Every participant in the healthcare market has a different point of view. We understand. So we can help you with solutions focused on what you need to be successful and get your best outcome.
Pharma develops, manufacturers and markets drugs. Pharma pays rebates to gain market share through formulary status and access.
RemedyOne is your market share partner. We will continue to develop and deploy solutions that can work for your corporate goals. Look to RemedyOne as a strategic partner to deploy your innovative strategies to work with payers in the areas of outcome contracting and effective market share movement.
PBMs administer pharmacy benefits including development and adjudication of pharmacy benefits. They decide placement of drugs on formularies, which dictates if a drug is covered and how much patients pay in copays and coinsurance. PBMs collect and retain rebate dollars for these activities.
RemedyOne can provide rebate services to independent PBMs looking for ways to compete and grow their businesses through innovative strategies and better rates.
Provides comprehensive health care coverage for care provided by physicians and drugs prescribed by physicians. Health plans have pharmacy experts or own PBMs, so they influence or dictate pharmacy strategy – including the placement of drugs on formulary. Health plans are paid rebates for this aspect of pharmacy benefit management.
Most health plans have some level of expertise in pharmacy and have been able to drive competitive rebate contracts. RemedyOne can help health plans take their rebate program to the next level with innovative solutions in specialty medications. If you are an Accountable Care Organization or a regional health plan without the resources necessary to manage the complexity of rebate contracting, RemedyOne can help you drive savings through increased rebates.
TPAs administer benefit plans mostly focused on services, like doctor visits and hospital care. TPAs also coordinate the pharmacy benefit and selection of PBMs for their customers. They negotiate rebate guarantees on behalf of their customers, but may not have the same level of expertise as the plans do for complex drug selection and rebate administration.
RemedyOne can provide enhanced rebates on pharmacy and medical drugs. In most cases, TPAs are not receiving market-leading rebates today – RemedyOne can increase those rebates through our expertise and transparency. TPAs are uniquely positioned to take advantage of RemedyOne medical rebates since TPAs process the medical claims and have efficient access to the data and benefit administration.
Employ people and provide them with healthcare coverage, including prescriptions. Employers are usually represented by brokers to help them make healthcare-purchasing decisions. Employers and their representation do not have the knowledge or expertise to manage the complexity of rebates – so they usually receive only a fraction, if any, of their potential rebate dollars.
Employers are responsible for a large percentage of pharmaceutical costs but, due to the lack of expertise and transparency, they receive a small percentage of the rebate. At RemedyOne, we will work with you to maximize your rebate potential, to manage cost for your company and your employees for expensive medications.