Reflecting on the pandemic, what health plans and employers need from a PBM, and how Prime is answering the call
A conversation with Stuart Meyerson, vice president of sales, Prime Therapeutics
April 30, 2021
What are the biggest challenges health plans face today, and how is Prime responding to those needs?
No matter the client, all health plans have the same three concerns: the cost of their plans, the coverage that they provide, and the access that they give. Looking at 2021, Prime is highly focused on challenges and opportunities our health plan clients face. Here are some examples of how we’re helping plans address these:
- We’ve made changes to improve Prime’s cost of goods sold, closed economic and service gaps, and drove efficiency around cost per prescription.
- We’re seeing an increase in virtual care, which expanded our need to align with caregivers who might be exploring new options for treating their patients. Along with this, we’re also recognizing the importance of expanding our focus on mental health services and their associated medications, and supporting our plans as they serve as “air traffic controllers” and integrate with caregivers more to help members get the care they need.
- Finally, we’re upgrading claims platforms and clinical and member services systems to help members understand and compare costs of services or drugs.
What are a few things Prime offers health plans and employers that differ from our competition?
Transparency, integration, adaptation, an unsurpassed ASO partnership model and our alternative to the consultant-led coalition – these are just some of our differentiators. While we prefer standardization, as any PBM would, Prime can adapt a lot more than our competitors can. Additionally, our competitors cannot say they’re not going to compete against the health plans they service for ASO business. Prime, on the other hand, doesn’t compete with health plan clients.
What’s one of the biggest challenges you have encountered?
It’s the misperception that we will eventually merge with another PBM. Of course these questions are only natural, given we recently completed two agreements that significantly improved our competitiveness in the market. My response: we’re moving from a pharmacy benefit manager to pharmacy care and knowledge management company. For example, we’re making increased, significant investments to update our claims processing systems. We’ll also enhance our entire data platform and our data analytics reporting capabilities over the next 24 months and we’ve brought in top talent to help us do this. So, once you know what Prime is doing, I’d ask, ‘Why would we make these major investments in time and resources if we weren’t 100% focused on our Prime+Blue market strategy?’
Which pieces of Prime’s 2021 investment plan are you most excited about? What will be game-changing from a sales perspective?
There are a number of existing products that we’re uplifting and repackaging as well as a bunch of new products that we’ll bring to market in 2021, totaling 5-10 product releases that will be really helpful to our clients. What I’m equally excited about is the data and analytics improvements we’re making that will help us track their performance and prove their returns on investment.
How has remote work in 2020/2021 impacted how the sales team works?
We’ve been able to engage our clients and prospects far more often since COVID began. We can include personnel in meetings that we previously couldn’t because it was cost prohibitive. We’ve been able to train people and get people more engaged in deals better than we ever have. Still, there’s no substitute for spending time with customers both in their office and socially — that’s still something that’s missing and expect to get back to at some point. But, consider this: in a year where we didn’t go visit a customer, a plan, or an employer group, we together with our plans set sales records. We supported our Blue Plans to increase our ASO new lives membership by an additional 775,000 members!
November 16, 2021
Prime Therapeutics (Prime) helped 30 of its Medicare Advantage Prescription Drug (MAPD) contracts,…
November 16, 2021
by Angela Maas As published in AIS’s Radar on Specialty Pharmacy (Content reprinted…
November 14, 2021
Although International Fraud Awareness Week is a dedicated seven days to encourage organizations…