Client Profile
| Industry: | County Government | | Number of Employees: | 1,100 on health plan | | Geographical Footprint: | Western Maryland | | Ownership Structure: | Government-owned | |
Challenge
Faced with the need to reign in its health plan spend to maintain the current level of benefits, an 1,100 - employee organization (a Coalition of 3 employers) engaged CBIZ and its National Pharmacy Consulting Practice.
Strategies Implemented
- Identified that the organization’s pharmacy pricing was uncompetitive and their utilization was not managed appropriately per the plan’s benefit design
- Implemented the following strategies:
- Marketed the PBM component of the benefit
- Implemented a new PBM on a carve-out basis
- Reviewed pharmacy set-up documentation to ensure the benefit was programmed correctly
- Included plan design changes to promote member cost awareness and consumerism
- Increased claims monitoring to track savings and create more programs as needed
Results
Expert pharmacy benefit consulting combined with local consultative administration provided first-year savings of an estimated $832,000, a 28% savings on Rx spend alone.
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