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PBM Purchasers Guide From URAC and NBCH Will Help Employers and Business Coalitions Evaluate, Manage Pharmacy Benefit Services

Thursday, January 29th, 2009

URAC’s quality standards offer framework for employers

Washington, D.C. Jan 29th, 2009 – URAC, a leading health care management accreditation body, and the National Business Coalition on Health (NBCH) today released a comprehensive PBM Purchasers Guide for employers and business coalitions to help them evaluate and manage pharmacy benefit services.  The PBM Purchasers Guide: A Quality Management Toolkit for Evaluating and Managing PBM Services is available as a free download at www.pqm.urac.org and www.nbch.org.

The PBM Purchasers Guide is a “how to” resource to assist employers and business coalitions and was designed to be used in the day-to-day management of PBM services and during contract negotiations with PBM vendors.  It was created in partnership with NBCH, a national organization of employer-based health care coalitions dedicated to value-based purchasing of health care services through the collective action of public and private purchasers.
The Purchasers Guide provides clear descriptions of how PBMs function, both operationally and clinically, and discusses the pros and cons of varying business and service models. It also demonstrates how URAC’s quality standards, represented in its Pharmacy Benefit Management Accreditation program, can help purchasers make informed buying decisions when purchasing PBM services.

URAC utilized its experience in bringing industry experts and stakeholders together to form the editorial advisory committee for this guide.  The committee worked together to leverage URAC’s PBM Standards and with the help of our advisors created this practical guide for employer health benefit managers to use to gain the most value for their employers in the complex world of pharmacy benefit management.  Editorial advisors included:

Michael E. Bailey, RPh                         Director, Clinical Strategy Integration
                                                                MedImpact Healthcare Systems, Inc.

Judith A. Cahill                                      Executive Director                
                                                                Academy of Managed Care Pharmacy

Dawn Geren                                          Healthcare Manager           

Christopher V. Goff, Esq.                      CEO & General Counsel      
                                                                Employers Health Purchasing Corporation of Ohio

John D. Jones, RPh, JD                         Senior Vice President, Professional Practice and Pharmacy Policy              

                                                                Prescription Solutions and Chair, URAC Pharmacy Advisory Committee

James R. Lang, PharmD, MBA            Vice President of Pharmacy Services 
                                                                Blue Cross Blue Shield of Michigan

Vernon C. Rowen                                  Vice President Government Affairs
                                                                Express Scripts, Inc.

 Alan T. Wright, MD, MPH                  Senior Vice President of Strategy
                                                                Caris Diagnostics, Inc.

Ruth Ann Opdycke, PharmD, MS       President               
                                                                TPG Healthcare Consulting LLC

“Whether purchasers use a consultant or go through the PBM selection process on their own, this Purchasers Guide will help them approach the process with greater sophistication and understanding of how pharmacy benefit management works,” said Alan P. Spielman, URAC’s president and chief executive officer.  “URAC’s accreditation standards included in the Purchasers Guide are a framework purchasers can use to evaluate an operation’s effectiveness and commitment to the highest standards for care and quality improvement.”

“Value-based purchasing of PBM services requires that employers and employer group purchasers develop a clear understanding of the price and service structure that these vendors use,” said Andrew Webber, president and CEO of NBCH.  “The Purchasers Guide is a strong evaluative tool to assist employers and illuminates how URAC’s PBM accreditation standards offer beneficial guidance in this critical process.”


For 25 years, URAC has been the independent leader in promoting health care quality through accreditation, education, and measurement. URAC offers a wide range of quality benchmarking programs that reflect the latest changes in health care and provide a symbol of excellence for organizations to showcase their validated commitment to quality and accountability. URAC’s evidence-based measures and standards are developed through inclusive engagement with a broad range of stakeholders committed to improving the quality of health care.

For more information about URAC, contact us.

Interested in accreditation?
Contact businessdevelopment@urac.org

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