Outstanding Clinical Care Model
Our patient-centered model works to improve health outcomes.
Our robust patient-centered clinical care model, which is URAC accredited, enables us to deliver high-touch support to promote adherence, close gaps in care and improve health outcomes. Using our highly informative claims data and 360-degree view of the patient, we can identify patients who can benefit from additional support. By combining this knowledge with evidence-based guidelines, and leveraging our relationships with members, pharmacists and prescribers, we can deliver meaningful interventions that improve health.
Built on proven practices, our service model is focused on providing superior service for members. Through our outstanding customer care center, award-winning web portal and best-in-class communications we ensure that education and engagement work together to improve health.
- Get proven clinical programs that offer additional support for adherence, misuse and abuse (i.e. opioids) and condition-specific needs
- Receive real time, 24/7 personalized support for members via the latest in omni-channel engagement
- Get best-in-class care with our use of 360-degree patient data and evidence-based guidelines
- Experience improved outcomes with robust member support to promote adherence and close gaps in care
- Give members secure, user-friendly access to Navitus member portal to answer benefit questions
The Bottom Line
When you work with a fully transparent and pass through PBM the results are a given, but the experience is unique. Our expert advisors will lead you into a new adventure in pharmacy benefit management where you’ll get:
• A Clear View into your pharmacy benefit costs and savings opportunities
• The Guidance to get your benefit management going in the right direction
• Peace of mind that our expertise and experience are on your side every day
As a result, we make managing your Rx benefits feel less like work and more play. On top of that, our clients experience a substantial savings of 10-15%. We call it Pharmacy Benefits Reinvented.
Here are a few highlights of our results:
Navitus Results and Highlights
New Client Savings
Our pass-through model is so successful that in 2019, clients that switched to Navitus from another PBM saved 25%*, on average, in drug spend. Although these clients come from a wide range of industry sectors, by adopting our model and using recommend cost-reduction strategies, they achieved substantial PMPM trend savings.
*2019 Navitus data analysis (included clients who provided historical data).
Navitus Results and Highlights
Gross Profit Per Claim
We take the unnecessary costs out of pharmacy spend to ensure our clients receive all of the savings. All discounts and rebates are returned to the client. As you can see from this graph, traditional PBMs tend to keep a portion of the revenue for themselves. An agreed upon admin. fee is the only way that we earn money.
*Starting in 2019 this information is no longer available due to industry mergers of insurers and PBMs, making it harder to see how a PBM's revenue impacts your Rx benefit costs.
Navitus Results and Highlights
5-Year Cumulative Savings
Navitus clients experience lower than average PMPM. In fact, in 2019 we helped our commercial clients achieve a PMPM of $78.12, which is 16% lower than the forecasted* industry average of $93.11. But the savings aren’t limited to one year. Looking back over 5 years we held PMPM costs to a significantly lower number than the industry average, helping our clients save more.
*Forecasted trend increase based on data from the 2020 Economic Report from the Drug Channels Institute.
4.5 out of 5 Overall CMS STAR RATING
For our Medicare Employer Group Waiver Plan (EGWP)
2021
100% SATISFACTION
Survey results from clients post-implementation
2013-2020
Consultants & plan sponsors: Have a question?
Members: Please call the number on back of your ID card. Clients: Contact your client services rep.