Posted by Everise on Aug 7, 2023
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Pharmacy benefits management (PBM) is integral to the operations and productivity of pharmacies. Through efficient PBM, pharmacies can save money, provide an elevated patient experience, and effectively communicate with both healthcare providers and insurance companies. 

Pharmacy benefits management can significantly impact the patient experience, both affecting customer retention rate and overall sentiment. Implementing quality PBM practices will keep customers returning to your pharmacy and give them a better experience when they do, so it’s an important thing to invest in. 

In this blog, we'll discuss how business process outsourcing can help improve the patient experience by delivering excellent PBM and implementing proven strategies. 


The Benefits of Outsourcing 

Many pharmacies use a business process outsourcing provider to streamline their PBM and ensure that they're providing the best customer experience possible. There are a few different benefits that can come from outsourcing this area of pharmacy tasks, including: 

Improved Operational Efficiency 

When it comes to pharmacy benefits management, improving efficiency is the name of the game. If your current team isn't as efficient as possible or feels overwhelmed with their workload, outsourcing could be the perfect option. 

Working with a skilled and experienced outsourcing team means you'll have access to workers who understand what they're doing and can complete tasks in a productive way. This increase in productivity can save you time and money, so it's an option that should be considered. 

Reduced Costs 

As we just mentioned, choosing to outsource PBM could save you money. Not only will your new team be able to complete tasks quicker, but they’ll also be able to implement strategies and systems that make sense. Because of this, you can expect to cut your costs while outsourcing. 

Increased Scalability 

Running a pharmacy and keeping up with its many demands can be challenging at times, so increased scalability is a topic that must be brought up in this discussion. 

When you choose the right BPO provider, they’ll be able to provide you with an understanding of how they handle scalability and how they would react in the future if you need to make adjustments to the scope of work. Scalability is an important factor to consider, so don’t be afraid to ask potential outsourcing partners about this while you’re in the evaluation period. 

Enhanced Customer Service 

One of the most important reasons to outsource PBM is that you can work on improving patient experiences. Doing this has a variety of benefits, including increasing retention rates, bringing in new customers, and receiving positive word-of-mouth reviews. 

Let’s dive into a few of the different ways that BPOs can help PBMs improve patient experiences. 

  • Claims Processing can be tedious if there aren’t specific systems set in place. When you choose to outsource this area, you can be sure that things are being done correctly and efficiently - two of the most important qualities when it comes to claims processing. 

    If your current claims processing system isn't working out how you want it to, then consider if outsourcing this area could be the right choice for you. When evaluating potential outsourcing partners, feel free to ask them about their claims processing experience and any systems they believe are helpful to implement to improve the customer experience. 

  • Customer Service can take up lots of time when it's not done correctly, and there isn't a team that's dedicated to this area of business, so investing in outsourcing this task is a great idea. Customer service requires a specific skill set and area of expertise, so working with the right outsourcing partner will mean you'll get the peace of mind from knowing your customers are receiving quality service. 

  • Pharmacy Network Management  can be very complicated, so it's helpful to have a team of professionals that are dedicated to making sure your business excels in this area. From communication to coordination, it's essential to be clear with your new team about your expectations for network management. By being clear about your expectations, you can ensure everyone's on the same page and increase your chances of getting the results you're looking for. 

  • Responsiveness - If you don't have a team that's specifically dedicated to PBM, then you may not be able to provide a quick response time if customers need help in a certain area. This can decrease your retention rates and leave customers confused and unable to get the medications they need. 

  • Step Therapy Programs - Having efficient step therapy programs is important when it comes to making sure that patients get the medications that they need and that they get them when they need them. By having a PBM outsourcing provider who can focus on step therapy programs, you can be sure that customers are getting timely responses and that communication with insurance companies is being done efficiently. 

  • Patient Education - Did you know that PBMs can provide patient education? From getting prior authorization to dealing with rejected medication requests, PBM teams can communicate with patients and provide them with the education that they need to make informed decisions. 

    This benefit of hiring a PBM team is one of the many reasons why it's important to choose a provider that's experienced and understands the industry. They'll be communicating with clients, so it's essential that they provide them with accurate and reliable information. 

  • Emotional Considerations - Getting the right medications can be extremely stressful for patients, so PBM providers often need to have an empathetic and compassionate outlook. From dealing with patients who won’t be able to get their medications in time to coordinating with providers to get replacements, there are so many different ways that outsourcing can improve the patient experience.  

    By choosing a PBM outsourcing provider that understands the importance of the psychology behind the industry, you’ll be able to provide patients with a holistic experience that accounts for their comprehensive needs. 


Outsourcing Pharmacy Benefits Management 

Choosing to outsource pharmacy benefits management is a big decision, but it’s one that you likely won’t regret. There are so many different ways that quality PBM can improve the patient experience, including providing patients with timely responses, quality options, and continuing education. 

There are so many different ways that PBMs can improve the patient experience at your pharmacy, so consider if outsourcing could be the right option for your business.

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