How We Help Pharmacy Benefit Managers
BenMedica partners with PBMs to enhance formulary information that health plans send to physicians through Electronic Health Records (EHRs). When PBMs provide clinicians with information such as copay and relevant alternatives at the point of prescribing, significant cost savings can be realized by all stakeholders.
PBMs that work with BenMedica can also help their health plans improve their Healthcare Effectiveness Data and Information Set (HEDIS) and Medicare Part D Star Ratings, which leads to higher reimbursement and better outcomes.
PBMs + BenMedica = Savings
BenMedica can assist PBMs with augmenting the following data through EHRs:
Copay information in the formulary at the time of prescribing
Restrictions on drug coverage customized to the health plan or group level
Alternatives for formulary information
PBMs partnering with BenMedica can have our systems create formulary data customization at the individual health plan or group level. The enriched data can be viewed and edited by PBM customers prior to distribution.
We can also help ensure that alternatives are consistent between Formulary and Benefit data and Real-Time Prescription Benefit data.