Pharmacy benefits management program brings value to organizations & their employees

Joseph M. Dizenhouse, FSA, MAAA

Pharmaceutical contracting and supply chain management processes are multilayered and complex, which is why so many plan sponsors rely on third-party support from pharmacy benefits managers (PBM). HealthTrust operates the largest sole-sourced PBM aggregated contract in the country, with almost 300 participating plans and over $4 billion in covered spend. This provides leverage to benefit not only member organizations, but also to positively impact their employees and their families.

“We do everything we can to improve the lives of the members who use our program and their employees and their families. We achieve this in several ways,” says Joseph Dizenhouse, FSA, MAAA, SVP & Head of Pharmacy Services, HealthTrust.

Managing costs

The most obvious benefit of using a well-designed program is financial, explains Dizenhouse. The savings an employer achieves through working with HealthTrust’s PBM solution are often passed down to the employee by way of reduced pharmaceutical prices at the pharmacy, as well as lower payroll deductions for prescription benefits.

A variety of tools, some behind the scenes, also help individual patients find the lowest-cost drugs. These tools are focused on providing both the prescriber and the patient with the lowest cost and efficacious option for the individual. In the complicated world of pharmaceutical pricing, patients sometimes pay for a drug that may work just fine, but is actually a better choice economically for the PBM or the health plan (and/or at the expense of the plan and patient).

HealthTrust’s PBM program is highly managed to determine which drug is the most effective for the individual’s health and costs them the least, says Dizenhouse. “Because of our size, access to information and deep subject matter expertise, there are custom ways we can help make sure the patient gets paired with that lowest-cost drug that is most efficacious for their need,” he adds.

Care & convenience

HealthTrust’s PBM also delivers value through comprehensive care for individuals and their families, says Nancy Price, VP, Employee Benefits Strategic Sourcing, Pharmacy Operations, HealthTrust. One example is that HealthTrust’s PBM contract lets member hospitals with in-house pharmacies allow their employees to do their pharmacy business where they work, explains Price. This offers an invaluable convenience because they don’t have to make a separate trip to a commercial pharmacy to fill their prescriptions. And often, adds Dizenhouse, hospitals that allow their employees to access the in-house pharmacy pass on more significant savings on prescriptions.

Nancy Price

“The PBM, when properly guided, also enhances the customer experience,” Price says, “by having dedicated customer service teams and offering convenience services. The dedicated customer service teams offer end-to-end support for member organizations that individuals don’t necessarily see, but they benefit from.” For instance, if individuals run into an issue and contract their administrator, that person has 24/7 access to the customer service team to resolve the employee’s issue quickly and seamlessly.

Leveraging its size to create financial benefits for individuals and their families is an important part of the value HealthTrust’s PBM delivers. “Drugs are expensive, so getting good prices is important, and that’s one of the great things that HealthTrust does for its patients.” Dizenhouse says. “But, when it comes down to it, there’s so much more to it than that: Patients should have the tools to obtain the right medication at the right time and at the right price.”


Find out how HealthTrust’s Pharmacy Benefit Management program can work for your organization. Email humancapitalsolutions@healthtrustpg.com

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