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Predator or Prey – The PBM Games with Terri Dill
Manage episode 320060039 series 3314908
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Terri Dill is an expert in pharmaceutical and Pharmacy Benefit Manager contracts. She is the Principal at Skylight Arcs, a consulting company which focuses solely on employer groups’ PBM contracts.
Despite a good amount of market consolidation taking place in today’s PBM space, competition continues to thrive as many smaller and mid-size options have sprung up for employers to choose from. Nevertheless, there is a confusing array of “games” that these companies play which result in employers losing money without even realizing it.
Pharmaceuticals are almost 50% of the cost of what employers spend towards healthcare, and that number continues to grow rapidly. Pharmacies are being merged with health insurance companies resulting in consolidated and hidden fees. Terri concurs, admitting that the industry “is 100% rigged,” and that “PBMs continue to change the games all the time.”
Because of this, working with many Pharmaceutical Benefit Managers (PBM’s) can be seen as dealing with the Mafia or stepping into a casino, where the odds are stacked against you and everywhere you turn you are charged a “vig.”
Listen in as Terri discusses all the hidden tricks PBMs use to take as much money as they can from you as an employer. She explains how you can save between 8% to 27% a year on that 50% of your healthcare spend. This can result in savings ranging from 4% to 13.5% a year on your total healthcare spend and potentially lower your healthcare costs by almost 100% in the next few years.
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