Victory! End the Healthcare Black Box

Speak up before April 15

Americans are paying more for health care every year, yet much of the system that determines healthcare costs operates behind closed doors.

One of the least transparent parts of that system involves Pharmacy Benefit Managers (PBMs). These companies negotiate drug prices and manage prescription benefits for employer health plans. PBMs often receive payments such as rebates, administrative fees, and other forms of compensation tied to prescription drugs.

In many cases, the employers paying for health plans do not have clear visibility into those payments or how they affect the cost of care.

The Department of Labor has proposed a rule requiring PBMs to disclose their compensation to the employer and union health plans they serve.

This is an important step. Greater transparency would help employers and plan sponsors better understand where healthcare dollars are going and evaluate whether fees being charged are reasonable.

Employer health plans cover millions of workers and families, and the organizations managing those plans have a responsibility to protect the healthcare dollars workers contribute. Other service providers—such as insurers and third-party administrators—also receive compensation and control important pricing and claims data within employer health plans.

To properly protect workers and their families, employers responsible for these plans need full transparency across the system and access to the data necessary to evaluate costs and negotiate fair contracts.

Stronger transparency requirements will help ensure healthcare dollars are being used responsibly and can help employers improve benefits and manage rising healthcare costs.