When reviewing a PBM proposal, it’s not all about the bottom line. While it’s certainly important, it’s equally as important for self-funded employers and their broker partners to understand how that number was built, what is guaranteed, and what the experience will look like for their members.
A proposal from MedOne Pharmacy Benefit Solutions is structured to answer those questions in a clear and logical way. Each section is designed to show how savings opportunities are created, how pricing works, and how decisions are made before anything is finalized.
1. MedOne’s Savings Waterfall
Every MedOne proposal starts with the Savings Waterfall, as it shows how savings are created step by step when our strategies are implemented. We begin with gross spend and then walk through each strategy that reduces cost before rebates are applied. That includes biosimilar adoption, low value drug exclusions, patient and copay assistance programs, and active management of high-cost categories like GLP‑1s. Each lever is given its own line so brokers and prospective clients can see what is driving change and what assumptions sit behind the numbers. From there, rebates are passed through in full, administrative fees are clearly listed, and member cost share is accounted for, landing on a true net spend. You should be able to follow the math, explain it to a client, and trust that the savings shown reflect how the plan will actually be managed.
2. Financial Terms
Once the savings are clearly laid out, the proposal moves into financial terms. This section is about setting expectations and removing uncertainty. MedOne pricing is built around minimum guarantees, not optimistic projections. Discount guarantees are shown by channel and drug type, with dispensing fees listed clearly. Rebate guarantees are separated by formulary types so brokers and prospective clients can see how those decisions impact results.
Administrative fees are handled the same way. Instead of tying revenue to drug spend, MedOne uses a transparent per member per month (PMPM) fee. Core services like implementation, claims processing, account management, pharmacist access, reporting, and standard clinical programs are included, not added later as line items. Optional programs are clearly identified with straightforward pricing, whether that is a per review fee or shared savings. The result is a proposal where you know what you are paying for, what is included, and how MedOne gets paid. Financial terms that are easy to explain and easier to trust.
3. Network Disruption Analysis
The final section of the proposal looks at network disruption because pricing only works if members can still fill their prescriptions without friction. MedOne owns and manages our own pharmacy network, which gives us more options and greater control when evaluating network design. In the proposal, we show exactly how many pharmacies and claims are in network today, what percentage fall outside the network, and which locations (and members!) may be impacted. That analysis helps brokers and prospective clients understand the real tradeoffs before any changes are made.
In cases where disruption is minimal, MedOne can pursue deeper discounts or tighter network strategies with confidence. When disruption is higher, we walk through alternatives and talk through the impact by employer group. The goal is to balance access, member experience, and cost in a way that fits the plan, not force a network decision that looks good on paper but creates issues for members.
Together, MedOne proposals give brokers and prospective clients a full view of how MedOne approaches pharmacy benefit management. The savings are clearly built, the financial terms are easy to follow, and network decisions are evaluated with member impact in mind. The goal is simple: Make it easier to understand the plan, easier to explain the plan, and easier to trust the results once the plan is live.