Tag: pharmacy benefit manager

The Rebate Racket: Why Employers Are Still Getting Fleeced (Ep. 35)

The Rebate Racket: Why Employers Are Still Getting Fleeced (Ep. 35)

By |

Podcast: Play in new window | Download | Embed

Subscribe: RSS | More

Ralph Weber is joined again by PBM insider Rachel Strauss to deconstruct how rebate programs have evolved into hidden commissions and cost traps. Learn how to avoid rebate mirages, leverage 340B strategies, and spot the telltale signs your PBM is profiting more than they should.

00:00 Introduction to Pharmacy Benefits and Rebates

02:39 The Evolution of Rebates in Healthcare

07:08 Understanding How Rebates Work

10:12 The Importance of Net Cost Tracking

15:28 Exploring Alternative PBM Models

18:17 Understanding Fiduciary Responsibility in PBM Contracts

19:01 The Role of Prior Authorization and Step Therapy

24:48 Navigating Pharmaceutical Pricing and Transparency

26:53 Quick Wins for Employers in Pharmacy Benefits Management

Guest: Rachel Strauss | rachelmstrauss.com | LinkedIn: linkedin.com/in/rachelmstrauss | Email: rachel@rachelmstrauss.com

Host: Ralph Weber | ralph@thebenefitwhisperer.com | Phone: (832) 924-3330 | Website: fixmybenefitsnow.com | Schedule a FREE consultation with Ralph: bit.ly/4i8Zpsw

The PBM Princess: From Rebate Myths to Deception, How PBMs Hide True Rx Costs (Ep. 30)

The PBM Princess: From Rebate Myths to Deception, How PBMs Hide True Rx Costs (Ep. 30)

By |

Podcast: Play in new window | Download | Embed

Subscribe: RSS | More

On this episode of The Benefit Whisperer, Ralph Weber interviews Rachel Strauss, the “PBM Princess,” to expose how pharmacy benefit managers manipulate contracts, rebates, and definitions to extract margin from employers. They break down contract landmines, phony transparency language, weak audit clauses, and the real story behind “100% pass-through.”

If you’re an employer, broker, or benefits leader struggling to contain pharmacy costs, this episode is your roadmap to fighting back.

00:00 Understanding Pharmacy Benefits and PBMs

01:17 Contract Landmines and Definitions

03:58 Rebates and Their Implications

06:24 Guarantees and Risk in PBM Contracts

09:56 Audit Rights and Transparency

15:37 The Illusion of Pass-Through Pricing

18:39 Prior Authorization and Cost Management

23:06 Navigating High Deductible Health Plans

26:46 The Need for Transparency in Healthcare Pricing

Guest:
Rachel Strauss • rachelmstrauss.com
LinkedIn: linkedin.com/in/rachelmstrauss
Email: rachel@rachelmstrauss.com

Host:
Ralph Weber • ralph@thebenefitwhisperer.com
Phone: (832) 924-3330
Website: fixmybenefitsnow.com

Schedule a FREE consultation with Ralph: https://calendly.com/ralph-weber-routethree?utm_source=blubrry&utm_medium=emails&utm_campaign=ep30&utm_id=podcast