Pharmacy Benefit Management and Workers Comp Complete Guide
You need to provide certain things to attract the best employees to your business. A salary competitive with other companies in your field is vital. People need to make a living and want fair market value as compensation. A safe and comfortable work environment is also essential. This means emotional, intellectual, and physical security.
Employees also need benefits. Vacation, sick, and personal time off are necessary. Retirement and profit-sharing plans can also help with hiring excellent workers. Tuition reimbursement and opportunities for advancement are also desired by those looking for a career.
Health insurance is among the most important benefits a company can provide. Medical, dental, and vision plans for employees and their families will be greatly appreciated. Along those lines is workers’ compensation for employees hurt on the job.
Medication may be part of their treatment, and a pharmacy benefit management company can be helpful in that regard.
Pharmacy Benefit Management Companies
A pharmacy benefit management company can benefit employees on comp who require prescription drugs. Using one of the top PBMs as part of your workers’ compensation insurance is a brilliant idea for controlling medication costs.
A PBM is a third-party company that administers prescription drug programs on behalf of insurance providers. It can negotiate lower costs for prescription medications for wholesalers, pharmacies, and, most importantly, patients.
PBMs create lists of drugs called formularies. The medications on the list are covered under the insurance plan and allow patients to choose name-brand or lower-cost generic drugs of the same type.
Advantages of PBMs to Workers’ Compensation Insurance
Nearly three million workplace-related injuries or illnesses are reported each year. Employees who suffer from these incidents need compensation for medical costs and salary lost due to time off work. In many cases, prescription medications are a significant part of the treatment and recovery.
Co-pays and the cost of these drugs to insurance plans can be high. A PBM is beneficial for workers comp insurance and provides several advantages.
Lower Costs
Medications can be expensive, creating high insurance premiums for businesses and high co-pays for employees who use the insurance. PBMs negotiate for the best possible prices, saving employers and workers considerable amounts of money. With access to proper treatments, employees heal faster and can get back to work sooner, which is also helpful to a company’s bottom line.
Provide Quality Prescription Medications
Formularies allow PBMs and pharmacies to ensure that the medications that reach employees are effective in treating what they are prescribed. Generic substitutes can do the same things as name-brand drugs. Lower prices do not mean lower-quality medications.
Provide Access to Pharmacies
PBMs work with chains and local pharmacies across the nation. This ensures that patients can access the medications they need in their communities. Having to drive long distances can cause employees not to purchase the drugs their doctors prescribe, thus negatively impacting recovery. It also prevents them from buying medication online, which is risky.
Provide Management of Drug Utilization
Many injuries require prescription pain medications to allow patients to experience a pain-free recovery. These are potent drugs with side effects, and many are addictive. The misuse of prescription pain meds has spurred the opioid crisis.
PBMs work with reputable pharmacies. This ensures that patients have a doctor-written prescription and only get the medications on those prescriptions. It also ensures that they get no more than the prescribed amount and that only the authorized refills are distributed. This kind of security is essential to dealing with the crisis.
Pricing Transparency
Patients have access to formularies, either online or through their provider. This ensures that they can see the actual costs of the drugs. Transparency in pricing is ethical for employers, their workers, and pharmacies. PBMs provide this through the use of formularies.
Workers’ compensation insurance is one of the most important benefits a company can provide its employees. When a worker is injured on the job or becomes ill because of conditions at the place of employment, the company is responsible. PBMs help ensure employees get the medications they need at a reasonable cost to them and the employer.