Optimize your government health plan with custom solutions
Our associates are government program experts and leverage collective experience to support you with all facets of your Medicare program needs.
Part D program management
We offer full program management that’s tailored to meet the unique needs of your health plan. From bid development to day-to-day operations, ClearStone can help you achieve operational and financial success in your Part D program or help develop a new Part D program that fits your needs.
- Go-to-market strategy development
- Scale pricing for lower administrative costs
- Product development support
- Robust oversight and monitoring practices
- Regulatory adherence
- Marketing and sales support
Pharmacy benefit manager (PBM) oversight and management
Choosing the right PBM is an important decision that directly affects the success of your Part D program. PBMs can be complex and oversight and management are constant needs. ClearStone can consult with you about your PBM options and help determine which PBM provides the greatest value for your needs. We can also provide PBM oversight support, so your organization can focus on other areas.
- Ongoing oversight and monitoring of performance
- Contract negotiation
- CMS-required reporting
- Audits and financial analysis
- Support formulary selection to meet your plan’s needs
- Issue identification and resolution support
Consulting
We have extensive knowledge of and experience with government health plans at a national and local level. You can tap into this wealth of knowledge with our consulting services.
- Operational and financial assessment
- Build vs. buy analysis
- Market assessment
- Product strategy
- Compliance program development and implementation
- Vendor sourcing, selection and contract development
