Why Medical Rebates Matter to Your Health Plan

This is the final installment of a three-part series by Sam Warman , Vice President at Gateway Health Partners on understanding and optimizing medical rebates.

Unlocking the Value of Medical Rebates

As the number of specialty medications utilized in a healthcare setting continues to grow, so does the need for strategies to control costs and optimize savings. This is where a quality medical rebates program can be beneficial. These programs work directly with manufacturers to ensure your plan receives rebates on eligible drugs, helping to lower the overall cost burden on the plan and its members.

 The Benefits of Medical Rebate Management at Gateway

With nearly 30 years of experience as a pharmacist, I’ve had the privilege of developing a comprehensive medical rebates program at Gateway Health Partners that helps clients maximize their returns on specialty medications administered under the medical benefit.[SW1]  Alongside a team of experts in their respective fields, our program handles everything from identifying opportunities to submitting rebate requests, ensuring that our clients don’t leave any cost-saving opportunities on the table and get the full benefit of the medical rebates they are entitled to.

 At Gateway, we help our clients optimize their medical rebates by offering the following:

• End-to-End Management: We manage your rebate program from start to finish to ensure no savings opportunity is missed.
• Flexible Solutions: We offer two medical rebate solutions to fit your needs and ensure you don’t leave money on the table.
• Comprehensive Analysis: We analyze your current medication utilization to optimize your rebate potential, ensuring you don’t leave money on the table.
• Maximizing Opportunities: As our volume of eligible products grows, so does yours. Our program applies rebates to all qualifying medications.
• Real-Time Monitoring: Our partnerships with manufacturers allow us to stay updated on changes and identify new rebate opportunities.
• Compliant Policies: If you don’t already have medical policies, we can provide them, ensuring compliance throughout the approval process.
• Customized Reporting: Comprehensive reporting that is customized to your business needs, including immediate feedback on claims errors and details on every paid claim.
• Rebate Submission and Recommendations: We handle all submissions and provide detailed recommendations on product eligibility, helping you get the most out of your rebate.

 As Our Program Grows, So Do Your Cost-Savings Opportunities

With the rising cost of specialty drugs, medical rebates offer the opportunity to find cost-saving opportunities for plan sponsors while still providing access to affordable and effective treatments. In 2019, Gateway Health Partners managed rebates for 29 products. Today, we have contracts to manage rebates on over 100 products—a number that continues to grow. As that number grows, so do our program offerings and solutions that we continue developing to help you better optimize and manage your savings opportunities.  

Contact us today at swarman@gatewayhealthpartners.com to learn more about navigating the world of medical rebates and our growing medical rebates program. We’d love to talk and help optimize your cost savings potential.