Medications account for about 20% of total health care spending, are the most frequent clinical intervention delivered by doctors to patients, and are the most frequent interaction patients experience with their health plans. Medications (particularly specialty) are also the fastest growing spend category for health plans. Health plans rely on pharmaceutical benefits managers (PBMs) to develop formularies and negotiate prices. We believe PBMs have misaligned incentives with health plans and patients. Traditional PBMs tend to make more money when medications are more expensive and when patients take more of them. Renew Health’s business model is designed to align with health plans and patients. We envision charging fixed fees on a per-member and per-task basis to administer medications while passing through drug related costs and rebates to health plans. Renew Health would also be compensated for delivering clinical services designed to improve outcomes and lower the total cost of care for health plans, thereby aligning Renew Health’s revenue with value for payers and patients.
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