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Health Plan Market Drivers

Health plans are under increasing pressure to improve consumer health and lower costs in order to stay competitive in the marketplace.

To do this, they are looking for ways to better control their pharmacy spend while improving the effectiveness of clinical programs offered to members. Health plans seek a partner that will support the implementation of defined cost-containment strategies and clinical programs to meet their unique goals. 

We have proven success in working with health plan clients to improve their net return and make them more competitive.  

Today, many health plan clients believe that the traditional PBM business model is not flexible enough to meet their needs. They can routinely find themselves at odds with their PBM’s business objectives. informedRx is different. We create unique solutions for managed care organizations that promote their business objectives within their market. Our programs can be sized and adapted to effectively support and serve their strategies.  

We deliver the ability to take back control of pharmacy offerings

SXC delivers the key requirements to successfully manage pharmacy spend and contain costs. 

We recognize the need for health plans to control their pharmacy offering. For the large plans that currently have a staff of pharmacists and pharmacy benefit experts, SXC offers flexible services and technology that will support their in-house capabilities according to their objectives. For mid-sized health plans, that may have fewer internal resources, SXC typically provides a broader suite of solutions to support those strategies.

Our solutions and services for health plans include:

  • Pharmacy Benefit Administration
  • Network Management
  • Rebate/Formulary Administration
  • Pharmacy/Member Help Desk
  • Financial Management
  • Member Communication
  • Clinical Programs

SXC has the expertise and resources to meet the needs of the health plan marketplace. It is our exceptional flexibility, customization, and proven ability to adapt to individual health plan needs that set us apart. 

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