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
June 2019 Question of the Month
How quickly will payer and EHR real time benefit checks be implemented?
6 months: 0%
1 year: 0%
2 years: 75.0%
3 years: 12.5%
4 years or more: 12.5%
Never: 0%
May 2019 Question of the Month
HHS has proposed altering the safe harbor for pharmaceutical rebates. When will the proposed POS rebates be implemented for Medicare Part D and Medicaid plans?
2020: 27.27%
2021: 9.09%
2022: 9.09%
2023: 18.18%
Never: 36.36%
April 2019 Question of the Month
CVS and Walgreens have announced they will carry CBD products in select states. How soon until we see CBD products in all retail chain pharmacies?
0-6 months: 23.08%
6-12 months: 30.77%
12-24 months: 30.77%
24+ months: 0.00%
Never: 15.38%
Contact
968 Perry Highway
Pittsburgh, PA 15237
Get Directions »
Phone: (412) 635-4650
Follow/Subscribe:
