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Prescriptive Analytics for Positive Impact & Outcomes

Creating industry leading strategies across the healthcare value chain

Prescriptive Analytics for Positive Impact & Outcomes

Creating industry leading strategies across the healthcare value chain

What Makes Us Different

Our extensive industry knowledge, growth mindset, and analytics are incorporated in every working piece to enable our clients to thrive in the marketplace.

About us

Proper Consulting Group was founded in early 2019 and is based in Chicago. Our team has 50+ years of combined pharmacy experience, working with Pharmacy Benefit Managers (PBMs), Payers, and various types of Pharmacies. Our core engagements focus on identifying, implementing, and tracking non-labor cost reduction to deliver value and a ROI for our clients.

Our mission

To help our clients maximize their return on investment and internalize business acumen and skills for sustained growth and capabilities.

Our mission

To help our clients maximize their return on investment and internalize business acumen and skills for sustained growth and capabilities

Our vision

We are a value driven company shaped by the desire to help create positive, enduring changes in the healthcare space.

Our values

– Leadership Mindset
– Inclusion
– Integrity
– Fun

Our Solutions

Health Plan & Payers

Client & Pharmacy Network Pricing Management

Formulary & Rebate Alignment & Management

Pharmacy Financial Performance, Modeling, & Forecasting

New & Renewal Client Underwriting

Clinical Reporting & Analytics

Pharmacies

Contract Reconcilation with Payers

Purchasing Strategy

Operational Reporting & Analytics

Full RFP Management & Reporting

Self-Insured Employer Groups

Contract Reconciliation & Audit

PBM & Clinical Program Strategy

RFP Management & Administration

Success Stories of our Clients

We work alongside our clients every day to deliver business results and create enduring change.

PBM Tailored Retail Network Contracting

PBM Simplified Pricing Management

Another case study title

Connect With Us

We look forward to engaging with you about our services, product accelerators, or about joining our growing team.

contactus@properconsultinggroup.com

185 N Franklin St, 3rd Floor Chicago, IL 60606

contactus@properconsultinggroup.com

185 N Franklin St, 3rd Floor Chicago, IL 60606

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PBM Tailored Retail Network Contracting

We help our clients better manage their business efficiency through a combination of contract design, benchmarking analysis, and near real-time performance dashboard.

Client Situation

PBMs experience constant change throughout the year, including sizable network performance fluctuations impacting client guarantees, and financial planning.

In this instance, a PBM’s current retail network contract did not represent a viable long-term response to its needs for pricing competitiveness, flexible management, and predictable outcomes. The PBM sought improved results from within the industry aligning available solutions to its specific size and scale.

Opportunities/Actionable Items

The PBM required solutions catered to strengthening its operational efficiency and bolstering its economics while continuing to support its client-facing business model. Within the network contracting market, there are several pathways that lead to accomplishing these goals, but few that afford the required level of transparency and value maximization.

The Proper team conducted a benchmarking analysis of the PBM’s current retail network contract economics and terms against industry competition. Faced with contract pricing that was lagging in the market, along with obsolete definitions and caveats, Proper recommended seeking competitive bids from several vendors.

Upon selection of a new vendor, the Proper team was engaged in validating, reviewing, and negotiating the proposed agreement’s financial savings estimates, terms and conditions, and functional requirements. The new agreement necessitated significant business process enhancements in conjunction with its strong financial benefits. The Proper team facilitated the creation of repeatable, efficient processes leveraging existing data structures to measure and interpret improved performance and associated value as well as adherence to contractual obligations.

Results

The Proper team’s involvement in the PBM’s retail network contracting efforts bore measurable improvements. With new market-aligned economics, the PBM was able to grow annual retail network margins by over 110%.
By implementing near-real time dashboards to monitor and track key performance indicators, Proper allowed the PBM increased clarity into its day-to-day operations and the ability to minimize risk by anticipating potential future variabilities in performance.

PBM Network Management

We assist our clients by simplifying their network management methods and intricate data structures through centralizing pricing and client contracts and creating versatile
data sets.

Client Situation

PBMs experience constant change throughout the year, including sizable network performance fluctuations impacting client guarantees, and financial planning.

Opportunities/Actionable Items

Proper partners with the PBM to identify inadequacies within their network and pricing management. After conducting a diagnostic, Proper can determine and offer the following solutions depending on client specific situation:

Develop a complete repository of all network pharmacy and client contracts
Build a centralized data warehouse as a signal-source of truth with daily claims updates
Create automated dataset and dashboards to reconcile client and pharmacy contracts in near-real time
Collaborate with the client’s Plan Build configuration team to reconfigure the adjudication system in a manner to efficiently manage client and pharmacy side pricing
Implement network pharmacy and client specific pricing changes

Results

Proper’s network management engagement with just one of their PBM clients resulted in both quantifiable and qualitive improvements including:

$10M+ in annual margin improvement
Accurate client pricing
Minimal member impact
Funded investment in new client wins
Automated near real-time reporting