Pharmacy Benefit Segmentation: Emerging Models for Health Plans

Wiley Podcast

In this episode of The Wiley Contracting Chronicles, hosts Jordan Ross and Brooke DeLoatch discuss the growing trend of pharmacy benefit segmentation among health plans. They outline three emerging models identified at Wiley: Product Service Disaggregation, Program Segmentation, and Industry Disruption—each offering varying levels of complexity and control. The hosts highlight key considerations for implementing these models, including resource commitment, clear contracting terms, and ensuring service provider capabilities. With careful planning and strategic contract management, health plans can leverage segmentation to foster competition, improve efficiency, and lower drug costs.

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