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Pharmacy Benefit Dimensions Shines with 5-Star Rating

Pharmacy Benefit Dimensions’ Star Rises Again

One of the best, unbiased ways to compare pharmacy benefit managers’ Medicare Advantage plans is through the Centers for Medicare & Medicaid Services (CMS) 5-Star Rating program.

The annual Star Ratings are designed to help Medicare beneficiaries assess the quality, value and performance of every Medicare plan throughout the nation. Plans are rated through information gathered from clinicians, member surveys and other trusted sources based on a 5-star system — 1 star meaning “poor” quality and 5 stars for “excellent” quality.

The goal of the Star Ratings is to ensure health plans commit to improving their performance as it relates to disease management, preventive care and customer service.

Pharmacy Benefit Dimensions (PBD) is proud to announce that it has earned a 5-Star Rating for its 2022 plan year Medicare Employer Group Waiver Plan (EGWP) Prescription Drug Plan (PDP). By achieving this top-level 5-Star Rating, PBD has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

“We are honored to once again be recognized as one of the top EGWP administrators across the United States for our Medicare membership,” said Lynne Reilly, president of PBD. “We are very proud to achieve this prestigious designation from CMS. To be among the nation’s best is a testament to the hard work and dedication by our team to provide top-notch customer service and a personalized member experience.”

For the 2022 plan year, only 10 out of 54 PDPs were awarded a 5-Star Rating nationwide and 46% of PDPs received a ranking of 3.5 stars or lower. The average overall star rating of all PDPs for the 2022 plan year was 3.70.

“We are focused on doing what is right for our employer groups and their employees and continuously strive to deliver the best experience and outstanding service to all of our customers,” Reilly added. “I am so proud of our hard-working and dedicated team.”

The key components that Part D prescription drug plans are measured on each year include:

·         Drug Plan Customer Service

·         Member Complaints and Changes in the Drug Plan’s Performance

·         Member Experience with the Drug Plan

·         Drug Safety and Accuracy of Drug Pricing

EGWP PDPs are customized Medicare prescription drug plans developed exclusively for employer and union groups. Employer groups partner with a PBM that has contracted directly with a Medicare Part D plan sponsor. An EGWP PDP is not open to the individual market, but rather a specific plan only available for employers or union groups. Employers generally use EGWP PDPs to provide supplemental coverage for Medicare-eligible retirees and covered Medicare-eligible dependents beyond the standard benefits typically offered by other Medicare prescription drug plans.

For the 2021 plan year, PBD earned 4.5 stars, ranking us among the best in the country. The average overall star rating of all PDPs for the 2021 plan year was 3.58.

We have consistently earned high star ratings (4.0 or higher) since receiving a Medicare EGWP PDP contract in 2015, including being one of only four PDP contracts to receive a perfect 5-star rating in 2019.