New AIS Report Reveals PBM Contracting Loopholes

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New from Atlantic Information Services, 12 PBM Contracting Pitfalls Health Plans Should Avoid examines the loopholes some PBMs build into contracting language with health plans — and how to avoid them.

Atlantic Information Services, Inc. (AIS) is pleased to announce the publication of 12 PBM Contracting Pitfalls Health Plans Should Avoid, the latest addition to its Management Insight Series. The report provides health plans and employers with a “checklist” of items to guard against when negotiating pharmacy arrangements, and also includes a comprehensive listing of PBMs and their insurer clients, plus a collection of articles about PBM contracting strategies. The report examines issues such as:

  • How PBMs’ indirect revenue streams work, and how PBMs are likely to make money off of a health plan contract vs. an employer contract.
  • The key loopholes consultants have found when negotiating new PBM agreements on behalf of their payer clients.
  • How to incorporate suitable audit rights into an agreement to ensure that the PBM is delivering on pricing and service levels in line with the contract terms.
  • How a well-crafted market check provision can help a PBM deal remain competitive over time.

For more information on 12 PBM Contracting Pitfalls Health Plans Should Avoid, including a full table of contents, visit

AIS’s Management Insight Series is designed to provide practical solutions to complex business challenges with the help of the industry’s most insightful advisors and managers. See a full list of titles in this series at

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Jill Brown, Executive Editor
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since: 01/2011
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Atlantic Information Services, Inc.

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