HealthTrust’s Pharmacy Services Group offers advice around pharmacy benefit management programs

The concept of transparency is central to any discussion on contracting for a pharmacy benefit management (PBM) program. But what exactly does that mean?

Joey Dizenhouse, FSA, MAAA

Joseph M. Dizenhouse, FSA, MAAA, SVP, Pharmacy Services Group at HealthTrust, offers advice on PBM transparency in a blog recently published on the SHRM* Executive Network.

In the article, Dizenhouse demystifies four of the most pervasive misconceptions surrounding PBM deals:

  1. If I, as plan sponsor, receive full pass-through, my deal is transparent.
  2. I have a transparent deal, therefore my PBM will be incentivized to do the right thing.
  3. Transparent deals deliver more efficient plan utilization.
  4. Transparent deals lead to effective clinical management.

Dizenhouse also offers suggestions on what to consider when evaluating a PBM program. “Make sure to push aggressively for information, challenge the status quo and never simply rely on the front-facing elements of a PBM proposal,” he advises.

Read the full article.


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