PHSI Designs MAC Pricing Benefiting HMO and Retail Pharmacy
| Industry | Managed Care/ PBM |
| Problem | A Medicaid HMO wanted to ensure that their Maximum Allowable Cost (MAC) list was controlling generic expenditures while providing a reasonable profit to their retail pharmacy networks. |
| PHSI Solution | PHSI created a unique model to analyze the costs associated with generic drugs in order to create competitive MAC lists incorporating the needs of all market segments. The MAC list aligned incentives for all stakeholders to promote generic substitution. |
| Results | The Medicaid HMO aligned financial incentives while increasing their generic substitution rate and lowering network complaints on generic pricing. |
Poll Results
March 2018 Question of the Month
Which of the following best describes how you were affected by the 2017-2018 flu season?
Received the flu vaccine, did not get the flu: 58.33%
Received the flu vaccine, did get the flu: 8.33%
Did not receive the flu vaccine, did not get the flu: 16.67%
Did not receive the flu vaccine, did get the flu: 16.67%
Do you plan to receive the flu vaccine for next flu season?
Yes: 70%
No: 30%
February 2018 Question of the Month
What is the biggest challenge faced by pharmacists today?
Drug shortages: 9.52%
Reimbursement for clinical services: 0%
Staff shortages/long working hours: 23.81%
Managing patient prescription coverage: 4.76%
Reimbursement for prescriptions: 57.14%
Verifying prescription orders/instructions: 0%
None of these: 4.76%
January Question of the Month
Should physicians be required to participate in mandatory education on opioids as part of ongoing attempts to limit opioid addiction?
Yes: 100%
No: 0%
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