Sigmund Freud was quoted as saying, “Out of your vulnerabilities will come your strength.” The Employers Health pharmacy benefit contract is evaluated more than 250 times annually by most major pharmacy consultants throughout the United States. The vulnerability of sharing this contract for evaluation by independent consultants as well as consultants with their own coalitions truly does make our contract stronger. We hear the good and the bad feedback, which enables us to adapt and improve with each evaluation.
This continuous improvement ultimately resulted in record-setting growth in 2022. We added 63 new clients and an additional $600 million in spend. And, we are proud to share that in 2023 we will surpass $3 billion in spend. This continued growth means more purchasing power for our organization which directly helps your organization reduce its pharmacy spend.
In another act of vulnerability, annually, we ask our clients to evaluate their satisfaction with our organization. This year, an added measure of satisfaction was incorporated through a net promoter score (NPS). If you are unfamiliar, the NPS is solely based on the client’s likelihood to recommend our organization. We are proud to report that we scored 85.7 (on a scale of -100 to 100) in the 2022 survey. A “good” NPS varies by industry, and we are optimistic that this number will only improve in 2023.
Finally, in 2022 specialty drugs continued to make headlines. On average, specialty drugs accounted for 47.6% of our total book of business pharmacy spend. As predicted, this is a 6% increase from 2021 and specialty continues to comprise an even more significant amount of total spend. As always, the team at Employers Health stays ahead of these trends to help employers achieve better adherence rates and consistently maintain flat-to-negative trend.
We thank you for entrusting us to play a positive part in the well-being of your organization and its team members.
Best Regards,
Joe Chaddock & Chris Goff
Joe Chaddock
CHAIRMAN OF THE BOARD
“ Outside of the pharmacy component, EH gives me the ability to bounce ideas off additional individuals, research new ideas and the legal and compliance help is priceless. I can trust I’m getting a correct answer, not a “sales” answer, and that integrity means a lot. ”
Mission
Employers Health is committed to providing resources, tools and expertise to help plan sponsors deliver high-quality health care benefits at a sustainable cost.
- How we accomplish our mission:
- Managing group purchasing strategies.
- Benchmarking and data interpretation.
- Building physically and mentally healthy workforces.
- Sharing ideas and best practices.
- Collecting and analyzing market intelligence.
- Supporting population health improvements.
- Creating an environment where all team members bring their best selves.
Vision
Employers Health will be a premier, nationally recognized employer-led organization with a focus of:
- Earning the trust of our clients and their consultants as a reliable and consistent resource for unbiased, objective resources and expertise.
- Managing a variety of growing and market-leading collective purchasing solutions including pharmacy, medical and ancillary benefits.
- Achieving consistently-high levels of client and participant satisfaction and loyalty by delivering on our promises and helping employers achieve their desired results.
Value
Employers Health brings value through a host of solutions that help our clients achieve:
- Affordable, high-quality health care benefits.
- Healthier employees who are more productive in their individual jobs, thereby creating better organizational performance.
- An informed workforce that interacts with the health care delivery system more effectively, leading to better health outcomes and lower costs.
- Fully engaged, resilient employees who can more effectively meet the challenges of today’s work and family environments.
- Work cultures with aligned incentives that produce employee loyalty and create “great places to work.”
Board of Directors
Clients By Region
Clients by Region
Clients by Industry
29%
manufacturing
27%
education & government
14%
health care
12%
financial & professional services
18%
other
Pharmacy Benefit Management Providers
JANUARY 1998 RELATIONSHIP START
CVS Caremark is a leading pharmacy benefit manager. Together our dedicated account management teams work to reduce spend, increase adherence and improve outcomes.
89%
limit days’ supply on specialty drugs
93%
utilize the national retail network
94%
utilize the Advance Control Specialty Formulary
JANUARY 2013 RELATIONSHIP START
Optum Rx is a pharmacy care services company going beyond traditional pharmacy benefit management. With synchronized engagement, PreCheck MyScript and personalized care through Optum Rx Specialty, Optum Rx provides customized solutions to employers.
97%
utilize the exclusive specialty strategy
100%
limit days’ supply on specialty drugs
100%
limit new-to-market drugs
“ They provide industry knowledge that other companies don’t share so easily. ”
Contract Management
With more than 25 years of pharmacy benefit purchasing experience, Employers Health’s dedicated team of pharmacists, data analysts, business intelligence professionals, lawyers and employee benefits experts develop and maintain a straight-forward contract free of elaborate pricing games and confusing terms. Through comprehensive contract negotiations, clients participating in our pharmacy benefits group purchasing program have exclusive access to market-leading pricing guarantees, diverse network and formulary management options and robust service and performance guarantees.
One of the key components of the contractual arrangements between Employers Health and its PBM suppliers is the annual market check. The market check provision in Employers Health’s PBM program allows Employers Health to annually renegotiate the terms of its contractual arrangements to add service offerings, clarify terms, strengthen financial and non-financial guarantees, and, in a nutshell, adjust for market dynamics. Many PBM arrangements are three years long with no formal vehicle for adjustment based on market dynamics. Over a three-year period, a lot changes in health care, and the PBM industry is no exception to that rule. An annual market check is critical to ensuring that Employers Health clients have a contract that is responsive to current market dynamics.
The market check process is a synthesis of market intelligence and data analysis. Much of the market intelligence comes from participation in competitive bids. Evaluated more than 250 times in 2022, the Employers Health pharmacy benefit management contracts are among the most scrutinized in the industry. Regardless of the result of these evaluations, the information gleaned from our participation in the evaluation process helps to identify areas of strength or weakness.
The challenge with competitive intelligence from participation in competitive bids is the information gained from that process tends to be overly specific or broad. To get a complete picture of the competitiveness of Employers Health’s PBM offerings, each year Employers Health engages at least one national pharmacy practice to benchmark the aggregate value of the financial arrangements within its PBM contracts against the aggregate value of financial arrangements currently available through competitive offerings. Finally, Employers Health leverages its data analytics and business intelligence teams to identify trends that will impact financial guarantees. With these data, long-term relationships and the collective size of the Employers Health book of business, our in-house legal team annually negotiates with our PBM suppliers to ensure every group in an Employers Health pharmacy benefit management program achieves aggressive pricing and best-in-class contract terms.
Ancillary Vendors
Quantum Health is an award-winning consumer health care and benefits navigation company that delivers an unparalleled consumer experience based on empathy and trust, enabling employers to achieve industry-leading satisfaction rates and independently validated claim savings. Quantum Health’s model is based on years of consumer research and the insights learned from guiding millions of consumers and their providers through their health care journey.
EyeMed Vision Care knows that your eyes – and the eyes of your employees – are amazing. They see everything, everywhere and everyone. That’s why EyeMed offers Employers Health clients the network employees want with vision benefits that redefine expectations, all while making the experience easy for both you and your employees.
ComPsych Corporation is the world’s largest provider of employee assistance programs and is the pioneer and worldwide leader of fully-integrated EAP, employee wellness and work-life services under its GuidanceResources® brand. By creating “Build-to-Suit” programs, ComPsych helps employers attract and retain employees, increase employee productivity and improve overall health and well-being.
Smiles are important, and since dentists can detect more than 120 symptoms of non-dental diseases, it’s essential to follow good oral health habits for better overall health. Delta Dental is the largest and most experienced dental benefits carrier in the U.S. and is committed to oral and overall health.
“ Employers Health keeps us updated on market trends, new products coming down the pipeline, contract negotiations and Rx plan implementation guidance. All areas where we do not have the resources to dedicate to the complex area of prescription drugs. Employers Health is truly an extension of our benefits team. ”
Clinical
As managing pharmacy spend becomes even more complicated, employers are seeking innovative ways to tackle the rising costs head-on. At Employers Health, our dedicated clinical team proactively monitors the pharmaceutical pipeline and analyzes our book of business. Their goal? To recommend and implement tailored clinical solutions that promote appropriate utilization and cost management of high-price, low-value drugs. By staying one step ahead, we help employers achieve better adherence rates and consistently maintain flat-to-negative trend on targeted products.
Since 2016, our clinical team has identified over 1,000 unique drugs, multivitamins and combination products where custom clinical interventions could be implemented. These strategies primarily target medications that contribute to inefficient spending, focusing on strengthening the clinical criteria surrounding the appropriate use of costly drugs with a limited patient population. For the 2023 plan year, the team has introduced specific strategies for high-cost generics, obesity medications and acne treatments. By developing comprehensive reporting, they assess the savings achieved versus any potential disruption and offer valuable guidance to clients, ensuring the selected strategies align with their unique plan philosophy.
Beyond our custom management solutions, our clinical team creates timely communications that empower employers to understand impactful issues and effective strategies to best manage them. Employershealthco.com hosts a wealth of valuable resources, including engaging blog posts and articles from the team. Moreover, they are actively involved in sharing their expertise through presentations at conferences and webinars, covering a broad range of topics from specialty pharmacy to diabetes management. The Employers Health clinical team is here to serve as your resource for all of your clinical concerns. Together, we can navigate the complex landscape of pharmacy costs and achieve optimal outcomes for your organization.
Client Solutions
The client solutions team at Employers Health is dedicated to enhancing results and achieving your goals all while improving the participant experience. As a testament to their dedication to the industry, more than half of the Employers Health client executives have obtained or are in the process of earning their Certified Employee Benefit Specialist (CEBS) designation.
We’ve constructed a team of benefits experts to navigate the complexities of the pharmaceutical industry. Employers Health client executives serve as a conduit to the vast resources within Employers Health and your chosen PBM. Our size and scale allow us to take an active management approach in identifying proactive strategies for employers seeking to maintain a flat or negative trend in their drug spend. The team facilitates implementations, monitors spend and trend and delivers innovative solutions tailored to your unique needs.
In today’s complex benefits environment, increasingly intricate knowledge is required of human resource professionals to effectively manage the benefits offered to plan members. Our team seeks to aid our clients in the day-to-day management of the pharmacy plan allowing them to direct their focus on overarching benefits strategies. PBMs are complex organizations that can be difficult to navigate without the assistance of an experienced professional. We strive to reduce or eliminate those complexities for our clients to create a better experience for the plan and its members.
“ The service we receive is top notch. I particularly feel that any recommendations that are made to us really take our company initiatives into account. ”
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