Dec 22, 2023 | Acquisition Cost Index (ACI) pricing, Cost Plus Pricing, Cost Savings, Drug costs, MedBen Rx, Pharmacy, Prescription, Rx Costs, Savings, Spread Pricing
Spread pricing is the difference between what pharmacy benefit managers (PBMs) charge health plans for drugs and what the pharmacy actually pays for them. Often, this “spread” can be substantial, as PBMs profit greatly from their lack of transparency… so it’s not...
Nov 28, 2023 | Cancer, Cost Savings, Mental Health, Pharmacy, Prescription, Savings, Survey, Transparency
A recent survey of large employers by the Business Group on Health revealed considerations that self-funded plans expect to focus on in the coming year, including: Pharmacy costs. High-priced drugs and overall pharmacy costs are a source of concern for over 90% of...
Nov 27, 2023 | Case Studies, Claims, Claims negotiation, Cost Savings, Forensic claims review
A MedBen client realized an overall savings of 62% through repricing, forensic claims review, and provider negotiation. The client in question received a claim for IV infusion to a member with iron deficiency. After the PPO discount, MedBen saw an opportunity to...
Nov 24, 2023 | Cost Savings, MedBen Access, Member Prescription Portal, Mobile App, Online Services, Pharmacy, Prescription, Prescription Portal
In addition to the pharmacy solutions MedBen Rx provides to lower employer drug spend, plan members also have a great resource to help keep their prescription costs down. The MedBen Rx Prescription Portal, available through MedBen Access online or via our mobile app,...
Oct 17, 2023 | Cost Savings, Leveraged trend, Savings, Stop-Loss, Trend
Have you ever received a larger-than-expected stop-loss premium increase and your carrier blamed “leveraged trend”? Well, here’s what they mean. The fact that rising claim costs contribute to higher plan costs may be self-evident… but not just in ways that are...
Oct 16, 2023 | Cost Savings, MedBen Rx, Pharmacy, Prescription, Rx Costs, Savings
From a new report published by the U.S. Department of Health & Human Services: “Over the period from January 2022 to January 2023, more than 4,200 drug products had price increases, of which 46 percent were larger than the rate of inflation. The average drug...
