PBM Tailored Retail Network Contracting

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We help our clients better manage their business efficiency through a combination of contract design, benchmarking analysis, and near real-time performance dashboard.

 

Client Situation

PBMs experience constant change throughout the year, including sizable network performance fluctuations impacting client guarantees and financial planning.

In this example, a PBM’s current retail network contract did not represent a viable long-term response to its needs for pricing competitiveness, flexible management, and predictable outcomes. The PBM sought improved results from within the industry, aligning available solutions to its specific size and scale.

 

Opportunities/Actionable Items

The PBM required solutions catered to strengthening its operational efficiency and bolstering its economics while continuing to support its client-facing business model. Within the network contracting market, there are several pathways that lead to accomplishing these goals but few that afford the required level of transparency and value maximization.

The Proper team conducted a benchmarking analysis of the PBM’s current retail network contract economics and terms against industry competition. Faced with contract pricing that was lagging in the market, along with obsolete definitions and caveats, Proper recommended seeking competitive bids from several vendors.

Upon selection of a new vendor, the Proper team was engaged in validating, reviewing, and negotiating the proposed agreement’s financial savings estimates, terms and conditions, and functional requirements. The new agreement necessitated significant business process enhancements in conjunction with its strong financial benefits. The Proper team facilitated the creation of repeatable, efficient processes leveraging existing data structures to measure and interpret improved performance and associated value as well as adherence to contractual obligations.

 

Results

The Proper team’s involvement in the PBM’s retail network contracting efforts bore measurable improvements. With new market-aligned economics, the PBM was able to grow annual retail network margins by over 110%.

By implementing near real-time dashboards to monitor and track key performance indicators, Proper allowed the PBM increased clarity into its day-to-day operations and the ability to minimize risk by anticipating potential future variabilities in performance.

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185 N Franklin St, 3rd Floor Chicago, IL 60606

contactus@properconsultinggroup.com

185 N Franklin St, 3rd Floor Chicago, IL 60606

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