| State & Municipal Government –
It’s Time to Revisit Your PBM Outsource Decision!
Many government institutions provide Pharmacy Benefit Programs to their employees and to other mandated programs supporting indigent and other wards of the local state or municipal community. In most instances such programs are outsourced to existing PBMs after an extensive and expensive Proposal Specification development, submission process and implementation. Of course, all these expenses are paid for by the issuing government entity with Taxpayer funds. This process, expensive as it is, invariably lasts for over 12 months thereby foregoing a major portion of the anticipated savings offered by system implementation. The internalized Benefit process and responsibility limits the exposure of the membership personal data. All data is under the control of only the responsible government department or agency that eliminates the mandated oversight and auditing that may required for outsourced processing and administration of sensitive data. Another advantage is available by direct contracting with the drug providers (as compared to indirect contracting via the PBM’s network of providers). Every additional layer of distribution invariable adds an expense burden for each provider party involved. This approach also lowers the exposure to Acts of God and labor problems that may occur in the private sector. Mergers and Acquisitions are no longer an additional aspect that furthers the complications associated with contract management. Without a PBM contract to contend with, all the protections required in oversight to protect and prevent corruptive practices are completely avoided by internalizing the Benefit process. |