Julie Black – ScriptSourcing

Hidden Costs in Healthcare

Hidden costs in healthcare are a pervasive issue that significantly impacts patients, providers, and the overall healthcare system. These unexpected expenses often catch patients off guard and can lead to financial strain, delayed care, and reduced trust in the healthcare system.

One of the most common hidden costs is facility fees, which are charges imposed simply for using a medical building or facility. These fees can add hundreds or even thousands of dollars to a patient’s bill, often without any prior notification. For example, a patient visiting an ENT specialist might be charged $348 for the consultation and an additional $645 just for using the medical office building.

Another source of hidden costs is the lack of price transparency in healthcare services. Many patients are unaware of the full cost of their treatment until they receive a bill weeks or months later. This opacity in pricing makes it difficult for consumers to make informed decisions about their care and can lead to unexpected financial burdens.

Out-of-pocket costs, such as copayments, deductibles, and coinsurance, can also accumulate quickly and unexpectedly. These expenses may not be clearly communicated to patients beforehand, leading to surprise bills and financial stress.

The healthcare industry’s complex billing practices and varying insurance coverage levels contribute to the problem. Patients may unknowingly receive care from out-of-network providers, resulting in higher out-of-pocket costs through surprise medical billing or balance billing.

To address these issues, there’s a growing push for greater transparency in healthcare pricing. Some states have enacted laws requiring healthcare entities to publicly post their prices, and federal regulations like the Hospital Price Transparency Rule aim to make pricing information more accessible to patients.

Ultimately, hidden costs in healthcare not only burden individual patients but also contribute to the overall inefficiency and rising costs of the healthcare system. Addressing this issue requires a concerted effort from policymakers, healthcare providers, and insurers to improve transparency, simplify billing practices, and empower patients to make informed decisions about their care.

ScriptSourcing: The PBM-Agnostic Solution for Consistent Pharmacy Benefits Management

ScriptSourcing’s PBM-agnostic approach offers a unique and valuable proposition in the ever-changing landscape of pharmacy benefit management. This strategy provides consistency and continuity for employers, even as they navigate the frequent transitions between Pharmacy Benefit Managers (PBMs).

Recent studies have shown that employers, on average, switch PBMs every one to three years. This frequent turnover is often driven by the search for better pricing, improved services, or more favorable contract terms. However, these transitions can be disruptive and costly, potentially impacting employee care and employer budgets.

ScriptSourcing’s PBM-agnostic model is designed to transcend these frequent changes. By remaining independent of any specific PBM, ScriptSourcing can maintain its relationship with employers regardless of which PBM they choose to work with. This consistency allows for long-term strategic planning and continuous cost optimization, unaffected by PBM transitions.

The company’s approach focuses on sourcing medications at significant discounts, typically achieving savings of 25-75% on specialty and brand-name drugs. This service complements rather than replaces the PBM’s role, allowing ScriptSourcing to work alongside any PBM an employer selects.

ScriptSourcing’s model aligns perfectly with employers’ interests. The company typically operates on a performance-based compensation structure, earning revenue only when it generates savings for its clients. This arrangement ensures that ScriptSourcing remains motivated to deliver value regardless of the PBM in place.

Moreover, ScriptSourcing’s PBM-agnostic stance allows it to provide unbiased advice and solutions. It can objectively assess the offerings of different PBMs and help employers navigate the complex pharmacy benefit landscape without any conflicts of interest.

By maintaining a consistent presence through PBM changes, ScriptSourcing offers employers a stable partner in managing prescription drug costs. This continuity not only simplifies the transition process between PBMs but also ensures that cost-saving initiatives and employee wellness programs remain uninterrupted.

In an industry where change is constant, ScriptSourcing’s PBM-agnostic approach provides a reliable anchor for employers seeking to optimize their pharmacy benefits while maintaining flexibility in their PBM choices.

Aligning Interests: How ScriptSourcing Transforms PBM Relationships for Business Savings

The misalignment of interests between a Pharmacy Benefit Manager (PBM) and a business can have significant and far-reaching consequences. When a PBM’s primary focus is on maximizing its own profits rather than optimizing costs for its clients, businesses often find themselves grappling with inflated prescription drug expenses and reduced healthcare efficiency.

One of the most direct impacts is the unnecessary increase in healthcare costs. PBMs with misaligned interests may engage in practices such as spread pricing, where they charge employers more for medications than they pay pharmacies, pocketing the difference. They might also push for the use of higher-cost drugs when equally effective, less expensive alternatives are available. These practices can lead to a substantial financial burden on businesses, affecting their bottom line and potentially forcing them to make difficult decisions about employee benefits or other operational expenses.

Furthermore, the lack of transparency in traditional PBM models can make it challenging for businesses to understand and control their prescription drug spending. This opacity can hinder effective budget planning and limit a company’s ability to make informed decisions about their healthcare strategy.

The ripple effects of these increased costs can extend beyond just financial considerations. Employees may face higher out-of-pocket expenses for their medications, potentially leading to decreased medication adherence. This, in turn, can result in poorer health outcomes, increased absenteeism, and reduced productivity – all of which directly impact a business’s performance and profitability.

ScriptSourcing stands out in the healthcare cost management landscape by offering innovative solutions that complement, rather than replace, existing PBM relationships. We are not a Pharmacy Benefit Manager (PBM), but rather a specialized service provider focused on alternative medication sourcing options. This unique position allows us to partner with nearly all PBMs, ensuring flexibility and continuity for our clients.

Our expertise in the PBM space enables us to provide valuable insights and analytics to brokers, helping them determine the most suitable PBM for their clients’ needs. We understand that employers often change PBMs every few years, which can lead to disruptions in service and care. To address this, ScriptSourcing has developed an agnostic approach to alternative sourcing services. This strategy ensures that employers receive the best solutions, engagement, and technology, regardless of their chosen PBM.

By offering our services independently of PBM changes, we help employers avoid the disruption typically associated with switching providers. Our model is designed to work seamlessly alongside various PBMs, providing consistent cost savings and improved medication access for employees. This approach not only benefits self-funded employers of all sizes but also creates a stable environment for long-term healthcare cost management and employee satisfaction.

Employee Wellness: The Role of Affordable Medications

In today’s competitive business landscape, employee wellness has become a critical
factor in organizational success. One often overlooked aspect of employee well-being is
access to affordable medications. The ability to obtain necessary prescriptions without
financial strain plays a crucial role in maintaining a healthy, productive workforce.

Affordable medications contribute significantly to employee wellness in several ways.
Firstly, they ensure that workers can adhere to their prescribed treatment plans without
compromising their financial stability. When employees can easily access and afford
their medications, they are more likely to follow their doctors’ recommendations, leading
to better health outcomes and reduced absenteeism.

Innovative Approaches to Medication Affordability
Employers play a vital role in making medications more affordable for their workforce.
By implementing strategic benefit plans, companies can significantly reduce the
financial burden of prescriptions on their employees. One innovative approach is
leveraging international sourcing options through companies like ScriptSourcing, which
can often cut the prices of brand-name and specialty drugs by more than half.

ScriptSourcing, for example, offers a unique business model that aligns their interests
with those of their clients. They only succeed when their clients save money on
prescription costs, ensuring a commitment to shared success. This approach stands
in stark contrast to traditional pharmacy benefit managers (PBMs) that may engage in
practices like spread pricing, which can drive up costs rather than reduce them.
Benefits of International Sourcing

International drug sourcing can provide significant cost-saving opportunities for
employers. By working with reputable partners, companies can access medications at
lower prices while still ensuring product integrity. Some key benefits include:

Zero copays: ScriptSourcing provides zero copays on name-brand maintenance
medications for both employees and dependents.
Free shipping: Prescriptions are shipped directly to employees’ homes with no
shipping or handling costs.
Substantial savings: Companies can save significantly on high-cost medications.
For instance, one company reported saving $24,000 a year on a single
medication through ScriptSourcing.
In conclusion, affordable medications, including those sourced internationally, can be a
cornerstone of comprehensive employee wellness programs. By ensuring access to
necessary prescriptions through innovative approaches like international sourcing,
employers can foster a healthier, more productive workforce while simultaneously
managing healthcare costs and enhancing their reputation as employee-centric
organizations.

ScriptSourcing: The Most Trusted Name in Savings

In today’s crowded market of international pharmacy vendors, ScriptSourcing stands out by prioritizing aligned interests with our clients. Our unique business model ensures that we only succeed when our clients save money on their prescription costs—it’s that simple. This commitment to shared success drives everything we do.

Decades of Experience and Expertise

Founded by Gary Becker, a veteran in health insurance and risk management with over 30 years of experience, ScriptSourcing leverages deep industry knowledge to deliver innovative solutions. We collaborate closely with benefit consultants, Pharmacy Benefit Managers (PBMs), and Third-Party Administrators (TPAs) to secure competitive pricing on specialty and brand-name medications, often achieving savings of 25-75% without imposing any administrative or setup fees.

Dedicated Member Advocates

What truly sets ScriptSourcing apart is our team of caring member advocates. These professionals guide group members step by step through the process, ensuring they feel comfortable and confident in managing their prescription needs. Our proactive outreach and monitoring not only enhance the member experience but also contribute to healthier employees and improved workplace productivity.

Comprehensive Health Plan Solutions

ScriptSourcing goes beyond just managing prescriptions; we offer a comprehensive suite of solutions designed to optimize health plans. Our advanced analytics tools help employers identify high-cost claimants, enabling them to make informed decisions about their healthcare strategies. This holistic approach not only maximizes healthcare spending efficiency but also enhances employee satisfaction and retention.

Commitment to Affordability

At ScriptSourcing, our commitment to affordability is unwavering. We provide zero copays on name-brand maintenance medications and offer free shipping directly to employees’ homes, eliminating hidden fees and simplifying access to necessary medications.

In summary, ScriptSourcing’s alignment of interests with clients, combined with our extensive experience, dedicated support team, and comprehensive solutions, makes us the ideal partner for employers looking to effectively manage their healthcare costs while ensuring the well-being of their employees.

The Hidden Costs of Prescription Medications: What Employers Need to Know

Prescription drug costs have become a significant burden for employers providing health benefits to their employees. As these expenses continue to rise at an alarming rate, companies are increasingly seeking ways to manage and reduce their healthcare expenditures.

One of the primary culprits behind inflated drug prices is the complex system of pharmacy benefit managers (PBMs). These middlemen often employ tactics that drive up costs rather than reduce them. For instance, PBMs may engage in “spread pricing,” where they charge employers more for medications than what they pay pharmacies, pocketing the difference. They may also retain rebates from drug manufacturers instead of passing those savings on to employers and patients.

The lack of transparency in the current system makes it challenging for employers to identify and control their prescription drug expenses. Bundled insurance packages often obscure the actual costs of medications, limiting employers’ ability to negotiate better prices or tailor drug formularies to their workforce’s specific needs.

However, there are strategies employers can implement to mitigate these hidden costs. Unbundling prescription drug plans from traditional insurance packages can provide greater transparency and control over expenses. This approach allows employers to negotiate directly with PBMs, customize formularies, and leverage data analytics to make informed decisions about their prescription drug coverage.

Alternative prescription sourcing companies like ScriptSourcing, LLC offer a powerful solution for reducing the cost of expensive medications. By leveraging both international and domestic
sourcing options, these companies can often cut the prices of brand-name and specialty drugs by more than half. This approach stands in stark contrast to the strategy promoted by some large agencies, which focuses on pursuing rebates. The rebate-chasing method simply cannot match the substantial savings achieved through alternative sourcing vendors, making the latter a more effective choice for those seeking to significantly lower their medication expenses.

To truly address the issue of rising drug costs, employers should also advocate for policy changes. Supporting legislation that requires PBMs to be more transparent and accountable can help create a more competitive and fair market for prescription drugs.

By understanding the hidden costs associated with prescription medications and exploring alternative solutions, employers can take proactive steps to control their healthcare expenses while ensuring their employees have access to necessary medications.

Impacts Of Rising Drug Costs on American Families

Rising drug costs have become a significant burden for American families, affecting
their financial stability, health outcomes, and overall quality of life. Between 2013 and
2015, prescription medication spending grew by 20%, nearly doubling the 11% increase
in overall healthcare spending. This rapid rise has forced many families to make difficult
choices between paying for essential medications and other necessities.

Financial Strain
High-deductible health plans have led to increased out-of-pocket costs for medications.
A 2019 survey found that 24% of people taking prescription drugs reported difficulty
affording their medications. This percentage rises to 35% for those with annual incomes
below $40,000.

Health Consequences
When patients cannot afford prescriptions, it leads to poor health outcomes and
increased healthcare expenses. About 29% of adults report not taking medicines as
prescribed due to cost, with 8% saying their condition worsened as a result.

Medication Adherence
High costs significantly impact adherence. Patients may ration medications or abandon
treatment altogether. For those with chronic conditions, this can lead to serious
complications and reduced quality of life.

Societal Impact
The effects extend beyond individual families. Increased hospitalizations and
emergency care due to poor disease management strain the healthcare system.
Productivity losses from illness and absenteeism impact the broader economy.

Potential Solutions
Addressing this issue requires a multi-faceted approach:

Encouraging generic and biosimilar competition
Allowing Medicare to negotiate drug prices
Implementing value-based pricing
Increasing transparency in the drug supply chain
In conclusion, rising drug costs have created a crisis for many American families,
impacting their health, finances, and well-being. Addressing this issue requires
concerted efforts from policymakers, healthcare providers, and the pharmaceutical
industry

Balancing Cost Control and Quality Care: ScriptSourcing’s Approach for Self-Insured Brokers

Self-insured brokers face a tough challenge: helping clients control healthcare costs while maintaining quality care for employees. This balancing act is especially hard when it comes to prescription drugs, where prices keep going up fast. ScriptSourcing, started by CEO Gary Becker, offers a smart solution to this problem.

Key Programs

ScriptSourcing combines several important programs to help employers cut Rx costs and risks without reducing benefits:

International Pharmacy Management: This program lets employers buy certain medications, especially expensive specialty drugs, from carefully chosen Tier-1 countries at much lower prices. The savings can be big, often 50-75% less than U.S. prices.

Comprehensive Services: ScriptSourcing does more than just find cheaper drugs. They offer a full set of services to improve pharmacy benefits:

Employee education
Finding savings opportunities
Helping employees with insurance and pharmacy issues
Ongoing cost and use tracking

Benefits for Self-Insured Brokers

Partnering with ScriptSourcing can help brokers in several ways:

Offer clients a proven way to control Rx costs
Help employees get affordable medications
Show innovative thinking and added value
Build stronger client relationships through real cost savings

A Holistic Approach

By looking at the whole picture, ScriptSourcing helps brokers tackle one of the biggest issues for self-insured employers today. Their approach allows for big cost savings while making sure employees can still get the medications they need. This strikes that crucial balance between controlling costs and providing quality care.

As healthcare keeps changing, brokers who can offer these kinds of complete solutions will be in a good position to help their clients manage self-funded health plans.