In today’s marketplace, trust and expertise help PBMs stand out
Stakeholders across the workers’ compensation industry trust pharmacy solutions organizations, including pharmacy benefit managers (PBMs) to deliver medications to injured workers in a safe, effective and affordable manner. This will become an even bigger priority as an aging workforce encounters new health care challenges, and our society as a whole looks to turn the corner on the COVID-19 pandemic.
To respond successfully, workers’ compensation PBMs must be able to offer proactive clinical expertise, actionable data, and the ability to build relationships through exceptional service.
myMatrixx has built a reputation as a class-leading PBM by committing to these fundamentals and keeping an overriding focus on patient safety and driving down drug costs. This reputation is consistently backed up by independent data. As just the latest example, myMatrixx has received the highest PBM ranking in a recently published survey by consulting group CompPharma.
What workers’ compensation payers are looking for in a PBM
CompPharma is an independent service providing valuable insights to both payers and PBMs across the industry. The firm’s annual Prescription Drug Management in Workers’ Compensation Survey Report gathers the perceptions and thoughts of payers on managing prescription drug programs. The goal of the survey is to gain insight on the major cost drivers, management approaches, problems and trends that decision makers are facing — and how they are working to control costs and meet clinical goals.
According to the 2021 report, workers’ compensation payers are balancing their focus on core drug management issues, including:
- The ongoing opioid crisis
- Physician dispensing
- The impact of COVID-19
Even as workers’ compensation pharmacy spending continues to decrease — CompPharma estimates $1.8 billion over the past decade — payers in workers’ compensation still look to PBMs to continue meeting claims strategy goals and prioritize the safety of injured workers.
A major theme of the survey is that respondents have high expectations for PBMs. Payers repeatedly said they are looking for:
- A more proactive approach
- More actionable data
- Increased pricing transparency
Overall, the PBM sector has become highly competitive, requiring organizations to invest in staff, resources, operations, technology and thought leadership to deliver the level of service that will help them meet claims strategy goals.
myMatrixx is once again the best-in-class PBM
The survey also assesses and rates PBMs according to feedback from payers. These ratings gauge the degree to which payers believe PBMs are complying with contractual terms and commitments and to determine the overall reputation of the PBM among the industry at-large. Of the seven workers’ compensation PBMs ranked by the 28 survey respondents, myMatrixx received the highest rating in the 2021 survey.
The 2021 report combines data from 2019 and 2020 after a pause last year due to the COVID-19 pandemic.
Meeting the high expectations of workers’ compensation payers
Through the PBM assessment, the survey gauges performance based on communication, organizational stability, commitment to clinical and data expertise, IT security and other factors driving the industry. myMatrixx's number one ranking reflects a PBM that is truly delivering high touch service to our clients that is built for long-term success.