How to Lower Prescription Drug Prices: Beyond PBMs to Complete Cost Control
Lowering prescription drug prices takes more than negotiating with PBMs. Self-funded employers can stack DPC, transparency, and direct contracting to control total spend.
Lowering prescription drug prices takes more than negotiating with PBMs. Self-funded employers can stack DPC, transparency, and direct contracting to control total spend.
A group captive lets like-sized employers pool risk, share data, and capture savings together. It’s the structural alternative to fully insured health insurance.
For most CFOs, healthcare costs now eat directly into profitability. This Roundstone leadership study shows where the spend goes and how to control it.
Healthcare cost containment finds waste, removes it, and keeps outcomes intact. Self-funded plans give you the claims data to do it at scale.
Self-funding gives you the control, claims visibility, and flexibility to attack the cost drivers that fully insured plans actively hide from view.
GLP-1 medications are reshaping employer drug spend. Here’s what self-funded employers should know about coverage, eligibility, and managing the cost impact.
A medical group captive is a self-funded health insurance model where employers share risk to gain stability, transparency, and buying power.
Employers using fully-insured pay a fixed premium for the carrier to take 100% of the risk and keep any profits. Captives allow employers to band together to control costs and receive refunds for better-than-expected claims.
Employers using level-funded pay a fixed monthly fee to cover administrative, claims, and stop-loss insurance expenses. Any surplus may be partially refunded at the carrier’s direction. With captives, you gain control—full data ownership, plan flexibility, and the ability to keep any savings.
Roundstone works with employers ranging in size from 25 to 1,000+ eligible employees.
Yes, with the right partners, transitioning to self-funding is easy. Roundstone assigns a dedicated Customer Outcomes Manager to guide clients through the process. Your third party administrator (TPA) then handles day-to-day administration and claims.
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