A priority for many health plans is to negotiate a PBM contract that offers the most competitive pricing with the highest levels of service and flexibility for their plan and members. In order to achieve this, health plans must maximize their leverage by executing a well-strategized RFP. Nothing maximizes a health plan’s leverage more than an RFP in which the bidders perceive an uncertain, but potentially successful, outcome. This article outlines how a health plan can best prepare for an optimal, efficient and successful RFP.
The following are best practices and tips for pharmacy department leaders and other health plan professionals charged with owning the PBM RFP process:
Going through a PBM RFP process is more than just a check-the-box task or an exercise in reworking past boilerplate contract language. A well-planned and thoroughly executed RFP that includes multiple internal stakeholders, dedicates adequate resources, allows sufficient time and reflects your health plan’s unique value prop will maximize your leverage and drive your plan to the best pricing and services that meet or exceed your plan’s needs throughout the PBM relationship.
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