Gateway Health Partners: Unprecedented Expertise in Rebate and Formulary Management

Gateway Health Partners: Unprecedented Expertise in Rebate and Formulary Management

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Ashley Beatty, President, Gateway Health PartnersAshley Beatty, President, Gateway Health Partners
“Clarity Insights Expertise.”

This pithy, short, and precise tagline perfectly surmises the value proposition that Gateway Health Partners brings to the table. Operating as the largest independent provider of rebates and formulary management services in the US, Gateway draws on its rich experience to ‘develop the discipline and precision to navigate the ins and outs of custom formularies, negotiate lowest net cost solutions and maximize rebates—like pros.’

Indeed, it does. That deep-rooted knowledge of formulary and rebate management, combined with best-in-class service and lowest net cost, fueled by a unique “standalone” pharmaceutical purchasing model makes Gateway a formidable ally to pharmacy benefit managers, health plans, and employer groups.

Bridging a Gaping Void in the Market

When it comes to fulfilling the pharmacy management needs of PBMs, health plans, and employer groups, a host of providers offer varying competencies. While some focus on rebates and formulary and specialty pharmacy management, others excel at mail service management and retail pharmacy network. However, there is a common thread that often binds most of these providers: the lack of expertise to see every client and every situation in a new light and cater to their unique needs and go-to-market strategies.

For long, this ‘one-size-fits-all’ approach has plagued the pharmacy management realm. Hamstrung by such cookie-cutter solutions, PBMs, health plans, and employer groups struggled to have the right level of expertise that allowed the flexibility needed to quickly adjust to the market dynamics and create solutions and programs for their customers. These organizations did not have a choice until Gateway Health Partners came on the scene.

In the complex and confusing world of formulary and rebate management, Gateway is heeding the call, priding itself in enabling PBMs, health plans, and employer groups all over the country with all the core competencies for pharmacy management in a holistic offering. As a healthcare purchasing alliance, the company specializes in providing flexible, transparent, unbundled, à la carte prescription cost management solutions. “Our technology solution wraps all the aspects and elevates our clients in every situation that they approach us with. Gateway’s concierge service helps clients navigate through the complex pharmacy environment where one-size-fits-all does not prevail. We take a deep dive and understand our client’s needs and pain points to drive value and growth for them through quantitative services, tools, and technology. In doing so, we work as an extension of their organization, listening, researching, negotiating, and creating customized, tech-forward solutions to meet their needs,” says Ashley Beatty, President, Gateway Health Partners.

Unprecedented and Unmatched

As a true problem solver, Gateway is not just helping clients manage formularies and rebates but also making it exceedingly simple. “We work behind the scenes with our analytic tools to take the burden off of our clients and allow them to have a simple view of how a formulary and rebate management solution is going to be the best fit for them. The fact that we make it so much easier for our clients and provide that level of nimbleness is pretty unique in the industry,” informs Ashley.

As someone with more than 20 years of pharmacy benefit management experience, and extensive knowledge of negotiating and contracting with pharmaceutical companies and retail entities, Ashley hasn’t witnessed a situation or a client need that she could not solve or meet. Today, she leads her team with diverse healthcare and financial background to help clients expand their market and gain competitive advantages. Since its inception, Gateway has been approached by clients with diverse needs. For clients in need of supplemental clinical program support, Gateway employs a platform that defines different aspects of the pharmacy management ecosystem. The company also provides supplemental P&T support—Formularies Business Review Committee (FBRC)—allowing clients to come together and discuss different clinical initiatives and opportunities in the market. Ashley explains that Gateway deeply understands the clients’ needs within the specific markets they serve. Accordingly, the Gateway team helps them drive clinical programs and evaluate the ones that can improve their members’ health and outcome, while also bringing in overall savings.


The fact that we make it so much easier for our clients and provide that level of nimbleness is pretty unique in the industry

Benefits Galore

In essence, when it comes to pharmaceutical purchasing, decisions are fueled by Gateway’s analytical engine that delivers advanced data and ensures informed decision making. The company also supports its clients in customized reporting and pricing by offering custom quotes and tailored data to strengthen their RFPs. For clients bidding through an RFP process, Gateway digests the data pertaining to a particular bid, understands the unique business model and value proposition that the clients want to bring to the market. This is followed by providing insights into the data and recommendations around formulary or rebate management opportunities for that bid.

The impeccable benefits delivered by Gateway do not end here.

Besides its comprehensive consulting services, Gateway also presents its proprietary platform for clients who have direct contracts with pharmaceutical manufacturers. Gateway’s dynamic contract management analytical tool— ProOptimizer—allows users to automate their submission and drive compliance in regard to the contracts with pharmaceutical manufacturers. Accurately and efficiently administering pharmaceutical manufacturer arrangements, ProOptimizer adds clarity and provides insights into their contract management, using Gateway’s deep expertise, industry-wide relationships, large-scale volume positions,
and more. The flexible tool allows clients to derive value from the contracts by adhering to contractual parameters with their pharma agreement and establishes seamless integration with their other tools for analytics. Ashley adds, “We equip our clients with a software tool that allows them to not only avoid risks from a contract compliance perspective but also ensures that they get the best value out of the contracts that they have with their pharmaceutical manufacturers.”

Besides market check analysis and robust net cost modeling capabilities of the platform, users can also experience a more seamless invoicing and payment reporting process for their downstream clients. With the reconciliation reporting service feature, comprehensive reconciliation reports compare actuals to invoiced amounts with the ability to allocate payments to downstream customers. In a nutshell, Gateway’s platform takes the pain out of submissions and resubmissions for pharmaceutical manufacturer rebates and enables a faster implementation process with a significant ROI.

To illustrate more on its technology platform, Ashley cites a customer success story that involved health plans with direct contracts for pharmaceutical rebates. With their pharmacy rebates management in the doldrums, the client approached Gateway for its insights and expertise. Along the implementation process, the experts at Gateway walked the client through specifics of the tools and trained them to use the software. Gateway also provided additional formulary, P&T, and clinical program support that enabled the client to identify opportunities tied to the pharmaceutical manufacturer agreements and increase the value delivered to their customers. Post deployment of the platform, Gateway spotted that the client had several products that they did not have contracts for. To overcome this challenge, the company provided a supplemental product and service for those specific debatable formulary products that were not contracted. “Not only were we able to leverage our platform to drive automation contract adherence with their rebate submission, but also wrapped that with an additional value for the rebatable products that they did not have a direct contract for,” informs Ashley.

Nowhere to go but up

By staying true to its brand pillars, “Clarity. Insights . Expertise.” Gateway is successfully bringing clarity to the complex world of rebate and formulary management, industry insights in terms of opportunities and strategic planning, and then profound expertise around the overall pharmacy benefit management solution. Being the growth engine of its clients’ success, Gateway’s level of expertise and sound knowledge across all facets of the pharmacy management ecosystem is steering them ahead of the competition. By harnessing advanced technology with its suite of expert services, Gateway has added new dimensions to rebate and formulary management. Moving ahead, the company has no plans to slow down. The company also plans to launch an innovative self-serving, real-time data modeling and analytics tool to optimize customer experiences in the future.

If the last six years are an indicator, Gateway is the biggest independent provider of its kind. As an unsurpassed leader in formulary and rebate management services, Gateway is committed to reaching out to more clients and meeting their needs with its comprehensive services.

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Gateway Health Partners

Company
Gateway Health Partners

Headquarters
Pittsburgh, PA

Management
Ashley Beatty, President

Description
Gateway Health Partners (GHP) is a leading independent provider of rebates and formulary management services. Through various levels of P&T support ranging from drug detail support (monographs) to fully out-sourced administrations and multiple formulary options ranging from broad national to exclusionary-based, GHP generates the best outcomes for its clients. ProOptimizer, GHP’s dynamic contract management system technology, stores key contractual information, and provides a seamless invoicing experience for its customers by integrating customer databases. The robust tool conjointly analyses market demands and prepares a comprehensive net-cost modeling and reconciliation report. Through the effective implementation of its agile solutions and tools, GHP has become the growth engine of its client’s success