Technology Solutions Help Clients Better Manage Pharmacy Benefits

Technology Solutions Help Clients Better Manage Pharmacy Benefits

Maren Phillips, VP, Growth Initiatives, Gateway Health PartnersMaren Phillips, VP, Growth Initiatives, Gateway Health Partners
At Gateway Health Partners, we set out to make the complex, confusing world of formulary and rebate management less complex and confusing. Making life simpler for our clients is our number one priority. As we work with PBMs, Health Plans and Employer Groups all over the country, we listen, negotiate, and research ways to customize tech-forward solutions that will help them meet the needs of their clients and to save money for their membership.

Gateway Health Partners continues to look for new ways to leverage tech-inspired solutions that help our clients, from underwriting and pricing, to contract and utilization management. These solutions uncover insights and create ideas for clients to improve pharmacy management for their members.

Gateway’s ProOptimizer tool is an example of how Gateway is helping clients to accurately and efficiently administer pharmaceutical manufacturer rebate agreements. The ProOptimizer platform calculates drug rebate contract agreements while also providing financial reconciliation for internal finance and underwriting teams.

Features of ProOptimizer include:

- Manages contract criteria: Stores all key contractual information, including the ability to support various calculation methodologies.
- Produces manufacturer invoices: Invoices are generated using the terms of the clients’ negotiated agreements and claim utilization on a monthly or quarterly basis. Supporting both current and legacy NCPDP standard files
- Data Analytics: Robust data collection and detailed reporting.
- Expert support and guidance: Provides supporting resources to guide contract management and invoice processing.

ProOptimizer’s functionality was expanded last year to allow for Gateway internal teams to manage rebate operations such as aggregator invoicing, inbound receipts, and client payment processing. Platform adopters can take advantage of this new innovative functionality to provide reconciliation of finance activities to downstream clients.

Gateway’s pharmacy network solution, the NetOptimizerRx, is the next generation of network management services for our clients. The NetOptimizerRx leverages Gateway’s years of expertise by providing consulting services that optimizes a client’s current network and robust data analytics focusing on contract management for pharmacy and clients. The concierge of services provides pricing management for MAC – automated algorithmic model, data blending, analytics and business intelligence, and geospatial automation.

Simply put, in every situation we bring clarity, insight and expertise. At Gateway, we understand that it’s through technology that we can continue to bring the best value to our customers.