MMA Rx Solutions
- Why pharmacy management?
- About MMA Rx Solutions
- Plan Analysis
- Plan Utilization
- Why MMA?
Why pharmacy management?
Quite simply - drug spending within the U.S. is expected to rise to almost $500 billion in 2016, an increase of 148% from 2005. With pharmacy benefit costs representing nearly 15 - 20% of overall total health care costs, employers must take steps to manage their pharmacy plan. By taking an active role in managing their pharmacy program, employers can experience double digit savings along with lowering the ongoing trend rate. But employers can't do it alone - they need an expert partner to help navigate the complicated pharmacy landscape.
When attempting to rein in cost, employers must not only assess the plan design structure, but also the way employees access the plan. MMA Rx Solutions addresses both components and thus increases the opportunity to experience savings.
Recognizing the growing needs of our clients and an opportunity to deliver additional value, Marsh & McLennan Agency has launched MMA Rx Solutions, a premier service designed to help employers not only understand their pharmacy options but to also help them maximize bottom line savings.
Built on deep dive analytics, pharmacy contract expertise, and an employee engagement tool, MMA Rx Solutions is a unique and exclusive service offered to our clients.
When evaluating cost saving strategies, employers often find themselves in the cycle of deductible changes, plan design tweaks, contribution adjustments, and the like. While these tactics can offer savings, they do not deliver the long term results employers are seeking in their efforts to rein in costs. One approach employers should be using when it comes to managing cost is a thoughtful review, assessment, and ongoing management of their pharmacy spend. This entails much more than simply what is being paid for each prescription.
Part One: Plan Analysis
Part one of the cost equation is addressing the unit cost structure; this includes the contract, discounts, rebates and overall plan design. MMA offers employers the assurance that every component of the contract is negotiated with optimal deal terms. There are many different parts to a PBM contract - transparent versus traditional contract, admin fees, prorated payments, MAC pricing, just to name a few.
MMA helps employers achieve more control and better cost and trend management over their PBM contract by performing an analysis and when necessary, a market comparison audit. Regardless if your contract is on a carve-in or carve-out arrangement, MMA's pharmacy experts will work with you to find cost savings and offer innovative solutions to achieve long term success.
Part Two: Plan Utilization
Part two of the cost equation is addressing utilization, or in other words, employee purchasing decisions. Their choice of which drug (generic vs. brand), where the prescription is filled, and the level of engagement can have a major impact on plan costs.
MMA Rx Solutions offers a mobile application tool designed to help employees make cost effective decisions at the time of script. By arming employees with a tool, completely unique to their plan, they are better prepared to make decisions to lower their costs and save the employer money.
Once the plan and utilization have been addressed from a global perspective, it is important that employers continue to actively monitor the pharmacy plan performance. Through the MMA Rx Solutions team, employers are assigned a dedicated account manager who provides ongoing oversight and management.
Comprised of seasoned experts, this team of service professionals offers employers access to reporting that details cost data, trends, key performance indicators (KPIs), and key statistics.
The traditional pharmacy management programs of the past have focused on the large “jumbo” sized employers, leaving a void for the mid-size employer. With Rx Solutions, MMA has established a model that meets the needs of the mid-sized employer, thereby allowing for real time access to eligibility and claim data and ultimately having more control over the pharmacy program.
As part of our pharmacy management services, clients receive:
- — Best in class pricing through our management of over 1 million pharmacy claims
- — Better cost and trend management over traditional and specialty drugs through deep dive proprietary analytics
- — Expert review and negotiations on pharmacy contracts
- — Innovative solutions specific to pharmacy management
- — More control over the plan
- — Ability to customize plan contract to reach desired goals
- — Performance management of the PBM
To discuss how MMA Rx Solutions can reduce costs and simplify plan administration, please contact one of our consultants at 314-594-2700, or request more information.