BLOOMINGTON, Minn.--(BUSINESS WIRE)--HealthPartners today announced that two evaluations from Validation Institute found its net pharmacy cost was roughly 20 percent lower than industry averages, and its management of pharmacy benefits met Validation Institute standards for transparency. The findings are backed by a credibility guarantee.
“We commissioned this independent review to help ensure that our pharmacy benefits management is doing right by our customers. It’s one way we’re trying to make health care simpler, understandable and more affordable for our employer groups, members and patients,” said Dave Busch, HealthPartners vice president of pharmacy. “Pharmacy spending is a major cost driver for employers that purchase health insurance for their employees. But, many insurers and pharmacy benefits managers are not using a lowest net cost approach to managing pharmacy spending like we are.”
Validating data, guaranteed
As part of its RxRevealed Guarantee, HealthPartners partnered with the Validation Institute, an independent firm that reviews the performance assertions of organizations and provides a credibility guarantee to those whose assertions are valid.
It evaluated the way HealthPartners manages pharmacy benefits. Pharmacy costs were calculated for nearly 600,000 members with HealthPartners commercial insurance for calendar year 2020. HealthPartners cost was then compared to published industry data. Data show:
- Across the Midwest, HealthPartners risk adjusted pharmacy costs were 20.3 percent lower than average
- In Minnesota, HealthPartners risk adjusted pharmacy costs were 19.1 percent lower than average
- In Wisconsin, HealthPartners risk adjusted pharmacy costs were 23.4 percent lower than average
In addition, an independent clinically trained pharmacist reviewed HealthPartners pharmacy contracts, confirming that an administrative fee is the only revenue that HealthPartners collects for its work serving employer groups. It doesn’t negotiate hidden, consulting or consortium fees or use spread pricing to generate revenue, which are all common tactics used by many insurers and PBMs. HealthPartners also returns all rebates or any manufacturer payments from drug manufacturers to the employers.
Following results from its evaluation, Validation Institute will provide a $25,000 guarantee that HealthPartners can reduce pharmacy spending for employer groups. It also provides a $10,000 guarantee of HealthPartners lowest net cost approach to pharmacy benefits, which pass savings on to customers.
RxRevealed: The truth about pharmacy benefits management
Pharmacy benefits are increasingly managed by a type of business known as a pharmacy benefit manager (PBM). PBMs negotiate directly with drug manufacturers, distributors, pharmacies, insurers and employers. While some PBMs use this unique position to lower drug costs, many large PBMs use this position to negotiate undisclosed revenue streams that are more beneficial to their own bottom lines than those they’re hired to manage.
In response to these unsavory business practices, HealthPartners launched its RxRevealed Guarantee to show customers the value and integrity of its pharmacy expertise and to help educate those purchasing a pharmacy benefit.
“Business leaders don’t always recognize how rebates and hidden fees are driving up costs of pharmacy benefit management,” said Busch. “We’re trying to reveal how this complex area of health care works and use our industry expertise to help educate employers purchase pharmacy benefits more effectively and manage drug costs to make them more affordable.”
About HealthPartners
HealthPartners is an integrated health system, providing care to more than one million patients and coverage to more than 1.8 million medical and dental health plan members nationwide. HealthPartners also provides medical education and conducts research through its HealthPartners Institute.
