A Better Way to Implement a PBM: Work with a Purchasing Cooperative

Plan sponsors and their partners lean on their pharmacy benefit manager (PBM) to facilitate the implementation process. However, some PBMs have better processes than others. That is why working with a trusted PBM is crucial.

Work With a Trusted PBM Purchasing Cooperative

Partnering with a purchasing cooperative like National CooperativeRx, offers significant advantages such as competitive pricing, favorable contract terms, customized solutions, and top-notch support. However, our value extends beyond these benefits. During PBM implementation, we deliver an added layer of support to plan sponsors and partners, ensuring a smooth and successful transition.

FACILITATING THE COLLECTION OF INFORMATION

National CooperativeRx starts the implementation process by building a foundation of customized insights tailored to a member groups’ specific situation. To do this, we first gather necessary plan information through questionnaires and pre-implementation summary forms, collecting a wide range of data, including plan details, claims history, and member specifics. We ensure that nothing is missed, and all relevant information is considered.

Detailed data allows us to present cost management strategies and new plan design options and identify potential member impact—an important consideration.

Kyle Kapusta, director of sales and marketing at National CooperativeRx, emphasizes the importance of this first step, “Gathering as much information as possible from the start helps us provide more accurate comparisons, identifying potential savings opportunities and pinpointing potential impact to plan participants. This early data also enables us to explore alternative solutions for those who may be affected, providing peace of mind before the benefit plan year begins.”

MAINTAINING MOMENTUM AND MEETING DEADLINES

Executing a successful implementation takes time to plan, coordinate, and administer for the plan sponsor, their broker partner, a PBM purchasing cooperative, and the PBM. When all the planning is compressed into a timeline of less than 90-days, everyone, including the plan’s participants, will feel squeezed. The most manageable and successful implementations are when all parties have at least 120 days before the new plan goes live.

National CooperativeRx’s PBM partner, CVS Caremark, plays a crucial part in our successful implementations. Their efficient system is well-structured and based on a 90 to 120-day project timeline. This allows ample time to process each stage of implementation, easing the pressure on everyone involved. Together, we work to keep all stakeholders on track.

Jesse Dudley, implementation and clinical support manager at National CooperativeRx, stated, “Some of my biggest contributions are making sure all the details are taken care of and deadlines are met in implementations. There is a lot on the line, but my additional layer of oversight ensures a seamless transition for everyone involved, most notably the plan participant.”

The National CooperativeRx team provides potential members and implementing members with detailed timelines and resources to understand what to expect before, during, and after our PBM implementation.

FOSTERING COMMUNICATION

Open dialogue is crucial throughout the PBM implementation process. National CooperativeRx fosters informative discussions between the plan sponsors, partners, and PBM to ensure everyone is aligned. Early in the process, we offer clear guidelines and support to help plan sponsors understand the required information and its importance. Throughout the process, we provide guidance on best practices, outline expectations for all parties, and address any general questions about the plan or process. This approach ensures that goals are aligned and provides clarity at every step.

Of course, communication does not end once a plan goes live with a new PBM. National CooperativeRx helps direct and update all parties involved with clear understandings of how the plan is performing at any given time, confirming plan setup and correct claims adjudication.

EXECUTING A WORRY-FREE IMPLEMENTATION

Partnering with a trusted PBM purchasing cooperative like National CooperativeRx transforms the intimidating task of a PBM implementation into a streamlined, manageable process. Our comprehensive approach ensures that every detail is meticulously handled, from initial data collection to meeting deadlines and fostering communication throughout the process.

Trust National CooperativeRx to deliver a smooth and efficient PBM implementation, guiding plan sponsors and their partners through the complexities of the process with confidence and ease.

Contact us today to learn how National CooperativeRx can simplify your PBM implementation, deliver significant savings, and provide exceptional support.