Cleveland, Ohio -- Health Action Council is pleased to announce the renewal of its partnerships with CVS Health and OptumRx, effective January 1, 2025, through December 31, 2027. These agreements are the result of a comprehensive request for proposal (RFP) process that included the collaboration of members, consultants, and staff. The resulting agreements deliver new programs, audits and reviews, and cost savings to members.
“We are excited to continue our partnerships with CVS Health and OptumRx,” said Patty Starr, President & CEO of Health Action Council. “These agreements underscore our commitment to providing exceptional value and support to our members, helping to create meaningful change within the healthcare industry and building a healthier, more productive workforce for today and tomorrow.”
Key Elements of the Agreements:
A new addition to both pharmacy programs is Poly-Pharma Management. A CVS or OptumRx clinical pharmacist will identify individuals taking five or more prescriptions, conduct a medication review and reach out to the prescribing physician to discuss de-prescribing. This helps decrease the number of adverse drug events, medical complications, and financial hardship.
Plan specific enhancements include:
CVS Health:
- Focus on Social Determinants of Health (SDoH): Health Action Council and CVS Health will pilot a SDoH program to increase access and adherence to non-Specialty drugs.
OptumRx:
- Rebate Hub which provides access to formulary utilization, transparency on rebate earnings, and performance forecasting.
- Specialty Standards & Review My Care Bundle which conducts outreach to providers and specialty patients to ensure efficacy of high-cost specialty drugs.
- Outreach Advanced Pharmacy Audit Services are conducted by clinical teams that audit chronic health condition protocols to ensure patients receive the right care at the right time.
Value to Members:
These agreements are designed to enhance value and support for organizations and their employees. Both of the Health Action Council pharmacy programs will continue to:
- Pass through 100% of rebates with minimum guarantees.
- Conduct annual audits with 100% of findings returned to plan sponsors.
- Track and measure contractual commitments quarterly.
- Perform independent clinical reviews of high-cost specialty medications.
- Offer complete transparency and visibility to all data within the PBM agreement.
The renewed partnerships provide value to employers by improving the quality, cost and value of pharmacy benefits and supporting a healthier workforce.
About Health Action Council
Health Action Council is a not-for-profit 501(c)(6) organization representing mid and large-size employers that enhances human and economic health through thought leadership, innovative services, and collaboration. It provides value to its members by facilitating projects that improve the quality and moderate the cost of healthcare purchased by its members for their employees, dependents, and retirees. Health Action Council also collaborates with key stakeholders - health plans, physicians, hospitals, and the pharmaceutical industry - to improve the quality and efficiency of healthcare in the community.