Solutions for Hospitals & Health Systems

Market-Leading Pharmacy Benefits

You’ve been handed a tough job-selecting a pharmacy benefits partner that can meet your organization’s needs as both an employer and a healthcare provider. RxBenefits doesn’t offer yet another off-the-rack pharmacy benefits program. Our solution uniquely balances the otherwise competing priorities of the director of pharmacy, CFO, and human resources. Ask your trusted benefit consultants about our tailored hospital solution that leverages both a large national pharmacy network and your organization’s owned resources to optimize employee and population health while containing costs and driving revenue.

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Contract Management

Your path to better value begins with a pharmacy contract that works for you.

Harness RxBenefits’ market-leading purchasing power to secure a pharmacy benefits contract that rivals those extended to large health systems’, with terms your hospital likes and benefits your members will love.

Best Rates & Rebates

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Take advantage of competitive, volume-based discounts based on our size, not yours

No doubt about it, pharmacy is a scale business, which means PBMs typically reserve the best rates and rebates for robust employer sized companies. Partnering with RxBenefits, you’ll tap into our market-leading purchasing power to access competitive volume discounts and rebates. We don’t take spread or retain any portion of your rebates, so 100% of your savings are applied directly to your bottom-line.

Transparent Terms

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Enter a contract you can understand and measure to be sure it performs as expected

In pharmacy, the terms of a contract can, and often do, significantly alter the price and impact projected savings. We deliver contracts that make sense to you and your consultant with client-centric terms, clear definitions, and no hidden conditions. You’ll have full visibility into how your contract is performing so there are no unfortunate surprises later.

Channel-Agnostic

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Drive script fulfillment to the optimal location with the most competitive rates

If your organization has its own pharmacy resources, our experts will work with you to establish an innovative, channel-agnostic model. You’ll be able to leverage both a large national pharmacy network and your pharmacy operations resources to maximize your cost of goods advantage and deliver the best clinical and bottom-line results.

Assess Your Savings Potential

Answer a few simple questions to see what an RxBenefits managed pharmacy contract could do for you.

GET MY ESTIMATE
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Utilization Management

Deploy a tailored clinical strategy to take pharmacy plan performance to the next level.

RxBenefits’ full-time team of licensed, independent pharmacists work for you and your members, not the PBM or drug manufacturer. They’ll design a strategic set of utilization management programs that help drive waste out of the system, better manage specialty costs and drug trend, support patients with chronic conditions, and increase member health and safety.

Step Therapy

Guarantee the appropriate lowest-cost equivalent drug is tried prior to higher cost alternatives.

Quantity Limits

Guarantee the appropriate lowest-cost equivalent drug is tried prior to higher cost alternatives.

Basic Prior Authorization

Require rules-based, electronic pre-approval for certain medications to help reduce inappropriate prescribing.

Advanced Utilization Management

Apply greater clinical expertise with managed programs proven to strike the right balance between access and cost. It is possible to achieve greater cost savings with minimal member impact. Trust our team of registered pharmacists to evaluate the medical necessity, appropriateness, and effectiveness of prescription medications through the lens of what is in the medical best interest of the member and the financial best interest of the plan.

Low Clinical Value Formulary

Encourage safe, effective, and less expensive drug alternatives by restricting coverage for non-essential Low Clinical Value medications.

High Dollar Claim Reviews

Mitigate costs associated with off-label prescribing with a personalized clinical review of all high-dollar claims.

In-house Prior Authorizations

Apply a very personalized touch to the review process by having an independent pharmacist review suspect prescriptions and collaborate with care providers, as needed.

Plan Design Management

Deliver better outcomes while optimizing trend management.

Combat the many financial levers pulled by manufacturers to influence prescribing behavior and medication coverage. Preserve member advantages associated with manufacturers’ offers while protecting plan integrity and maximizing the savings potential.

Accumulator Protection

Protect plan integrity while allowing members to use manufacturer-provided coupons to reduce their out-of-pocket expenses at the pharmacy.

Variable Copay

Maximize plan savings by dynamically adjusting copays at the point of sale to take full advantage of all available manufacturer assistance dollars.

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Experience Management

Exceed everyone’s expectations with a high-touch service experience.

When only the best will do, you can count on RxBenefits’ exceptional hospital-centric service model to deliver. Our high-touch approach to servicing hospital clients sets us apart in the industry. We are the only pharmacy partner with a team dedicated to helping you balance your competing clinical and cost-saving goals. We provide expert advice, consultative guidance, and clear direction in every interaction.

Worry-Free Implementation

Launch your hospital’s pharmacy benefits plan on time and with the expected results by leaning on RxBenefits’ dedicated hospital implementation team.

Expert Consultation

Rely on seasoned hospital pharmacy experts to understand your goals, provide a long-term strategy that optimizes your on-site pharmacy with 340B/GPO, provides in-depth pharmacy support, and enhanced reporting.

Exceptional Service

Hire the partner that goes above and beyond to make every client and member feel deeply valued and appreciated, with every interaction.

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