Meet Ohio’s New Single PBM for Medicaid Beneficiaries
March
11
Ohio recently cleared a key hurdle in its plan to revamp how Medicaid enrollees’ pharmacy benefits are managed, choosing Gainwell Technologies as the single PBM that will replace big-name firms including Cigna Corp.’s Express Scripts, CVS Heath Corp.’s Caremark, UnitedHealth Group’s OptumRx and Centene Corp.’s Envolve Pharmacy Solutions.
Although PBMs and insurers generally oppose state moves to carve out pharmacy benefits from their Medicaid managed care contracts, Ohio says it expects the new single-PBM approach will “drive transparency, reduce pharmacy costs and simplify provider administration.” And one health policy expert tells AIS Health that Ohio appears to be on the right track to achieving its goals with its selection of Gainwell.
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Lauren Flynn Kelly Executive Editor, AIS Health, and Managing Editor, Radar on Medicare Advantage
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