Transparency is here. Lawsuits are on the horizon.
Johnson and Johnson, Wells Fargo, and Blue Cross Blue Shield are among the major lawsuits that have sparked a conversation around transparency in health insurance plans. Plan sponsors now face legal recourse if they are not fulfilling their fiduciary responsibilities. Fiduciary Responsibility entails the ethical and legal obligation to act in the best interests of stakeholders, including employees and beneficiaries – making sure they are providing a plan that allows members to get prescriptions and medical services at reasonable prices. This has been especially difficult given the current state of health plans that are riddled with gag clauses that hide inflated fees and hidden financial agendas.
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Consultants can no longer afford to offer benefit plans that aren’t up to date with the latest transparency and compliance regulations. Novo Connection makes the transition easy for consultants by always offering transparent and independent program components. Our data analytics platform is a complete solution that quantifies and identifies components that can help groups reach their long-term financial goals within their benefit program.
Medical and Rx Market Checks
Many data analytics platforms only reveal the problem in a group's data - showing the numbers without offering actionable solutions. Novo Connection goes beyond this by analyzing each group’s unique data through a program management lens. Helping consultants through the RFP and implementation process with independent solutions that offer compliance and cost savings.
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Everything starts with a comprehensive Medical and Rx market check. Which involves taking the group's data, analyzing it, providing holistic recommendations, and uncovering potential savings ranging from tens to hundreds of thousands of dollars. By leveraging services such as international and specialty sourcing solutions, cost plus models, pharmacogenomic (PGX) testing, and strategic specialty drug management, we ensure medication plans are both effective and personalized. These plans offer employers the ability to provide the best solutions at the best cost to their members, ensuring fiduciary compliance while protecting the plan from future lawsuits.
Lowest Net
Cost Formulary
Opting for a rebate-driven approach for a pharmacy benefit solution can often lead to higher costs for employers and their health plans. Rebates can create the illusion of savings but often encourage higher-priced name-brand drugs over equally as effective and less expensive alternatives. Pharmacy Benefit Managers (PBMs) tend to favor high-cost drugs because they can generate additional revenue from rebates. Savings from rebates often don't reach employers and members, leaving them to pay more for medications and missing out on the true cost savings of alternative solutions.
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Consultants can help their clients manage pharmaceutical expenses more effectively by choosing a lowest net cost approach. Novo Connection’s strategy includes an independent clinical team that reviews cases to ensure patient outcomes are prioritized over rebate incentives. This guarantees that members receive the best treatment options available, while employers can save on their annual prescription spend by choosing effective and lower cost alternatives. With all rebates fully passed through and an emphasis on affordable medications, Novo Connection enables employers to lower their prescription costs and increase the value of their health plans.
Why Novo Connection?
Novo Connection was started to address the industry's need for advanced and transparent self-funding solutions and metrics to help employers. Novo Connection is the first fully integrated technology platform for building, implementing, and managing self-funded programs. From marketing stop-loss to plan management and oversight, Novo Connection is the one-stop platform for transparent and independent program analysis.
With a focus on data analytics and cost containment, Novo Connection empowers plan sponsors to fulfill their fiduciary responsibility to design self-funded plans that align with their member’s unique needs and provide access to affordable health and prescription benefits. The platform also provides tools like intelligent analytics and detailed reporting to identify and implement cost-saving solutions.
Novo Connection Programs & Products:
Fully integrated stop loss shop with competitive discounts
Choice to only purchase stop-loss/captive funding solutions
Custom-built self-funded programs
Intelligent analytics
Savings recommendations engine for plan fiduciary compliance
Ongoing prescription and medical contract oversight
Prescription market checks
Medical market checks
