Challenge

• A combination of industry competition and cultural factors made rich employee benefits essential to this self-funded client.
• Like all employers, the organization faced the challenge of balancing ever growing health insurance costs with the costs of benefits offered to employees.
• As a self funded employer, the client was engaged in ongoing efforts to identify efficiencies and cost improvement with minimal impact to employee benefits — a mission of paramount importance for their organization.
• The most common strategies for managing health care cost increases via plan design changes and employee contribution increases were not feasible in this case.

Solution

• Determining that a strategic change in vendors could reduce pharmacy benefits costs, the client’s PBM was marketed with several vendors, including 360 Rx Solutions’ PBM.
• The client’s PBM at that time was CVS. 360 Rx Solution’s preferred pricing (leveraging 800,000 members) with CVS and OptumRx allowed 360 Rx Solutions to project savings of 31% of the client’s current pharmacy benefits costs while staying with CVS.
• 360 Rx Solutions’ proactive cultivation of transparency gave the client the ability to fully see and understand all PBM costs.

Results

• Greater transparency gave the client significantly more understanding and control over their pharmacy benefits costs.
• The client realized a projected $119K in savings on their pharmacy benefits costs, a significant cost savings on prescription drug spend in their health plans.
• Included in the projected $119K decrease was a rebate increase of almost $64K .
• Because the client was able to continue using CVS with no change in copays, the employee transition was virtually seamless.
• The switch to 360 Rx Solutions included a partnership with OneRx, an app providing employee education and tools to find the most beneficial and cost-effective prescription drugs available to them.