In 2023, the pharmacy benefit management (PBM) industry witnessed a significant shift in client sentiment. Health plans, employers, health systems and unions reported a notable decrease in satisfaction with their PBM vendors, as detailed in the 2023 Pharmacy Benefit Manager Customer Satisfaction Report by Pharmaceutical Strategies Group (PSG).
In this article, HealthPlan Data Solutions’ (HDS) claims analysts will review the purpose and limitations of traditional PBM audits, offer insights to help health plans establish robust pharmacy payment integrity programs, and provide suggestions to enhance accountability in the pharmacy benefit.
Supercharge Your Campaign Management: 5 Best Practices for Health Plans to Hit Their KPI’s and Optimize Member Satisfaction
HealthPlan Data Solutions Clinical Pharmacy team discusses five best practices to improve payer campaign management strategies and drive improvement of key quality measures.