PLAN MANAGEMENT REVIEW
Data-driven, actionable review of all aspects of your benefit design with recommendations for improvement
COMPLETE ANALYSIS WITH RECOMMENDATIONS
HealthLinX (HLX) gathers all the information for the plan from the PBM necessary to identify the key components of the program. Data gathering includes an electronic data file, plan implementation documents, contracts, e-mails and plan change forms.
HLX reviews this information and identifies each area for plan structure, services offered, and pricing. The information is then compared to the marketplace with plans of similar size and type. General areas of comparison are copay, covered drugs, AWP discounts, dispensing fees, disease state management programs and services provided to the plan.
The contract is reviewed for accuracy compared to the implementation documents as well as areas of common pitfalls. An example is rebate payment structure; does your contract terminate rebates with the contract? Is there a net effective rate which guarantees the savings of all the components? HLX will define these areas and make recommendations to the plan for improvement in all areas of the program management.