances like these are logical endeavors for larger companies, the mid-market companies with similar concerns, do not have the volume or clout to engage in these type of arrangements.
RCM&D works with mid-sized companies to develop strategies that mirror those available to the larger market. These strategies often include stronger PBM contracts, a review of alternative reimbursement strategies and data analytics that utilize an algorithmic approach to build more educated designs for plan funding, contribution modeling, worksite benefit offerings, plan design and much more.
Reference
Walker, J. (2017, March 8). Health Costs Get a Rethink. Wall Street Journal.