Insight
PBM Best Practices Series: What to expect from your PBM account team
Pharmacy benefit managers play a key role in helping plan sponsors manage prescription drug spend, and good account management can make all the difference
While Medicare Advantage organizations (MAOs) have a number of items to focus on in their first few years after entering the market, it is important that achieving a high star rating does not fall from the top of the list. This white paper discusses the star ratings assigned by the Centers for Medicare and Medicaid Services (CMS), and why should MAOs prioritize getting them. The paper discusses how the star ratings affect revenue, and presents the distribution of star ratings for plans during the first five years of operation. It also shows how star ratings affect enrollment, with enrollees gravitating towards high-rated MAOs. A continual emphasis on improving star rating measures will help to ensure revenue is maximized year after year.
Insight
Pharmacy benefit managers play a key role in helping plan sponsors manage prescription drug spend, and good account management can make all the difference