SmithRx’s Post

Most people have no idea who their pharmacy benefits manager (PBM) is—but almost everyone has one. PBMs manage prescription drug benefits for over 275 million Americans, and in 2023, 80% of all U.S. prescription claims were processed by just three companies: Cigna’s Express Scripts, UnitedHealth’s OptumRx, and CVS Caremark. These giants have built an oligopoly, and the market is finally pushing for a shakeup. This is where Rightway comes in. We’re tackling the PBM industry's biggest issues head-on with an aligned, pass-through model that puts transparency and the needs of employers and employees first. Our CEO, Jordan Feldman, sums it up: "CVS is a failed healthcare vertical integration... extracting maximum profitability at the expense of employers and employees." I’ve been proud to help shape Rightway’s strategy and operations as Chief of Staff, and now I’m excited to join the commercial operations team to continue driving our innovation forward. Change is coming, and I’m ready to be part of it. #HealthcareInnovation #PBMRevolution #ProudToBeRightway #Rightway

Prescription prices surged faster than inflation between 2006 and 2020, with PBMs accounting for 30-40% of healthcare spend. In the recent Fortune feature, Rightway CEO and Co-Founder Jordan Feldman notes, “As we pull back the curtain, we uncover significant flaws, misaligned incentives, and challenges in the current ecosystem.” Rightway is fixing the industry's inherent flaws—aligning with employers and using every strategy to reduce pharmacy costs. From formulary design to the complete refusal to own any parts of the supply chain, Rightway is at the forefront of a new wave of PBMs shaking up the industry. #pharmacybenefits #pbm #pharmacy #healthcare #rightway #benefits

🌟 2-Minute Overview: PBM Reform Explained 🌟 Pharmacy Benefit Managers (PBMs) play a critical role in managing prescription drug benefits, but the traditional model has raised serious concerns for healthcare organizations and employers alike. At Wellyfe, we’re leading the charge for PBM reform with a focus on transparency, innovation, and putting patients first. 🔍 What’s the Problem with Traditional PBMs? The current PBM landscape often prioritizes profit over care, creating challenges for healthcare entities, employers, and patients: Hidden Fees and Spread Pricing: Costs are often inflated, leaving organizations in the dark about true pricing. Opaque Rebate Structures: Employers and patients rarely see the savings from manufacturer rebates. Misaligned Incentives: PBMs profit from higher drug costs rather than finding ways to reduce them. 💡 Wellyfe’s Solution: The Direct Pharmacy Care Model Our approach is built to disrupt the traditional PBM framework and bring clarity and value back to pharmacy benefits. Here’s how we do it: ✔️ Transparent Pricing: No hidden fees or spread pricing—just clear and honest cost structures. ✔️ Rebate Alignment: We ensure rebates are passed back to employers, directly benefiting your bottom line. ✔️ Tailored Cost-Saving Strategies: Customized solutions that meet the unique needs of your organization. ✔️ Better Patient Outcomes: By focusing on cost-effective care and medication adherence, we prioritize patient health. 📊 Why PBM Reform Matters in 2025 and Beyond With the rising costs of specialty medications, increased regulatory scrutiny, and a growing demand for cost-effective healthcare solutions, reform isn’t optional—it’s necessary. By embracing transparency and innovation, healthcare organizations and employers can: Save millions annually on prescription costs. Enhance employee satisfaction through better benefits. Improve health outcomes with aligned incentives and patient-focused care. 💬 Why Choose Wellyfe? At Wellyfe, we specialize in helping healthcare entities and employers navigate the complexities of pharmacy benefits. Our Direct Pharmacy Care Model delivers: 1.Real savings you can measure. 2.Sustainable solutions that grow with your needs. 3.A transparent partnership focused on your success. Let’s transform how you manage pharmacy benefits. Reach out to Wellyfe today and discover how PBM reform can create a lasting impact for your organization. #PBMReform #DirectPharmacyCare #Wellyfe #PharmacyBenefits #HealthcareInnovation #CostSavings #Transparency #BetterOutcomes

💊 Pharmacy costs are skyrocketing, but they don't have to break your benefits plan. Understanding the four key drivers—Price, Product Mix, Utilization, and Cost Share—is essential to controlling spend without sacrificing outcomes. 🏥 Partnering with a fiduciary PBM ensures transparency, aligns incentives, and puts your plan’s best interests first. Don’t let hidden markups and inefficiencies derail your goals! 🚀 #EmployeeBenefits #PharmacyCosts #PBM #HealthcareSavings #FiduciaryModel #TransparentRx 🌟

💊 Pharmacy costs are skyrocketing, but they don't have to break your benefits plan. Understanding the four key drivers—Price, Product Mix, Utilization, and Cost Share—is essential to controlling spend without sacrificing outcomes. 🏥 Partnering with a fiduciary PBM ensures transparency, aligns incentives, and puts your plan’s best interests first. Don’t let hidden markups and inefficiencies derail your goals! 🚀 #EmployeeBenefits #PharmacyCosts #PBM #HealthcareSavings #FiduciaryModel #TransparentRx 🌟

💊 Pharmacy costs are skyrocketing, but they don't have to break your benefits plan. Understanding the four key drivers—Price, Product Mix, Utilization, and Cost Share—is essential to controlling spend without sacrificing outcomes. 🏥 Partnering with a fiduciary PBM ensures transparency, aligns incentives, and puts your plan’s best interests first. Don’t let hidden markups and inefficiencies derail your goals! 🚀 #EmployeeBenefits #PharmacyCosts #PBM #HealthcareSavings #FiduciaryModel #TransparentRx 🌟

💊 Pharmacy costs are skyrocketing, but they don't have to break your benefits plan. Understanding the four key drivers—Price, Product Mix, Utilization, and Cost Share—is essential to controlling spend without sacrificing outcomes. 🏥 Partnering with a fiduciary PBM ensures transparency, aligns incentives, and puts your plan’s best interests first. Don’t let hidden markups and inefficiencies derail your goals! 🚀 #EmployeeBenefits #PharmacyCosts #PBM #HealthcareSavings #FiduciaryModel #TransparentRx 🌟

When discussing Pharmacy Benefit Managers (PBMs) with your broker, it is critical to ask specific and intricate questions to ensure that everything aligns with your organizational goals and provides value in managing prescription drug benefits. Doing so will allow you to better comprehend PBM's practices, negotiate more effectively, and ultimately enhance the health and well-being of your workforce while controlling costs. https://lnkd.in/gSSBKvTP

As you assess your organization’s needs and pharmacy benefit management (PBM) options, asking the right questions is essential to ensure your team receives the benefits they deserve. Discover key considerations in the article to guide your decisions amid today’s PBM challenges. #Benefits #Pharmacy #EmployeeBenefits

As you assess your organization’s needs and pharmacy benefit management (PBM) options, asking the right questions is essential to ensure your team receives the benefits they deserve. Discover key considerations in the article to guide your decisions amid today’s PBM challenges. #Benefits #Pharmacy #EmployeeBenefits