The Importance of Having a Multi-Year, Multi-Faceted PBM Audit Strategy

Performing PBM audits on a regular basis as part of a broader, integrated audit strategy helps health plans monitor different aspects of how well the PBM performs in multiple operational areas. Often, uncovering issues during one specific type of audit can signal where other issues may be present and deserving of additional focused oversight and monitoring. Because of the complexity of today’s pharmacy benefit plan designs, and an ever-changing regulatory and market landscape, audits are among the best strategies for getting a 360 degree view of how well your PBM is performing across business areas. Having an integrated audit strategy can help your plan recover monies, improve levels of member service, and reduce compliance risks — while also improving your leverage to get the best pricing and levels of support available in today’s market.

Learn more about how The Burchfield Group did this for three clients.