Western Healthcare Alliance’s Community Care Alliance Launches Pharmacy Benefit Management Program
Grand Junction, CO, April 11, 2023 – Western Healthcare Alliance’s (WHA) Community Care Alliance (CCA) is excited to announce the formation of a Pharmacy Benefit Management (PBM) program for self-funded employers.
Through research, the CCA determined the need for a PBM program to help self-funded, rural healthcare facilities manage their pharmaceutical costs for employees. Over the last year the CCA worked to develop a comprehensive program that saves both the employer and employees money on their pharmaceutical costs. By eliminating the need for the large, insurance driven PBM, the CCA program allows employers to better control costs, offer better employee benefits, and ultimately improve population health in their communities. The program gives employers control and flexibility over formulary development and management, so they can design a plan that fits their unique needs. More information on the PBM can be found here Community Care Alliance – Western Healthcare Alliance (wha1.org).
“We are excited to bring to our members and our communities a business model that dramatically reduces drug costs and puts the control of drug prescribing solely in the hands of our local healthcare providers,” said Tom Northey, WHA Chief Innovation Officer. “The ability to shed sunlight on the opaque commission and rebate complexity of large PBM structures and ultimately bypass those structures, is what makes this locally controlled PBM a game changer for transparency and cost.”
The PBM is part of the larger scope of work for the CCA, which focuses on healthier patients, increased access to care, and lower healthcare costs. Through coordinated care, patients can better avoid illnesses caused by inefficient or poorly organized care, therefore lowering their cost of care. Patients impacted by CCA programs partner with their healthcare provider to personalize their care plan. Supported by care coordination throughout the year, patients are not only connected to healthcare but also support for social and environmental influences.
Through the CCA, providers share in the risks and rewards related to the care they provide. This is done by sharing the savings that come with healthy patients, as well as sharing responsibility for losses. Resources from the CCA program are intentionally directed to support one’s provider in keeping their patients healthy and keeping care local in our rural communities.
About Community Care Alliance
Community Care Alliance (CCA) was established in 2015 by members of Western Healthcare Alliance (WHA) to provide a population health infrastructure for rural hospitals and provider communities to learn and succeed in the new healthcare environment. Meeting members wherever they are on the value-based care delivery spectrum, the CCA offers services and educational resources that allow rural members to create medical homes by implementing care coordination and chronic care management strategies to effectively manage their patients. For more information, visit https://www.wha1.org/community-care-alliance/.
About Western Healthcare Alliance
Western Healthcare Alliance (WHA) began in 1989 when a small group of rural Colorado hospitals decided that there was power in numbers. Today, WHA celebrates over 30 years of collaboration with 30 healthcare members in Colorado, Utah, and Michigan. A subset of WHA members own Healthcare Management, a sister company of WHA, which provides revenue cycle solutions to healthcare entities. Developing and managing a menu of member-owned and partner programs, WHA saves members money that helps them remain sustainable and viable in their communities. For more information visit www.wha1.org.