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The Important Role of PBMs in Health Care Reform Highlighted as the U.S. Government Delays Requirement for Businesses

The delay of the Affordable Care Act employer mandate accentuates the important role that PBMs will continue to play as Health Care Reform is enacted on both a national and state level.

PBMs that bridge the relationships among employers, consumers and the pharmacy industry will always have an essential place in the health care system. With drug costs escalating drastically, the entire industry is monitoring the evolution of the Affordable Care Act, anticipating both opportunities and challenges to help individuals who are uninsured or under-insured.

The employer mandate, which would penalize those with more than 50 employees if they do not provide minimum standards of affordable health insurance, is now slated to come into effect in 2015. The delay gives companies more time to address rules and implementation procedures, but still leaves questions for the large number of workers who are without insurance and dealing with the high costs of health care. According to the Commonwealth Fund 2012 Biennial Health Insurance Survey, approximately 84 million Americans went uninsured or under-insured last year, simply because they couldn’t afford it. The number represents almost half of all working-age adults in this country.

To deal with the rising price of health care, while also showing support for their employees and community, a number of companies are adopting a consumer-driven health care model that utilizes a discount prescription card benefit. These programs give consumers wider access to affordable prescription drugs and provide more flexibility to manage their own health care expenses.

IBC Bank, one of the largest banks in Texas serving more than 85 communities, has utilized one such program with the help of Paramount Rx. Through the program, thousands of area residents and employees at businesses served by IBC Bank across Texas and Oklahoma receive a prescription discount card at no cost. To date, they have saved nearly $1 million off the retail price of their prescriptions.

Bank customers and family members simply present the We Do More Rx discount card to the pharmacist each time they fill a prescription, and they receive an average savings of 36 percent off retail prices. There are no deductibles or maximum benefit levels, and no exclusions for pre-existing health conditions.

“We’ve received very positive responses from customers about the money they are saving,” said Dale Randol, IBC Insurance Agency executive vice president and chief operating officer. “We had more than a hundred calls during the first month of the program from customers who said they appreciate what we’re doing. Businesses are also interested in participating in the program for their employees.”

In uncertain times, every little bit helps. As the Affordable Care Act continues to develop and unfold, the Paramount Rx Prescription Discount Program is doing its part by providing cost-effective solutions, and a breath of fresh air, for the millions of people struggling with escalating medical expenses.

To learn more about Paramount’s work with IBC Bank, visit the “Case Studies” section. Contact us to explore how Paramount Rx can help your organization.

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