Looking to partner with a vendor to help your plan sponsor clients?  

We are uniquely experienced to help!

About Us

PBM Partnering

For those PBMs who have fully explored the new Drug Cost Reporting Requirements, you are likely aware that as a PBM you do not have access to all the data necessary to report.  Specifically, you lack the data necessary to complete the plan level files (possibly) as well as data files 1 & 2. As we consult our PBM clients, this often comes as a surprise.

This creates a precarious situation for PBMs as the marketplace is under the impression that you ‘have it all covered‘ since, after all, this is supposed to be Drug Cost reporting.  In reality, PBMs have a complex set of questions to consider in determining their optimal strategy.  In the end, most will likely decide not to report on behalf of plan sponsors.

This creates a very challenging set of circumstances for the PBM to consider their options and not create a bottleneck on their portion of the reporting.  It was for this reason we developed solutions to:

    • Consult PBMs through understanding their options and develop their strategy
    • Assist with data configuration through our relationship with SelfInsuredReporting.com
    • Work directly with plan sponsors to service their questions and capture the information necessary to complete the TPA portion of reporting
    • Launch our proprietary software and processes to assist all parties through the process
    • Service plan sponsors and their brokers on an ongoing basis as questions or audits arise

One of our main goals for PBM clients is to ensure you aren’t blamed for not completing the reporting when in reality you control only a portion of the data for this entire requirement. 

Contact us for more information.


About Us

Healthcare Reporting was founded in 2015 to address new compliance regulations required under the Affordable Care Act.  Over the years the compliance burden has continued to grow and our organization has evolved to meet the needs of our clients and partners.  Our solutions have been developed from the collective wisdom of dozens of healthcare professionals who have worked in a myriad of different roles across the entire healthcare delivery system. 

Learn more