SmithRx’s Post

Embarking on a journey of healthcare transformation with Oswego Health has been nothing short of incredible! 🚀🌟 In this testimonial video, Oswego Health shares firsthand how ProAct PBM has become a trusted ally--contributing to a shared vision of delivering top-notch pharmacy benefit services. 🏥💙 #HealthcareInnovation #ProActPBM #OswegoHealth #SuccessStory"

The intention behind copay adjustment programs is to manage healthcare costs effectively by preventing the application of manufacturer copay assistance toward patients' deductibles and out-of-pocket maximums. This approach is designed to encourage the use of less expensive, often generic alternatives, thereby saving costs for both payers and patients in the broader healthcare system. However, the reality is that these programs can have unintended negative consequences for patients, particularly those requiring specialty medications for which there are no generic alternatives. By not counting the manufacturer's copay assistance towards deductibles, patients may face higher out-of-pocket expenses, potentially leading to medication non-adherence due to cost barriers. This situation is contrary to the fiduciary duty of healthcare plan sponsors to ensure patients access to necessary treatments at affordable prices. #education #cpbs #transparency #pbia

The intention behind copay adjustment programs is to manage healthcare costs effectively by preventing the application of manufacturer copay assistance toward patients' deductibles and out-of-pocket maximums. This approach is designed to encourage the use of less expensive, often generic alternatives, thereby saving costs for both payers and patients in the broader healthcare system. However, the reality is that these programs can have unintended negative consequences for patients, particularly those requiring specialty medications for which there are no generic alternatives. By not counting the manufacturer's copay assistance towards deductibles, patients may face higher out-of-pocket expenses, potentially leading to medication non-adherence due to cost barriers. This situation is contrary to the fiduciary duty of healthcare plan sponsors to ensure patients access to necessary treatments at affordable prices. #education #cpbs #transparency #pbia

The intention behind copay adjustment programs is to manage healthcare costs effectively by preventing the application of manufacturer copay assistance toward patients' deductibles and out-of-pocket maximums. This approach is designed to encourage the use of less expensive, often generic alternatives, thereby saving costs for both payers and patients in the broader healthcare system. However, the reality is that these programs can have unintended negative consequences for patients, particularly those requiring specialty medications for which there are no generic alternatives. By not counting the manufacturer's copay assistance towards deductibles, patients may face higher out-of-pocket expenses, potentially leading to medication non-adherence due to cost barriers. This situation is contrary to the fiduciary duty of healthcare plan sponsors to ensure patients access to necessary treatments at affordable prices. #education #cpbs #transparency #pbia

Enlightening article in NYT today about all of the problems caused by pharmacy benefit manager companies (PBMs, now in conglomerates with insurers, large pharmacy chains, and health care systems). PBM practices result in higher costs for medications for all of us and, in some cases, result in much poorer care for patients. I thought I was aware of these problems, but so many more problems than I knew of. NYT article: https://lnkd.in/dd4N53Vg Funny video highlighting some of these issues by the incomparable Dr. Glaucomflecken: https://lnkd.in/dDKYsk3a

The intention behind copay adjustment programs is to manage healthcare costs effectively by preventing the application of manufacturer copay assistance toward patients' deductibles and out-of-pocket maximums. This approach is designed to encourage the use of less expensive, often generic alternatives, thereby saving costs for both payers and patients in the broader healthcare system. However, the reality is that these programs can have unintended negative consequences for patients, particularly those requiring specialty medications for which there are no generic alternatives. By not counting the manufacturer's copay assistance towards deductibles, patients may face higher out-of-pocket expenses, potentially leading to medication non-adherence due to cost barriers. This situation is contrary to the fiduciary duty of healthcare plan sponsors to ensure patients access to necessary treatments at affordable prices. #education #cpbs #transparency #pbia

When I have the chance I want to get you in front of our senior leaders so you can get a front row seat to where the market is heading, where Simplify Healthcare is heading, and where you as a #payer and #healthplan leader can take your business. Take a quick minute below and hear directly from Nirnay Patel. Nirnay is a senior leader at Simplify Healthcare serving as EVP and GM of our Benefits1 platform. Having a payer and tech background, Nirnay understands firsthand the challenges and opportunities that payers and health plans have to optimize and innovate. In this segment, hear about how Simplify has vastly improved the #Medicare bid submission process and how leveraging our same platform, leaders can start to achieve other important business outcomes, such has personalizing benefit plan selection. The ability to get people the products, benefits, and services they want, where they live, for their life and family's needs is the big idea that in our own way we are helping payers and health plans achieve. You will enjoy this brief update from Nirnay. Let us know how we can continue the conversation with you and your team. #products #benefits #services #healthcare #sdoh #personalizedhealthcare #employers #employees #patients #physicians #nurses #insurance #medical #medicalinsurance

🚀 Is your health plan spend out of control?! 🚀 In an era where pharmacy costs are increasingly dominating healthcare expenditures, it's crucial to keep a close eye on spending and adopt effective cost-containment strategies. The power to regain control is within your grasp—by carving out your pharmacy benefits. 🔍 Introducing our Top 12 Reasons to Carve-out series, starting with Reason #1: Cost Transparency. Unbundling your pharmacy benefits enables you to grasp the specific costs associated with prescription claims, fostering transparency like never before. True transparency translates to auditability. Informed decisions can only be made when armed with all the facts.  Say goodbye to uncertainties about where your money is going. 👉 Say yes to cost transparency! 💊💙 #Healthcare #PharmacyBenefits #CostTransparency #TrueScripts #HealthcareSavings #EmployeeWellness #PharmacyManagement #TransparencyMatters #HealthcareCosts #SavingsStrategy #EmployeeBenefits #TrueScriptsDifference

Prescription Hope: Your Partner in Affordable Medications. Healthcare providers, find out how we can assist your patients. Visit our website for more information: www.PrescriptionHope.com #PrescriptionHope #Medication #MedicationAccess #Prescription #PrescriptionAssistance #HCP #Health #Healthcare #HealthServices #FDAApproved #AffordableMedication #PrescriptionDelivery #MedicationAssistance #AffordableHealthcare #HealthcareProfessional #PatientCare #HealthExperts #PatientSafety #HealthTip #WellnessTip #B2B #Marketing #Management #Innovation #Technology #Future #SocialNetworking #MedicationAssistance #PrescriptionProgram #MedicationProgram #Economy

Hear from Nirnay Patel, EVP & GM of Benefits1™, as he shares insights on future trends in the Medicare Payer market and how Simplify Healthcare continues to lead with a 30% market share for PBP bid submissions while supporting CMS modernization initiatives. #SimplifyHealthcare #SimplifyHealthCloud #Medicare #PBPbids #Benefits1