Highlights
- Small to midsize businesses (SMBs) face challenges with rising prescription drug prices, leading to poor coverage and high cost-sharing for employees.
- Roundstone offers SMBs an innovative approach to managing drug costs with an employee benefits plan focused on flexibility, data transparency, and control.
- With strategies like clinical management guidance, employee education, and using a pass-through Pharmacy Benefits Manager, you can better control medication costs.
- Roundstone’s self-funding solution helps you lower prescription drug expenses through claims data tools that let you analyze pharmacy spending and implement cost containment measures.
In the U.S., small to midsize businesses face daunting challenges from rising prescription drug prices that negatively impact the health of their employees. About 60% of adults need at least one prescription, and 82% consider these drugs expensive. As a result, nearly 30% of adults sometimes skip doses or change their medication routines due to cost.
At Roundstone, we’re helping reduce the financial burden of prescription drugs on smaller companies’ health plans with an innovative, cost-effective approach: self-funded health insurance through our group medical captive. The Roundstone Captive provides flexibility, data transparency, and control, letting you effectively manage pharmacy spending.
We used this approach ourselves to save $32 per member each month on prescription medication costs, a notable difference from the national average. This amount is enough to cover all or close to all of your broker/advisor fees!
Embracing Flexibility in Employee Benefit Plans
Flexibility in healthcare, especially in managing prescription costs, is crucial for small to midsize businesses grappling with rising drug prices. In fact, 25% of these business owners view skyrocketing drug costs as their biggest barrier to offering good healthcare coverage for their employees — it’s one of the biggest reasons healthcare has become so expensive.
The Roundstone self-funded health insurance solution reduces pharmacy spending in company health plans by offering flexibility in key areas such as clinical management programs, employee education, and Pharmacy Benefit Managers (PBMs).
PBMs are intermediaries who negotiate drug prices and manage medication plans in a group health insurance plan. Roundstone’s approach allows you to choose from a variety of pass-through or transparent PBMs to find the most cost-effective and suitable option for your needs.
Adding tailored critical care management programs and in-depth employee benefits education can reinforce this cost-saving strategy. This promotes efficient medication use and informed healthcare decisions, further driving down overall costs.
Championing Transparency for Data-Driven Decisions in Company Healthcare
When managing your healthcare costs, you need to be able to see your claims data to track spending and plan usage. Unfortunately, traditional models typically don’t provide access to claims data, leaving you in the dark about where your healthcare dollars are going. This means you have less control over what you spend and can’t identify areas for improvement or cost-saving opportunities.
Roundstone’s group captive supports your cost management efforts by providing clear insights into your claims data through our CSI Dashboard. This innovative platform aggregates and organizes your healthcare data and offers analytical tools and customizable reporting options.
Your data provides clear, actionable cost containment solutions to further optimize the savings of your self-funded insurance plan.
With these capabilities, you can explore your data in-depth, understand specific spending trends, and identify key areas for cost savings. For example, data insights helped save Totem Solutions $6,000 in their first year on the plan, resulting in “lower-cost coverage, higher-quality care, and happier employees,” according to Geoff Rowson, senior vice president of sales.
Empowering Members with Control Over Their Employee Benefit Plans
Medication coverages are often tied to fixed formularies and standard prescription drug pricing models, giving you little control over costs or medication choices. Gaining control over aspects like choosing between brand-name drugs or more affordable generics and deciding on the extent of coverage for various medications can help manage these expenses.
Empowering businesses to take charge of their healthcare plans is a cornerstone of our philosophy at Roundstone. We emphasize the importance of allowing businesses to design their healthcare plans, including prescription coverage.
This control means you can tailor your plan to fit your needs and budget rather than being tied to a one-size-fits-all employee benefits plan. It’s a way of providing healthcare for your employees that’s both affordable and high quality.
We focus on practical ways to cut pharmacy costs, like encouraging the use of generics instead of costlier brand-name drugs. For instance, opting for a generic cholesterol medication like atorvastatin ($46.15 per month) versus brand-name Lipitor (up to $1,217 per month) can reduce member expenses.
Along with clinical management advice, your team can make smart prescription choices, ensuring savings and health benefits. This helps you control your healthcare spending more effectively for an economical healthcare plan.
The Impact of Roundstone’s Approach on Prescription Costs
Roundstone’s self-funded approach to managing prescription drug costs in a company health plan is helping employers lower their healthcare costs while simultaneously improving care quality. Our focus on flexibility, transparency, and control offers a practical solution to the challenge of rising healthcare expenses. This method goes beyond cost-cutting; it promotes smarter spending and improved medication access.
The following case studies highlight how this approach has been effective for businesses that have witnessed substantial savings and enhanced healthcare outcomes, demonstrating the real-world benefits of Roundstone’s innovative strategy.
A New Start Recovery Center
A New Start recovery center in Kentucky, led by CEO Tim Dukes, transitioned to a self-funded insurance plan to tackle rising healthcare costs and improve employee benefits. Here are the key results:
- Lower prescription drug prices through effective pharmacy benefits management.
- Lower deductibles and $0 copay for on-site care.
- Employee use of benefits rose by 6-7%.
- In-house doctor visits save time and improve care efficiency.
Read the case study here.
Roundstone
At Roundstone, we took our own advice and set up a self-funded group captive medical plan to help curb the rising cost of prescription drugs for our own employee health benefits.
Here is a snapshot of our results:
- We achieved a total of $1,132,950 in savings.
- We experienced a surplus when comparing actual versus expected costs over five years.
- There was no increase in employee contributions for eight consecutive years.
- Our employees’ raises went into their pockets instead of rising insurance costs.
Save on Prescription Drug Prices With Roundstone
By lowering your prescription drug costs, you can help provide better health benefits for your employees while maintaining your bottom line. With Roundstone’s self-funded insurance, you have the flexibility to design your own plan to minimize costs. You can readily access transparent data and implement cost containment strategies like using generics over brand-name medications.
Prescription drug prices are going up. Get control over your pharmacy spending in your employee benefits plan with Roundstone. Book a demo with a Roundstone representative today to start saving on the cost of your corporate health benefits.
