Behind Intermountain Health's in-house PBM

Salt Lake City-based Intermountain Health, through its insurance arm Select Health, rebranded its pharmacy benefit manager to Scripius, a move that highlights the growing trend of health systems bringing PBMs in-house. 

By shifting to an in-house PBM, Intermountain said it aims to gain greater control over prescription costs, enhance transparency and eliminate inefficiencies. Additionally, Select Health partnered with Mark Cuban's Cost Plus Drug Co., aiming to provide its members with access to over 1,000 prescription products at lower prices. 

Becker's spoke with Eric Cannon, chief pharmacy officer at Select Health and general manager of Scripius, about operating Intermountain's in-house PBM.

Question: How long has Intermountain been managing its PBM in-house and what led to this transition? 

Eric Cannon: In 1998, Select Health, the integrated insurance arm of Intermountain Health, established its in-house PBM, now known as Scripius, to address the lack of transparency and high fees often found in the PBM industry. As an insurer, Select Health identified key gaps and issues within prescription services and sought to develop a solution to address these challenges. Scripius offers health systems tools to manage these services internally, reducing unnecessary costs and providing a more cost-effective and transparent solution for members and clients.

Q: What are some of the primary factors that health systems like Intermountain are increasingly choosing to bring PBMs in-house? 

EC: More health systems are bringing PBM services in-house due to concerns about the lack of transparency and high costs associated with for-profit PBMs. By bringing PBM services in-house, this shift allows Scripius to offer better, customized and transparent experiences for those we serve, and ensures patients and members receive the medications they need and can consider real costs when discussing treatment options with their provider.

Q: What financial benefits does Intermountain gain through an in-house PBM? 

EC: Health systems benefit most from operational efficiencies through aligned formularies and streamlined processes. A health system can achieve this efficiency by maintaining a unified formulary for its hospitals, clinics, and its health insurance arm, ensuring all covered medications are aligned. Additionally, close integration with electronic medical records and the ability to direct members to cost-effective pharmacy options — including in-house retail, mail-order and specialty pharmacies — ensure significant savings and convenience for members and clients while enhancing patient care.

Q: Can you speak to the flexibility and control that comes with operating an in-house PBM? 

EC: Scripius has complete control over its operations, allowing for tailored solutions that meet the unique needs of members and clients. In contrast to publicly traded PBMs or venture capital startups, which prioritize shareholder interests over customized and scalable solutions, an in-house PBM like Scripius is designed to support health systems in delivering personalized, high-quality care that meets patient needs. This distinction allows us to offer flexible solutions that are focused on positive patient outcomes.

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