Why Service Matters When It Comes to a Coalition

By Kiley Ward , President of CoeoRx?

Brokers frequently cringe at the thought of moving their groups to a different PBM because of the potential disruption it can cause. But it doesn’t have to be this way. Some coalitions today deliver 5-star customer service and comprehensive implementation support, making the transition smooth and hassle-free for everyone involved. While pricing and contract terms are crucial, the service provided by a pharmacy coalition can make or break your PBM implementation.?

The Critical Role of Service in Pharmacy Coalitions?

Good customer service in a pharmacy coalition is not just a bonus—it's a necessity. The right coalition partner will go above and beyond to ensure every aspect of the transition and ongoing management is handled smoothly, allowing you to focus on what you do best. Here’s why excellent service is so important:?

• Smooth Implementation: Transitioning to a new PBM can be complex, with numerous moving parts. A coalition with excellent customer service ensures that every detail is meticulously managed. They coordinate with TPAs, brokers, and PBMs to ensure that all members receive their new ID cards on time, prescriptions are transferred seamlessly, and everyone understands the new formulary. This reduces the risk of disruption and keeps members satisfied.?
• Ongoing Account Management: Quality service doesn’t end after implementation. A coalition with a dedicated account management team provides continuous support, quickly addressing issues and offering strategic advice. This proactive approach ensures your needs are met and any potential problems are resolved before they escalate. Look for a partner who implements annual pricing improvements to stay competitive in the market. Additionally, annual reconciliations and audits of PBMs should be conducted to ensure that contractual terms are being met or exceeded, thereby delivering maximum value and cost efficiency.?
• Comprehensive Data and Analytics: Access to detailed data and regular reporting is essential for effective management. A good coalition provides robust analytics to help you identify trends, spot areas for cost savings, and ensure that PBM contracts are being managed correctly. Regular reports and reconciliations ensure that you receive the full benefits of your negotiated terms and can make informed decisions.?
• Clinical Support and Guidance: The pharmaceutical landscape is constantly evolving, with new drugs and therapies emerging regularly. A coalition that delivers strong clinical support helps navigate these changes, ensuring your formulary remains up-to-date and cost-effective. They provide insights into new treatment options, manage specialty drug layers, and ensure clinical practices align with the latest best practices.?
• Member-Level Support & Experience: Ultimately, the member experience is what determines the success of a PBM implementation. High-quality service ensures that members are well-informed and supported throughout the process. This includes clear communication, educational resources, and responsive customer service. When members feel supported, their satisfaction increases, which reflects positively on the overall benefits strategy.?

Real-World Impact of Superior Service?

Consider the example of a large employer group that faced significant disruption during a previous PBM transition. They experienced issues with prescription transfers, delayed ID cards, and a lack of communication, leading to member dissatisfaction and increased costs. After joining a coalition known for its superior service, their next transition was markedly different. The coalition managed every detail, from pre-transition planning to ongoing account management. Member satisfaction increased, and the group saw significant cost savings and improved clinical outcomes.?

The importance of service in a pharmacy coalition cannot be overstated. Good service ensures smooth implementation, ongoing support, robust data analytics, and effective clinical guidance—all critical components of a successful pharmacy benefits strategy. By partnering with a coalition that prioritizes excellent customer service, you can mitigate disruptions, enhance member satisfaction, and achieve better overall outcomes. When selecting a pharmacy coalition, remember that superior service is not just a nice-to-have. It’s a crucial element that can significantly impact your success.?