As a team of benefits strategists, we work hard every day to make sure we’re exceeding client expectations and providing the most innovative and value-generating plan designs and advisory services.
Among Indiana employee benefits consultants, our Kinetiq Health Pharmacy Benefits Consulting Team has the most experience in and deepest understanding of the pharmaceutical industry. The team includes three registered pharmacists, a health care attorney, a former pharmaceutical industry executive, former PBM executives and nine Certified Pharmacy Benefits Specialists (CPBS).
Prescription drugs are one of the most complex aspects of employee benefits. In fact, we often find that many employers have never seen or effectively analyzed their pharmacy claims or pharmacy benefit management (PBM) contracts.
Some of the cost-saving services our team offers include:
We find savings because we know what to look for and where to look. And we know how to ensure discounts, rebates and other manufacturer-derived revenues pass through to the ultimate funders of employee health care — the employers — instead of to the PBMs’ profit margins.
Our team of health care industry professionals and Certified Pharmacy Benefits Specialists (CPBS) reviews pharmacy and drug-related medical claims and conducts PBM contract assessments to identify cost savings that translate into revenue for your organization.
We’ve been able to save our clients an average of 33% and up to 70% on their pharmacy benefits costs – without shifting costs to employees and with zero to little benefit plan disruption.
Line by line, our CPBS team will review and evaluate your PBM contract to assess its strength and transparency and assign a score from “A” to “C.” With that score in hand, our team audits your entire pharmacy benefits program to identify cost-saving opportunities.
When we renegotiate your contract, we will include:
Our team conducts hundreds of pharmacy benefit RFPs per year to source better pricing and contract terms from a client’s current PBM and/or new PBM companies. We hold no allegiance to any one PBM and have a growing list of nearly 50 vendors with whom we work.
Through this proprietary RFP process, we ensure the finalized agreement has fair pricing terms and guarantees that benefit your bottom-line — not the PBM’s.
Our Kinetiq Health Pharmacy Benefit Consulting team has the unique clinical and actuarial ability to quickly identify at-risk plan members and predict financial risk. They do this by reviewing, analyzing and reporting on clients’ pharmacy and drug-related claims on a regular basis.
Actionable insights are provided by the Kinetiq Health Rx team as well as Kinetiq Health’s financial analysts, actuaries and other clinical analysts who have practical health care industry experience.
Our clients also benefit from ongoing plan management and monitoring services, implementation assistance, pricing audits, annual reconciliation, employee education, issue resolution and much more.
Apex’s Kinetiq Health Pharmacy Benefits Consulting team saved our clients more than $8,000,000 in the last year alone. The following are several case examples.
Working closely with the insurance company’s reinsurance and pharmacy teams, the Kinetiq Health team came up with a solution to purchase the treatment directly from the manufacturer at actual cost while the hospital continued administering the dependent’s infusion therapy each …
Prior to Apex becoming the strategic advisor, this client also had a near-site clinic available to all members on the medical plan. After a thorough review of clinic data, our team found that the cost per visit exceeded $225 due …
The savings found were substantial for the client. After discounts, rebates and fees the annual identified pharmacy savings were $110,156 for the client. Apex also discovered additional savings through clinical and specialty drugs of another $100,581. Those combined savings cut …
News and Education from the Kinetiq Health Team
Millions of people in the United States have diabetes and don’t even know it. Signs and symptoms of diabetes aren’t always obvious and sometimes go unnoticed for several years before someone receives an official diagnosis. Understanding symptoms and catching them …
Whether you purchase your medications at the same pharmacy or multiple locations, it is important that you always have on hand one document listing everything you’re taking and that you regularly update this list with your most current medications and …
MSD of Wayne Township was dedicated to employee health and wellness prior to engaging with Apex Benefits and its Kinetiq Health team in late 2019. While mostly satisfied with their wellness program, the school system was looking for opportunities to …