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Services | DiversityRX

Expert Guidance

As prescription drug programs undergo dramatic change and costs continue to rise, employers are taking a more strategic approach to their programs.

Participation in the DiversityRx Program gives our clients a champion charged with optimizing both member outcomes and pricing. Participation offers clients access to our team of expert consultants, with decades of experience in all aspects of prescription benefit programs, to guide them through any challenges they may face.

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PROGRAM DESIGN

DiversityRx ensures that plan sponsors retain the flexibility to design their program while leveraging all the benefits of proactive negotiations and group purchasing power. Our high-level objective is to ensure that members have access to the most cost-effective prescription drug benefits plan.

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Contract Evaluation

Our experts evaluate the terms and definitions of each contract to improve clarity and remove ambiguous language that increases  costs through pricing reconciliation terms. In addition, we review each contract for any potential conflicts between a client’s objectives and the contract terms.

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Clinical Assessment

Clinical Review and assessment is essential to optimizing savings and outcomes for plan sponsors and their participants. DiversityRx assists in the review of formulary selection, generic utilization, clinical program assessment and plan design. Our clinical pharmacist is available as a resource to plan sponsors seeking an independent review.

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Rebate Opportunity

Rebates offer an opportunity for an offset to the cost of brand medications when a brand drug is appropriate and a preferred medication is utilized. DiversityRx works to maximize this opportunity so that the bulk of rebate dollars are returned to the plan.

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Financial Provisions

Every contract contains nuances and language that can have a significant impact on cost. We conduct a thorough review of all financial provisions to prevent and eliminate hidden costs.

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OVERSIGHT AND MANAGEMENT

Participation in the DiversityRx Program offers members value beyond the best pricing. DiversityRx monitors both the financial and clinical aspects of each group. Plan sponsors know that with DiversityRx as their advocate, they are receiving all that has been negotiated on their behalf.

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Ongoing Program Support

Our ongoing utilization reviews, plan design evaluations, pharmacist access, and savings suggestions help both plans and members navigate the increasing complexities of the prescription pharmacy benefit marketplace.

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Claims Review

 DiversityRx reviews drug utilization to confirm that claims have been adjudicated properly, rebates and discounts applied appropriately, and all performance guarantees have been met. We also verify that co-pays and all other plan design parameters have been accurately applied.

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Specialty Drug Programs

Specialty drugs offer a tremendous quality of life opportunity for patients with complex and chronic illnesses. Our team works to ensure that these drugs are prescribed with the monitoring and management needed for appropriate utilization, helping patients get the right drug at the right time for the right cost.

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Reporting and Monitoring

DiversityRx reviews all PBM reports and program offerings for clinical and financial  appropriateness. It is our core philosophy that reports and programs should be aligned with clients’ objectives for cost savings while maximizing member experience through clinical outcomes and minimum service disruption.

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Diversity SL is a full-service, minority MGU that provides stop-loss services to both public and private organizations. Diversity SL has formed strategic partnerships with leading national insurance brokerage firms to become the minority partner of choice for firms seeking to work in the urban marketplace, government, or in other areas where diversity initiatives are of concern. DiversitySL is a certified Minority Business Enterprise and works as a strategic and vital partner.