Pittsburgh Business Group on Health Case Study

The Pittsburgh Business Group on Health (PBGH) is a nonprofit organization and one of the leading employer-led health care coalitions in the United States, representing over $5 billion in health care spending and over 2 million lives across the country.

In 2015, PBGH was in its final year of a three-year pharmacy benefits contract. With the contract no longer allowing PBGH to offer competitive pricing, the organization struggled to win bids and was failing to retain the confidence and trust of its members. Threats such as the Affordable Care Act, consultant-driven coalitions and private exchanges only helped to lure members away.

With contract renewal fast approaching, PBGH needed a subject matter expert who could recommend how to move forward over the next contracting period and help the organization compete locally and nationally.

PBGH recruited Arxcel to revive and catapult its prescription drug program. Arxcel quickly and effectively negotiated PBGH’s new contract, giving the organization more control over its pharmacy benefits manager (PBM) arrangements and presenting the opportunity for considerable cost savings.

To prevent PBGH from facing the same pricing issues that plagued its previous contract, Arxcel built in a market check, allowing PBGH access to benchmarking data in years two and three to determine whether the PBM’s price points matched with the current market.

Arxcel negotiated more than 25 percent increase in savings over a three-year period. In 2017, the market check helped PBGH achieve an additional savings of 15 percent off contracted rates, resulting in more than $25 million in savings for employer-members enrolled in PBGH’s prescription drug program.

With its improved pricing structure and Arxcel’s leadership, PBGH quickly established itself as the leading employer-led health care coalition among its peers. The group saw a dramatic boost in credibility and is now viewed by members as a resource they can’t get anywhere else in the region. PBGH has since expanded its program, offering complimentary clinical programs to its members and attracting coalitions and companies outside of its core market.

“Health care is difficult, and you need the right trusted partners by your side to help you move forward and have actual sustainable results. I know through experience that Arxcel can help get it done.”

– Jessica Brooks, CEO/Executive Director, Pittsburgh Business Group on Health