Best-in-Class
In doing our Best-in-Class analysis, we focused on performance factors that are repeatable.
When we looked at top performers in our Book of Business (BOB), we found they had one characteristic in common: They take a proactive approach to pharmacy benefit management, relying on our analytics support to help them model and project how plan design changes will impact their future results. They consistently make the most of market opportunities and proactively engage plan participants to help them reach their goals.
Of course, every plan’s situation is unique, and every Best-in-Class solution may not be appropriate for a specific plan. Factors such as population demographics; geographic variations in health behaviors, medical care and physician practice; member health and plan goals have a profound impact on performance. Our goal with Best-in-Class analysis is to bring you actionable information. We eliminated plans with significant changes in eligibility year over year and those which had other factors that uniquely affected plan performance.
How We Determined Best-in-Class
- Included in BOB trend cohort group.
- Trend ranging from zero to 10 percent PMPM.
- Must have more than 10,000 lives and 50,000 annual claims.
- Excluded mail-only clients and those with negative trend.
- For metrics other than trend, such as GDR, Best-in-Class clients perform in the top 10 percent of the specified metric.