![]() It should clearly deliver messages from the plan sponsor about its cost savings goals and administrative requirements, such that the PBM responses address the needs of the plan sponsor effectively. The RFP document should be customized to meet the objectives of the plan sponsor. Summarizing analysis and choosing finalists.Analyzing financial bids and grading responses.Distributing the RFP to prospective PBMs.The steps required in the PBM vendor selection process include: An experienced consultant or advisor can help in this regard. It is vital to develop a proven, objective, and tailored grading process to evaluate the PBM vendor responses and make valid financial and administrative comparisons across vendors. Most plan sponsors partner with a pharmacy benefits consultant to guide them through the process and help them achieve the best results. Their experience will play an important role in achieving the best available PBM arrangement for the plan sponsor, including optimal financial terms and concise contractual language. It is imperative that the process involves individuals with extensive experience and knowledge in reviewing, implementing, managing, and auditing PBM arrangements. When selecting a PBM, a plan sponsor should follow a well-structured RFP process. In this article, we discuss the finer points of the PBM vendor selection process and provide an overview of PBM contract negotiations and market checks. These influences are leading other employers and funds to question their PBM deals, ask for more transparency, and scrutinize the contracts more. Their first big area of emphasis is getting a better PBM contract deal by potentially disaggregating the PBM functions across several vendors to get the best deals separately on claims processing, contracting, rebates, formulary, and specialty pharmacies. This issue has been brought to the forefront as large companies and employers have been very public about their PBM contracting approaches and as large coalitions are forming to better manage healthcare costs. Regardless of whether a plan sponsor decides to renegotiate with its current PBM or contract with a new PBM, it will save the plan sponsor money if it commits time and resources to reviewing opportunities to improve its PBM contracts. This can occur through regular PBM requests for proposals (RFPs) or market checks. With both pharmacy benefit costs and administrative complexities on the rise, plan sponsors should periodically review their current pharmacy benefits manager (PBM) arrangements to ensure they are receiving optimal contracting terms. Is your pharmacy benefits manager contract competitive in the current marketplace? This paper will walk a plan sponsor through a process that will result in reduced costs and increased transparency. ![]() Plan sponsors’ prescription drug costs can be reduced if they actively monitor their utilization and contracts. ![]()
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