Page 18 - Lockton Total Rewards Practice
P. 18
Optimize
Pharmacy analytics MEMBER COST SHARE/
SPECIALTY
Similar to medical, they are able to: • Specialty drug predictive modeling
tools
• Leverage domestic pharmacies • Focus on medication adherence
improvement
• Align the PBM with the outpatient MEMBER DETAILED
formulary COST-SHARE CLAIMS OBJECTIVE AND TRANSPARENCY
STRATEGIES ANALYSIS • Rigorous inancial valuation of
• Steer through plan design and proposals
networks • Not limited to Lockton collectives
• Optimize and steer J-Code drugs • Winning PBM must agree to client’s
SPECIALTY DRUG contractual provisions, guarantees, and
• Focus on a higher level of SPEND independent audits
pricing transparency MITIGATION PBM PROSPECTIVE COST MODELING
MARKETING
• Utilize quality and cost • Client-focused RFP
effective infusion clinics Lockton Pharmacy • Focus on key metrics
and resources Analytics • Financial and technical analysis
CLINICAL • Finalist meetings (as needed)
SAVINGS
ANALYSIS CONTRACT OPTIMIZATION
PROSPECTIVE
COST MODELING • Establish clear contractual deinitions
• Structure $ for $ performance
guarantees
• Structure objective audit procedures
FORMULARY • Deine clear algorithms for guarantee
MANAGEMENT CONTRACT and penalty calculations
OPTIMIZATION
FORMULARY AND
NETWORK ANALYSIS AND
RECOMMENDATION
• Specialty carve-out opportunities
(e.g., hemophilia)
Overview — Lockton Total Rewards Practice 18 Lockton Companies
Pharmacy analytics MEMBER COST SHARE/
SPECIALTY
Similar to medical, they are able to: • Specialty drug predictive modeling
tools
• Leverage domestic pharmacies • Focus on medication adherence
improvement
• Align the PBM with the outpatient MEMBER DETAILED
formulary COST-SHARE CLAIMS OBJECTIVE AND TRANSPARENCY
STRATEGIES ANALYSIS • Rigorous inancial valuation of
• Steer through plan design and proposals
networks • Not limited to Lockton collectives
• Optimize and steer J-Code drugs • Winning PBM must agree to client’s
SPECIALTY DRUG contractual provisions, guarantees, and
• Focus on a higher level of SPEND independent audits
pricing transparency MITIGATION PBM PROSPECTIVE COST MODELING
MARKETING
• Utilize quality and cost • Client-focused RFP
effective infusion clinics Lockton Pharmacy • Focus on key metrics
and resources Analytics • Financial and technical analysis
CLINICAL • Finalist meetings (as needed)
SAVINGS
ANALYSIS CONTRACT OPTIMIZATION
PROSPECTIVE
COST MODELING • Establish clear contractual deinitions
• Structure $ for $ performance
guarantees
• Structure objective audit procedures
FORMULARY • Deine clear algorithms for guarantee
MANAGEMENT CONTRACT and penalty calculations
OPTIMIZATION
FORMULARY AND
NETWORK ANALYSIS AND
RECOMMENDATION
• Specialty carve-out opportunities
(e.g., hemophilia)
Overview — Lockton Total Rewards Practice 18 Lockton Companies
