Market Checks: A Must for Health Plans Negotiating Their PBM Contracts

By Steve Baumgardner
Thu, Nov, 29, 2018

One way for health plans to get the best possible pricing from their PBMs is to include an effective market check provision in their PBM contracts. If your health plan hasn’t done market checks before, now is a good time to start planning, especially if you will be putting your current PBM contract out to bid in the near future.

Read More

Latest

Market Checks: A Must for Health Plans Negotiating Their PBM Contracts

Steve Baumgardner
Thu, Nov, 29, 2018

How CMS Data Validation Scores Impact Star Ratings

Jason Hoyme
Tue, Nov, 06, 2018

How CMS Data Validation Scores Impact Star Ratings - Specific for SNP Plans

Jason Hoyme
Tue, Nov, 06, 2018

12 Steps Health Plans Can Take with their PBMs Now to Prosper During Industry Disruption

Steve Baumgardner
Tue, Jan, 16, 2018

What Health Plans Need to Know about Medicaid Encounter Data

Sonya Henderson
Thu, Dec, 07, 2017

Improving Drug Utilization Review Controls

Jason Hoyme
Tue, Nov, 21, 2017

Why Health Plans Should Conduct Internal Medicaid Risk Assessments and Where to Start

Sonya Henderson
Wed, Oct, 18, 2017

Data Validation Audit Changes – Grievances: What to Expect in the 2017 Reporting Year Audit

Jason Hoyme
Thu, Sep, 07, 2017

PBM Audit Best Practices: Tips for Prioritizing and Conducting PBM Audits

Yvonne Zachman Fiedler & Derek Frye
Thu, Jun, 29, 2017

Emerging PBM Audits: Prescription Drug Events (PDEs), Eligibility, and Clinical Audits

Lynn Stauffer & Derek Frye
Thu, Jun, 22, 2017

Pharmacy Fraud Waste and Abuse (FWA) Audits: Protecting the Integrity of the Benefit

Serah Greenwalt & Derek Frye
Thu, Jun, 15, 2017

Pharmacy Benefits Plan Audits: Ensure Your Members Receive What They Were Promised

Jason Hoyme & Derek Frye
Thu, Jun, 08, 2017

Rebate Audits: Consider Auditing Manufacturer Rebates in Addition to Rebate Guarantees

Sharon Moritz & Derek Frye
Thu, Jun, 01, 2017

Pharmacy Audits: Removing the Ambiguity Between Health Plan and PBM

Margaret Berlack & Derek Frye
Thu, May, 25, 2017

Health Plan Administration: How to Get a Handle on Costs Without Unraveling Your Organization

Mike Takach
Wed, Apr, 19, 2017

Compliance Risk Management: Tips for Managing Your Health Plan’s Downstream Vendors

Derek Frye
Wed, Apr, 05, 2017

New CMS CMP Methodology Provides Few Clear Answers

Derek Frye
Thu, Mar, 23, 2017

Provider Networks Adequacy: Compliance Tips for Medicare Plans

Derek Frye
Thu, Mar, 09, 2017

New CMS Audit Protocols Increase Documentation Requirements for Medicare Plan Sponsors

Derek Frye & Yvonne Zachman Fiedler
Wed, Mar, 01, 2017

Receive full value from your PBM rebates

Chris Hanson-Ehlinger
Thu, Nov, 20, 2014

Don't let CMS timeliness standards hurt your data validation score

Chris Hanson-Ehlinger
Tue, Nov, 11, 2014

Align data validation stakeholders to avoid last minute mistakes

Chris Hanson-Ehlinger
Mon, Aug, 18, 2014

Bad data validation scores reduce your star rating and bottom line

Chris Hanson-Ehlinger
Wed, Aug, 13, 2014

Are your PBM pricing discounts seriously underperforming?

Chris Hanson-Ehlinger
Mon, Apr, 07, 2014

Adjust your drug plan strategy to manage specialty medication costs

Chris Hanson-Ehlinger
Wed, Mar, 05, 2014
Load More Content

Categories

Most Popular

Free Guide

The Health Plan's Guide to Auditing your Pharmacy Benefit Manager Contract from A to Z

Download Now
Privacy Policy

© 2017 The Burchfield Group All Rights Reserved.  |  Design by Hinge