Pharmacy Benefits Consulting

For Health Plans

Delivering maximum value to the plan while still providing best-in-class care is a tough task. It’s difficult to remain competitive by differentiating your plan while renegotiating with your PBM vendor or managing an open market RFP. With Health Strategy, you’ll have an expert in your corner, making sure that PBM interests align closely to the plan and the members you serve.

Get help pushing back against one-sided contracts.

Most contracts are created by and for the benefit of pharmacy benefit managers (PBMs). Health Strategy ensures a better balance of benefits and costs—for your clients and their members. Plus, with our experience, you’ll know when and where it’s most appropriate to keep negotiating—or move on.

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Planning for changes helps maximize your plan’s value.

A lot can change in the market during a pharmacy benefit contract’s standard 3-year term. Health Strategy incorporates rate adjustment mechanics to maintain the value for you beyond the first year. Periodic market checks and Most Favored Nation (MFN) provisions aren’t always enough. Ensure your plan is prepared to adjust to market changes.

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Control the flow of value.

You work hard to squeeze as much value as possible from your pharmacy benefit contract. Sometimes, it doesn’t make sense to pass it all along to your customers. Health Strategy actuaries and financial analysts have experience managing the complexities of health plan economics, and gross savings are just part of the story. Make sure your bottom line is just as strong as the plans you offer.

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It’s always a good time to explore improvements and savings.

It doesn’t matter if your pharmacy benefits contract is expiring in three months or three years. Health Strategy can help you identify vulnerabilities, forecast drug inflation, quantify your business opportunity, and prepare you for what’s ahead.

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“We engaged Health Strategy to help guide our pharmacy strategy in 2010 and have been working with them ever since. The return on investment every year has been greater than 15:1.

Health Strategy is engaged on every one of our PBM and pharmacy related calls to ensure they are up to speed on all facets of our pharmacy benefit. They weigh in and provide recommendations on all pharmacy strategy decisions. Working closely with us, they created our plan design, created a custom formulary and provide ongoing management of it. These items have allowed us to enjoy a world class 89% generic dispensing rate with significant annual savings.”

–Benjamin Ryder, Sr. Benefits Manager, Whirlpool Corporation

Check out the latest news, insights, and updates from Health Strategy.

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Applying Machine Learning to Solve Complex Industry Problems

Health Strategy is committed to utilizing the most cutting edge technology available. This means capitalizing on the recent explosion of interest in machine learning.

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