Pharmacy Benefit Management Services Built for Self-Funded Plans
Drug costs shouldn't be a black box. BHPS partners with plan sponsors to identify the right PBM, negotiate transparent terms, or get more from the one they already have.
Request your pharmacy benefits assessment
Get in touch with our team. We'll review your current pharmacy arrangement and show you where money is leaking. No obligation, no sales pressure.
Why pharmacy is the fastest-growing cost in your health plan
Specialty medications, GLP-1s, and biologics are pushing pharmacies past 25–30% of total plan spend for many self-funded groups, and these figures are climbing. Meanwhile, traditional PBM contracts make it nearly impossible to see where your money actually goes:
- Spread pricing: you pay one price, the pharmacy gets another, and the PBM keeps the difference
- Hidden rebates: manufacturer rebates negotiated on your drug volume that never reach your plan
- Formularies built for rebate revenue, not for your members' health or your bottom line
- Pharmacy data siloed from medical data, so no one sees the full picture of member health or total cost
If you can't answer "what did we actually pay for that prescription?" — your PBM contract is working for someone else.
PBM services that put your plan back in control
BHPS isn't a PBM — and that's the point. We partner with PBMs and provide independent consulting, oversight, and administration on your behalf. Because we don't earn revenue from drug pricing, rebates, or dispensing, our only incentive is making your pharmacy benefit work for your plan and your members.
Work with any PBM — or let us help you find the right one
No lock-in. Keep the PBM relationship you have, move to one of our vetted partners, or carve pharmacy out entirely. We structure the arrangement around your plan.
Integrated medical + pharmacy data
Because BHPS administers your medical benefits too, we connect claims across both — surfacing high-cost members early, flagging gaps in care, and showing true total cost per member in one set of reports.
Formulary & specialty drug management
Clinical formulary design, specialty drug utilization review, biosimilar and generic steerage, and site-of-care optimization for infusions — the levers that actually bend the trend.
Clinical oversight programs
Opioid oversight, medication adherence monitoring, and case management that coordinates pharmacy with the rest of a member's care.
PBM contract negotiation & auditing
We review PBM contracts line by line, negotiate pass-through pricing and full rebate transparency, and audit performance so guarantees are actually enforced.
Why plan sponsors choose BHPS
Full transparency.
Pass-through pricing, 100% of rebates disclosed, and reporting you can take to your board or leadership team.
Carve-in or carve-out.
We'll show you the math on both and build whichever serves your plan.
One point of accountability.
Pharmacy, medical, and ancillary benefits under one roof means no vendor finger-pointing when something needs fixing.
Who we serve
Health Systems
Extend pharmacy oversight into your direct-to-employer contracts and your own employee health plan without adding vendor complexity.
Talk to our health systems team →
Self-Funded Employers
Cut pharmacy trend without cutting benefits. Integrated medical + Rx administration that gives HR and finance the same clear numbers.
Get an employer assessment →
Brokers & Consultants
Bring your clients a pharmacy story they haven't heard: real transparency, PBM flexibility, and a partner that makes you look good.
Partner with BHPS →
Frequently asked questions about PBM
What is a pharmacy benefit manager (PBM)?
A PBM administers prescription drug benefits for health plans — processing claims, managing formularies, and negotiating prices with pharmacies and drug manufacturers. The problem: traditional PBM contracts often hide how much of those negotiated savings actually reach your plan.
Is BHPS a PBM?
No. BHPS is a third-party administrator, not a pharmacy benefit manager — we don't process drug claims, own pharmacies, or take rebate revenue. Instead, we partner with PBMs and act as your independent advocate: consulting on PBM selection, negotiating and auditing PBM contracts, and integrating pharmacy with your medical plan. Because we sit on your side of the table, our advice isn't shaped by drug-pricing profits.
What do BHPS’s PBM services include?
PBM contract negotiation and auditing, formulary and specialty drug management, clinical oversight programs, and integrated medical-pharmacy reporting. We work alongside your PBM — or help you select a new one — so your pharmacy benefit is transparent and accountable.
What's the difference between carve-in and carve-out pharmacy benefits?
Carve-in bundles pharmacy with your medical plan under one administrator; carve-out contracts pharmacy separately with a standalone PBM. Carve-in simplifies administration and integrates data; carve-out can offer more pricing leverage. We help you run the numbers on both — and support either model.
Can we keep our current PBM?
Yes. Our pharmacy services are PBM-agnostic. Many clients keep their existing PBM and engage us for oversight, auditing, and integration with their medical plan.
What is transparent or pass-through PBM pricing?
In a pass-through model, your plan pays exactly what the pharmacy is paid, all rebates flow back to the plan, and the administrator earns a disclosed flat fee — no spread, no hidden revenue.
How disruptive is switching?
Less than you'd think. A typical transition runs 90–120 days, with member communications, formulary mapping, and prior-authorization transfers handled by our implementation team. Most members notice nothing except their new ID card.