Pharmacy benefit managers (PBMs)

Pharmacy benefit managers (PBMs)

Looking and going deeper to advance pharmacy benefit management.

Pharmacy benefit managers (PBMs)

Looking and going deeper to advance pharmacy benefit management.

Working together to enhance quality of care while containing costs

The environment for PBMs continues to be challenging. Member and payer expectations are changing. EXL Health works with you to find ways to transform operations that reduce overall expenditures, improve pharmacy network performance, and ensure that members receive the best care possible.

Featured insights
EXL addresses your entire value chain to identify strengths, weaknesses, gaps, and opportunities, so you can achieve healthy operations, end-to-end, quickly and efficiently.
In a lean economy, where healthcare costs are rising alongside ever-tightening global spending trends, pharmacy benefits managers (PBMs) are looking for innovative ways to preserve margins, control costs, and differentiate themselves in a highly competitive marketplace. It’s not an easy task. Especially for an industry that has long been slow to innovate.
A leading healthcare organization was looking to improve its provider-focused contact center operations for precertification processing. EXL recommended our AI solution EXELIA.AI™and trained it to be able to instantly solve pre-certification queries using next-generation natural language processing and contextual understanding. EXL received a nine-out-of-ten score on implementation, performance, and ability to successfully deliver customer experience trans...
Client reporting is often a race to mediocracy for pharmacy and PBM organizations. Reports are often manually curated and extremely dense, which can lead to high costs and stretch limited internal resources.
Legacy PBM and pharmacy client reporting systems often lack structure, capability, and efficiency. Reports are dense, hard to navigate, and provide minimal value to the client. It’s not uncommon for reports to be dozens pages, with the information difficult to digest and lacking clarity on client recommendations.