The Pharmacy Benefit Management (PBM) industry, with a market value of $540.32 billion in 2023 and a projected annual growth rate of 8.77% through 2030, reflects the increasing complexity and pivotal role of PBMs in the healthcare industry. This trend has emphasized the importance of comprehensive PBM audits. These audits are a critical part of staying compliant with regulatory standards and identifying ways to reduce costs while healthcare expenses continue to rise.
PBM audits are essential for several reasons:
Given the stringent regulatory landscape, PBMs face significant compliance challenges. These include:
HR compliance professionals can take proactive measures to address these implications by exercising the following:
As the PBM market continues to grow, the need for expert audit services becomes increasingly crucial. Strategic consulting and thorough auditing are key to ensuring that PBMs not only comply with current regulations but also operate efficiently and ethically. Your AssuredPartners consultant is a great resource to help your organization strategize and evaluate potential PBM consulting and auditing service providers. Connect with your local team to discuss whether these services are a good fit for your organization.
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