Due to technicalities in contracts, the healthcare delivery system can be complex and confusing for an organization to understand. This often results in an additional cost burden. Having a clear understanding of the contracts with the drug manufacturers can help health plans, employers, and PBMs save significantly on their spending. However, figuring out the details can be tricky.
Clients require a level of service and support that helps them to make informed decisions to achieve their healthcare and financial goals. Having an expert solution to manage the formulary and to know which drugs come under rebates and which do not can enable companies to make suitable calculations to make the right decisions as and when needed.
One specialist company that simplifies the world of pharmacy management for organizations is Gateway Health Partners. The company leverages its expertise to help clients navigate the complicated world of pharmacy management by offering flexible solutions that save clients’ money.
Established in 2014, GHP has been effectively providing clarity, insights and expertise to manage the complexities of pharmacy management, to help clients save costs and make informed decisions on time.
Gateway Health Partners is the largest independent provider of rebates and formulary management services in the United States. GHP provides flexible, transparent, unbundled, à la carte prescription cost management solutions for rebates and retail pharmacy networks.
As an expert leader in the pharmacy industry, Ashley D. Beatty, President of GHP, is committed to always providing best-in-class solutions and an exceptional customer experience.
In the following extract, we will explore more about GHP’s journey, its healthcare delivery system simplification solutions, and much more.
Offering True Flexibility, Saving Costs
Founded by PBM executives, Gateway Health Partners is the largest independent provider of formulary and rebate management services.
More often than not, organizations seeking formulary and rebate management services quickly realize how complex and confusing it can be. Most organizations lack the expertise and insights to become key competitors in the marketplace and don’t have the flexibility that is necessary to quickly create real-time solutions and programs.
To deal with these complexities effectively, GHP was established. “Gateway Health Partners was started with the recognition of a need for true flexibility and transparency,” Ashley told us.
Furthermore, speaking about the mission statement of the company, Ashley says, “At Gateway Health Partners, our mission is to make formulary and rebate management simpler by creating solutions that are flexible and customizable to our client’s needs.”
The major benefit Gateway Health Partners offers to its clients is cost containment. The company covers the full spectrum of pharmacy spending: Commercial, Medicare and Medicaid. Ashley elaborates, “Our solutions span everything from pricing strategies, underwriting, marketplace trends and competitive intelligence to developing unique go-to-market strategies and business plans.”
The company works with PBMs, Health Plans and Employer Groups all over the country – listening, researching, negotiating and creating customized, tech-forward solutions to help save its clients’ money.
Below are some of the proven success stories of GHP in significantly helping clients save on costs.
Health Plans – who managed their direct contracts but were leaving at least 20% of their utilization with zero rebate contracts. Gateway was able to provide a wrap solution. In some cases, the client is now submitting all claims through Gateway contracts after seeing the additional savings using the company’s solutions. One client has Gateway managing their direct contracts and submitting the top two rebate-able contracts, and the other has a custom wrap contract and is now receiving 100% eligible rebates.
Mid-level market PBM – A PBM client was working with GHP but left after a new organization arrived in the market and promised them unrealistic pricing guarantees. After receiving their first few payments that did not match the promised guarantees, they returned to GHP, as they knew they could always count on Gateway’s commitment to providing the agreed-upon contract rate.
Helping Clients Make Informed Decisions
As with many parts of the healthcare delivery system, the space in which GHP operates can be opaque and overwhelming. To compound the problem, clients have often told the company’s team that “they have historically not received the level of service and support that is required to make informed decisions in order to best achieve their healthcare and financial goals,” says Ashley.
GHP has set out to change this system and is working ahead to become a true partner for its clients. Ashley underlines, “We strive every day to execute on our company’s core values of delivering Clarity, Insights, and Expertise to our clients.”
Further discussing the company’s culture, Ashley shares, “We set out to build the best team of experts who know the business well and share a passion that reflects our ‘customer first’ culture.”
Gateway Health Partners utilizes its experts and technology to cut through all the noise and combines that with its high-touch service model to ensure that clients have exactly the information they need to make the right decisions.
Customized Technology Solutions
Gateway Health Partners continues to look for new ways to leverage tech-inspired solutions that help its clients, from underwriting and pricing, to contract and utilization management, to network pharmacies. These solutions uncover insights, and create ideas for clients to improve pharmacy management for their members.
Gateway’s dynamic contract management analytical tool—ProOptimizer—allows users to automate their submission and drive compliance in regard to 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 providing seamless integration with other analytics tools. Along with rebate submission, the user can also manage the payments and reporting while monitoring the reconciliation functionality and downstream client impact within a single, sophisticated system.
Additionally, Gateway’s pharmacy network solution, NetOptimizerRx, is the next generation of network management services. It uses the best of technological advances and GHP’s years of expertise to optimize clients’ current pharmacy networks as well as provide data analytics that focuses on contract management.
Highlighting the essence of technology for the company in its solutions, Ashley says, “Technology drives our innovation to provide analytics and business intelligence, MAC management, data blending, and geospatial automation.”
Furthermore, she adds, “GHP brings pharmacy network expertise and analytics with concierge services.”
Primary Goals for 2022 and Beyond
Talking about the company’s path ahead in 2022 and beyond, Ashley says, “Great customer service and making complex things simple are the primary goals of Gateway Health Partners.”
GHP values its clients and wants to keep providing them with the best solutions and service experience possible. Ashley and her team are proud to deliver on the client’s expectations time and time again. She says, “We take pride in our ability to work with clients to collectively create customized, flexible options that create greater savings. We also take pride in the partnerships we have with our clients.”
“We want to facilitate more transparency and predictability as we become a growth engine for our clients,” she added.
The Experienced Leader
Ashley has more than 20 years of pharmacy benefit management experience, with extensive knowledge of negotiating and contracting with pharmaceutical companies and retail entities. She has led numerous operational activities, including pharmacy analytics, pricing management, operations, and product development.
Prior to joining Gateway, Ashley served as chief innovation & network services officer at Prime Therapeutics, where she led network management; product development and innovation; applied analytics; and pharmacy audit and fraud, waste & abuse.
Ashley previously led the consulting business strategy and audit services teams for Pharmaceutical Strategies Group. Prior to that, she spent ten years at Catamaran as vice president of industry relations, where she led network innovations such as managed discount cards, incentive-based plan designs, and restricted networks.
Ashley oversaw pharmacy network operations, industry relations, pricing analytics, pharmacy network reporting, network contracting, network financial reporting, cost of goods M&A due diligence, and network gross profit forecasting during her me at Catamaran.
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