PROVEN Strategies. Meaningful Impact.
Impact Stories
Explore these stories to dive deeper into ways we leverage our unique JA processes to Evolve® organizations from a state of passive risk to proactive plan management for their journey ahead.
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A REGIONAL HEALTHCARE SYSTEM
The Pharmacy Carve-Out Strategy
Despite being a healthcare provider, the organization’s own employee pharmacy spend was increasing rapidly due to the high cost of specialty medications. They were utilizing a bundled pharmacy benefit manager that lacked transparency regarding rebates and pricing structures.
A MID-SIZED MANUFACTURER WITH HIGH DRUG SPEND
International Pharmacy Sourcing
The organization was facing a steep rise in the cost of specific maintenance medications that were essential for their workforce. Despite negotiating with their current PBM, the domestic prices for these brand-name drugs remained significantly higher than the global market average.
A PROFESSIONAL SERVICES FIRM WITH SPECIALTY CLAIMS
Specialty Med Coupon Optimization
The firm was paying full price for several high-cost specialty medications, unaware that manufacturer assistance programs were available to offset these costs. Their bundled PBM was not actively pursuing these credits, allowing the plan to bear the full financial weight of the claims.
A LARGE DISTRIBUTOR SEEKING TO LOWER RISK
Predictive Health & Utilization Modeling
The organization was always looking in the rearview mirror, reacting to claims that had already happened. They lacked the vision to identify emerging risks within their population before they turned into high-cost catastrophic events.
A PROFESSIONAL SERVICES FIRM
Network Leakage & Utilization Audit
The firm’s employees were frequently utilizing providers outside of the high-value network, leading to increased costs for both the plan and the members. There was no clear understanding of why this leakage was happening or how to direct members toward more efficient options.
A SERVICE-INDUSTRY EMPLOYER WITH WAGE DIVERSITY
Social Justice as a Retention Strategy
The company’s health plan was becoming unaffordable for their entry-level staff, leading to high turnover in key operational roles. The benefits plan was inadvertently contributing to a two-tier workforce where only high-earners could afford to stay healthy and stay with the firm.