PBM Consulting Optimize your pharmacy benefits

Working to deliver a level of certainty that you’re receiving the greatest value for your participants from your pharmacy benefit manager.

Pharmacy Benefit Management (PBM) consulting

We help optimize pharmacy benefits programs including self-funded, claims administration, and hybrid models. We accomplish this by identifying cost savings, ensuring compliance and providing transparency. Our services include:

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  • Ongoing pharmacy support

    This includes helping manage the PBM relationship; monitoring pharmacy spending, key metrics, program savings, trend drivers, and high-cost pharmacy claimants; and ensuring the PBM handles escalated member issues.

  • Strategy development

    This includes development, analysis and implementation of all pharmacy-related employee benefit strategies; exploration of new opportunities; and review of new PBM programs and updates.

  • Contract management

    This includes annual market checks; review of PBM claims and ensuring adherence to all PBM Retail, Mail, and Specialty pharmacy pricing, rebates, and performance guarantees; and assisting with collections from PBM if needed.

  • RFP support

    This includes RFP creation and management of the process from assessing PBM capabilities, through leading finalist meetings and assisting with PBM contract negotiation and execution.

  • Implementation support

    This includes active oversight of PBM implementation; and deep clinical review and support with member issue resolution and review of member communications.

  • Communications consulting

    We provide full-service employee benefits communications consulting designed to increase awareness and improve participant experience.

    Communications Consulting
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Why Rael & Letson for PBM consulting?

The pharmacy benefit can be one of the most utilized—but also the most complicated, costly and confusing—aspects of any healthcare benefit package. PBM pricing, regulatory changes, and other issues that affect your plan are always evolving. This can make it difficult to monitor and feel confident you’re receiving the most value for your plan and your participants. With expert guidance from Rael & Letson, we can help you:

Manage costs

Our consulting team can ensure claims are paid correctly and help identify cost savings and emerging trends.

Increase participant satisfaction

We can help tailor your pharmacy benefits program to meet your organization's and participants' needs.

Increase transparency

Our oversight and detailed reporting can help you better understand the cost drivers of your pharmacy benefits program.

Stay current on compliance and regulatory changes

We keep up with regulatory requirements and can help you navigate the latest changes in the industry.

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Team Leader

Martin Fornataro

Pharmacy Benefits Consultant

Martin P. Fornataro, Pharm.D., has over 32 years of experience in consulting, account management, and pharmacy benefit management. His clients benefit significantly from his expertise in client management, strategic planning, analytics, and reporting, which he leverages to enhance their prescription drug benefit programs. Dr. Fornataro has held numerous influential leadership roles in various Pharmacy Benefit Managers and national pharmacy consulting firms, enabling him to provide insights that empower his clients to make well-informed business decisions and achieve their strategic pharmacy management goals. Martin has spoken on various prescription drug benefits topics at national healthcare conferences and local benefits association meetings on critical prescription drug benefit topics. He has been quoted in the national media. He has published articles outlining effective strategies to combat rising prescription medication costs, highlighting the value of generic medications, and cautioning against the pitfalls of direct-to-consumer advertising. During the pandemic, he presented information on effective treatments for COVID-19 at a multi-state public sector conference. Martin holds a Doctor of Pharmacy degree from the University of Southern California, School of Pharmacy in Los Angeles, and a Bachelor of Science in Microbiology from San Diego State University. He is a registered Pharmacist in California and Nevada and actively engages with the Academy of Managed Care Pharmacy (AMCP). With his extensive expertise, Martin is committed to helping clients navigate the complexities of pharmacy management with confidence and success.

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