Strategic Outcomes
We’re excited to share some examples of successful outcomes we've achieved for our clients.
Pharmacy Contract Management
Situation
Solution
Outcome
Situation out pharmacy. Client was placed in a 3 year contract with early termination fees and a 90% rebate share. Yates won the BOR on a large self-funded client with carved
Client was approaching the 2nd year of the contract. We reviewed and analyzed the pharmacy AWPs, rebate share and contract terms.
Yates moved the client to a one year contract and eliminated early termination fees, improved AWPs in all categories and improved rebate shares.
Stop Loss Analysis
Situation
Solution
Outcome
Yates conducted a Stop Loss analysis by reviewing historical claims for frequency and severity. We compared the savings of lowered stop loss premiums to the increased out of pocket expenses for a higher Specific Deductible.
Client is considering increasing their specific deductible liability. The client’s concern is balancing risk versus potential cost savings from lowering their stop loss premiums.
Based on the results of the Stop Loss analysis, the client was able to make an informed decision to reduce their stop loss premiums by increasing their specific deductible.
Wellness & Point Solution Support
Situation
Solution
Outcome
Our team implemented a program to improve adherence to medication and care standards, as well as, provide
Employees with diabetes experience better disease management, fewer complications, and improved quality of life due to regular monitoring, education, and personalized care. The employer also achieved cost savings.
After review of our Client’s claim utilization, there is a prevalence of diabetes among the group's membership. The rise in cost is affecting the health plan cost and the goal is to improve health outcomes.
lifestyle and behavioral support for their diabetic population.
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