US-Rx Care, a leader in pharmacy benefits management, has set a new standard in the industry. With the help of the Validation Institute, the company has proven its commitment to transparency and cost savings. This collaboration underscores their dedication to delivering effective and fiduciary-compliant services.
Key Insights on US-RxCare’s Impact in Pharmacy Benefits Management
- US-Rx Care stands out in the pharmacy benefits management industry by not originating from the traditional PBM environment. Instead, their roots in health plan management help them focus on true risk management.
- The company emphasizes a fiduciary duty, which includes transparency, acting in the best interests of the plan participants, and ensuring full visibility of financial and utilization data. This approach minimizes conflicts of interest and promotes trust.
- Validation Institute has played a crucial role in affirming US-Rx Care’s commitment to transparency and their ability to generate savings. This external validation is key in distinguishing them from competitors in the PBM market.
- By focusing on obtaining the correct medication and purchasing it at the lowest available price, US-Rx Care ensures high clinical rigor and cost efficiency. Their method significantly reduces wasteful spending, benefiting both employers and individuals.
Validation Institute:
Today I’m joined by Renzo Luzadi, president of US-Rx Care. Welcome Renzo and thank you for being here.
Renzo Luzadi:
Thanks, it’s a pleasure.
Unveiling US-Rx Care’s Unique Approach in Pharmacy Benefits Management
Validation Institute:
Just so everyone knows a little bit about US-Rx Care, you are a pharmacy benefits risk management company devoted to helping employers and individuals save money on their prescription drugs.
At the moment, many employers do not realize the amount of wasteful spending that is occurring on prescription drugs and the annual increases do not need to happen.
So let’s jump in and learn more about this and hopefully help many of the companies that are out there listening today.
Renzo, can you provide us a brief introduction to US-Rx Care and touch on what makes you unique in the pharmacy benefits industry?
Renzo Luzadi:
Sure, I’d be happy to and thanks for this opportunity. We are unique in that we are not a product of the PBM industry; we actually grew up in the health plan space.
Think of a director of pharmacy at Humana, for example, or Blue Cross Blue Shield, there’s Centene back in the day when they had two million Medicare, Medicaid, and commercial lives.
That’s where we cut our teeth managing pharmacy risk for at-risk health plans. It’s a very different environment than the traditional PBM model, particularly for self-funded employers where PBM is administering risk.
Unfortunately, it has developed conflicts of interest over time that don’t necessarily serve the best interests of the client.
We come at it from a risk management perspective and we took all the learnings from over two decades of managing risk for health plans and brought it to the self-funding marketplace so that they get the same clinical rigor and fiscal responsibility that they expect out of a benefit manager for their self-funded frankly at risk account.
How US-Rx Care’s Commitment to Transparency Drives Client Savings
Validation Institute:
The Validation Institute recently awarded US-Rx Care two validations for your ability to save employers money and your commitment to transparency. Can you talk more about how this commitment to transparency is translated into savings for your clients?
Renzo Luzadi:
Yes, and we’re proud that we were validated on transparency as you mentioned and savings, and we actually kick it up a notch in that we are committed to upholding and adhering to fiduciary standards. Part of fiduciary is transparency, right? And that’s important.
I’ve been in this business 30 years and I’ve been talking about transparency, and we’re still talking about it, right? We have clients that have a difficult time getting data out of their previous carriers even though that’s the law of the land now with the Consolidated Appropriations Act, right? So that was a start, but you know we have a ways to go.
But in terms of fiduciary, there are three components to a fiduciary under ERISA: one is no conflicts of interest, number two is only looking out for the best interests of the plan and the plan participants, and number three is all financial and utilization information is in full view, so transparency.
Transparency is one of three legs under the umbrella of fiduciary so we make a fiduciary commitment, we put it in our contract which means that number one, no conflicts of interest, so all the things that give individuals heartburn about their PBM don’t exist in this organization, and as a result, when you take all the shackles away you focus on two things: clinical rigor, getting the drug right, and number two buying at the lowest available price. So our mission as an organization is to deliver needed medication therapy at the lowest available cost.
Why US-Rx Care Chose Validation to Cut Through Industry Noise
Validation Institute:
Oh that’s awesome and you know we were very excited to have the opportunity to look at the numbers and see what you did there but can I ask why did you engage Validation Institute to take a look at the organization?
Renzo Luzadi:
Yeah very important, first of all, you’ve established a good name in the marketplace, congratulations, and there’s so much noise particularly in the PBM space, maybe on the carrier side too, but in the PBM space, there’s so many promises made and not kept, right?
You know, and I think of every time an organization goes to an RFP, they get all these promises for discounts and savings and additional rebates, you know for organizations that go through an annual market check, their cost for their pharmacy benefits should be zero by now because they’ve discounted it so many times, right? And that’s not the case.
Why is that? That’s another subject for another time but cutting through the noise, right? So being validated by an independent third party such as the Validation Institute was really important for us, it’s not us just saying that we’re effective and we’re cutting costs in half for example, we have the Validation Institute that took a look at our savings and validated and that’s really valuable.
Validation Institute:
Well, thank you and this has been all amazing information Renzo and thank you for being here today. If any of you are looking to learn more about US-Rx Care, I encourage you to go to validationinstitute.com and read the validation reports. I hope you all have a great day, thank you again Renzo,
Renzo Luzadi:
Thank you so much, take care.
