Listen "#188 - Demystifying PBMs and Transparent Pharmacy Benefits"
Episode Synopsis
In this eye-opening episode of The ASHHRA Podcast, hosts Bo Brabo and Luke Carignan welcome Kinjal Patel and Brady Heiner from RxBenefits to demystify the complex world of pharmacy benefit management (PBMs). As costs skyrocket, driven by specialty drugs accounting for 50% of spend from just 2% of prescriptions, HR leaders face fiduciary risks, hidden contract clauses, and potential class-action lawsuits. Kinjal and Brady reveal how transparent PBMs differ from traditional models, why "transparency" claims often fall short, and how RxBenefits operates as a client-aligned Pharmacy Benefits Optimizer with 3 million members' negotiating power.Discover actionable strategies for hospitals and health systems to leverage in-house pharmacies, avoid rebate pitfalls, and conduct essential market checks and audits. The duo emphasizes the critical fine print in PBM contracts (e.g., CVS, Express Scripts, OptumRx) that can erode savings if overlooked. RxBenefits offers free, comprehensive contract analyses to uncover hidden opportunities and protect your organization.Key takeaways for healthcare HR professionals:Understand true PBM transparency vs. marketing hype… demand bias-free alignment.Specialty drugs dominate costs; optimize high-dollar prescriptions for massive savings.Hospital pharmacies are goldmines; structure contracts to maximize rebates and utilization.Fiduciary duty demands expertise; avoid legal risks with proactive audits.Don't DIY pharmacy benefits; partner with consultants for smarter plan design and pricing.A must-listen for HR managing escalating drug spend and compliance. Take control… request your free RxBenefits analysis today!From Our Sponsors...Optimize Pharmacy Benefits with RxBenefitsElevate your employee benefits while managing costs. Did you know hospital employees fill 25% more prescriptions annually than other industries? Ensure cost-effective, high-quality pharmacy plans by leveraging your hospital’s own pharmacies. Discover smarter strategies with RxBenefits.Learn More here - https://rxbene.fit/3ZaurZNStreamline HR Compliance with oneBADGEhealthcareSimplify screening, credentialing, and compliance for healthcare HR. oneBADGEhealthcare from ISB Global offers a tailored solution to keep your workforce compliant and efficient. Built for healthcare leaders, it’s your all-in-one compliance tool.Get Started here - https://isbglobalservices.com/onebadgeunitedstates/ashhra/ Support the show
More episodes of the podcast The ASHHRA Podcast
#185 - Are We Seeing Trends Yet?
03/11/2025
#183 - The Unique World of Vail Health
29/10/2025
#181 - Adapting to the New HR Landscape
27/10/2025
ZARZA We are Zarza, the prestigious firm behind major projects in information technology.