Everise Insights

Transforming Healthcare Delivery: The Power of BPO in Pharmacy Benefits Management

Written by Everise | Aug 16, 2023

Pharmacy benefits management (PBM) is a fundamental part of the daily operations of many pharmacies, allowing them to operate efficiently and improve the patient experience. Learning more about PBM is an excellent way to understand your pharmacy’s needs and if outsourcing could be the right option for you. 

 

Pharmacy Benefits Management 

Pharmacy benefits management is an umbrella term for various tasks that allow pharmacies to operate well, ensure compliance, and provide their patients with the best experience possible. Some pharmacies handle PBM internally, while others outsource this area to a company like Everise. 

Managing pharmacy benefits is a large job.  

From coordinating with physicians to communicating with insurance companies and providing patients with information, many different things must be accomplished when an internal team deals with PBM. Because of these complexities for internal teams, some pharmacies choose outsourcing. 

Business process outsourcing (BPO) allows pharmacies to work with an experienced team who can take over their PBM and ensure quality. When a pharmacy chooses to outsource PBM, its internal team can focus on other priorities, and its outsourced staff can work to improve areas of the pharmacy that may have yet to get attention. 

From saving time to reducing costs and implementing revolutionary procedures, various benefits can come from outsourcing PBM. 

 

The Benefits of BPO in PBM 

As we mentioned, outsourcing PBM can be an excellent way to improve the operations of your pharmacy and ensure that patients get the best experience possible. Many executives need to realize how many benefits can come from outsourcing PBM, so let's go over a few benefits worth noting. 

Improved Efficiency 

When PBM isn't done correctly, it can waste time and overwhelm your staff. By hiring an experienced team, you can be sure that your operations will be done efficiently and streamlined. 

One of the most significant benefits of outsourcing is choosing a team with years of experience. This means you won’t have to worry about micromanaging and can trust that everything will run smoothly. 

Reduced Costs 

Along with efficiency comes reduced costs. It’s simple: less time spent on tasks means less money paid for those tasks. 

With the rise of value-based healthcare, organizations are being pressured to find ways to reduce costs without sacrificing quality. Outsourcing can be an ideal way to do this, as it can streamline operations. 

Many people need to realize that outsourcing could save them money, but it definitely can. If your budget is tightening, this might be the right time to consider outsourcing. 

Specialized Expertise 

Training internal staff to complete PBM tasks correctly can not only be expensive, but it's also often time-consuming. One of the most significant benefits of outsourcing is that the staff will already be trained and can get right to work. 

Being able to rely on a team of experts can provide you with peace of mind and the assurance that you're staying within compliance regulations (but more on that later). 

Core Competencies 

When you outsource, you can free up internal resources to focus on core competencies. 

Freeing your internal staff to focus on specialized tasks can benefit them and your pharmacy in general. If you're considering outsourcing, take some time to view the other functions your team could complete if they had the opportunity. 

Compliance 

Compliance is an essential component of the pharmacy operations discussion. Within the healthcare field, regulations are constantly being created, and it can be challenging to stay updated on them. When you outsource, your new team can ensure that you remain aligned with all compliance standards, so you don't have to worry about your business being at risk. 

There are so many different benefits that can come from working with an experienced team, but ensuring you're within all regulations is essential and one of the most notable reasons to outsource. 

Enhance Patient Care 

With so many things needing to be done around a pharmacy, it's easy for patient care to be forgotten. However, focusing on patient care is one of the most ways to improve your retention rate and ensure that you provide the best service possible. 

Outsourcing this area of tasks can be extremely helpful because there are so many things that need to be done in the patient care category. 

At Everise, we emphasize providing the best patient care possible to our clients. From providing information to pharmacy clients to educating them about medication adherence and dealing with formulary inquiries, we offer many different services to improve patient care. 

 

How to Choose a BPO Partner for PBM

If you outsource PBM, you may be slightly overwhelmed at the thought of selecting the right BPO partner. Because the BPO partner you choose will determine the quality of work you receive, this decision should be made mindfully. 

Below are a few different things to consider while you’re in the process of choosing a BPO partner. 

Your Organization’s Needs 

One of the first things you should consider when choosing a BPO partner is the size and scope of your organization’s pharmacy benefits management.   

Are you looking for an outsourcing partner to take over one or two tasks while your internal team takes care of the rest? Do you want a partner to run all of your PBM entirely? Answering these questions is an excellent way to ensure you're on the right track. 

A clear understanding of your pharmacy's needs is essential, and it's a good idea to think about this before vetting potential partners. Once you know the tasks you'd like to delegate, you can quickly speak with potential partners and be clear about what you want. 

You must be transparent and direct about your needs, so potential partners can know if they can fulfill them. Be bold and ask questions when speaking with potential partners and ensure you clearly understand the exact services they would provide. 

Experience and Expertise 

When you choose the right BPO partner, they can provide you with testimonials and case studies that speak to the success of their past work. If a partner can’t give examples of their work, that may be a sign that they’re not the right choice. 

One of the reasons why it’s helpful to know what tasks you want to outsource is that you’ll be able to find a partner with experience in those areas. 

 

Outsourcing PBM 

Choosing to outsource PBM is a decision that could save your pharmacy time and money. Not only can outsourcing improve the efficiency of your organization, but it can also help you stay updated on current regulations and ensure that your business aligns with all necessary compliance standards. 

If you’re curious about your outsourcing options, feel free to contact our team, and we’d be happy to provide you with further information about our outsourcing solutions.