A hospital in South Florida with 3,500 member lives had an annual pharmacy benefits cost of $4.5 million. The hospital wanted to optimize its prescription drug program to achieve its financial goals of enhancing margins and its human resources goals of improving employee satisfaction and reducing absenteeism.
RxBenefits provided a comprehensive, conflict-free pharmacy benefits solution that addressed both the contractual and clinical challenges the hospital was facing with its previous PBM arrangement. RxBenefits conducted a Comprehensive Pharmacy Analysis of the plan’s previous arrangement to identify contract red flags and pinpoint the major trend drivers impacting costs. Hospital-focused strategies were implemented on top of that to leverage the hospital’s own cost of goods advantage and in-house resources.
Independent Contract and Clinical Oversight
- Accessed aggregate purchasing to secure competitive, transparent pricing terms
- Remedied pricing deficiencies and contract misalignments
Tailored Hospital Strategies
- Created a channel-agnostic benefit design
- Provided 340B and GPO support with “best-of” pricing
- Delivered population and disease management to optimize care
- Engaged the employee physician community
Overall Optimization Results:
Through a more competitive contract and the strategic support of a transparent pharmacy benefits partner, the hospital gained greater insight and independence over its prescription drug spending. RxBenefits’ comprehensive solution helped the hospital net a trend of 0% year-over-year, compared to a national trend of 10%.