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 team has the most experience in and deepest understanding of the pharmaceutical industry. The team includes three registered pharmacists, a health care attorney, former pharmaceutical industry executives, 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.
Line by line, our 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 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 financial analysts and actuaries, as well as 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.
We saved our clients more than $8,000,000 in the last year alone. The following are several case examples.
After reviewing the language of the pharmacy benefit management (PBM) contract that determined the terms and cost variables, savings opportunities were identified without changing any benefits to employees.
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 …
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