Value Based Insurance Design for Medicare Part D, Medicaid, Commercial and Employers

Health disparities can be addressed by examining benefit design and the unintended consequences of cost-sharing/utilization management practices, such as shifting costs of expensive medications to patients and maximizing rebates, which disproportionately affect marginalized populations and people of color.

St. Vincent TRANSPARENT Rx Benefits offers a Value-Based Benefits Design to address health disparities for Commercial, Medicare, and employer unions.

Our model consists of:

• We use real-world data to ensure appropriate drug usage

• We have an "Exclusion Drug List" based on Outcome Based Contracting

• Our experts manage specialty claims and drug rebate programs

• Our Specialty Pharmacy offers national coverage and high-touch support

• We have unique reimbursement programs for high-cost therapies

• Our robust analytics guide clinical management and patient care.