York Prescription Benefits
1 Church St., Fifth Floor, New Haven, Conn. 06510; 203-781-3411; fax: 203-946-3591
www.yorkpbm.com
1997 revenues
Total gross revenues$21,000,000
PBM gross revenues$9,000,000
PBM unbundled revenues$7,500,000
PBM clients
Total53
Employer/group plans with direct service51
Lives covered
Group Health:
Total77,039
Active enrollees51,028
Through employers64%
Through third-party vendors16%
Through Medicare/Medicaid20%
Workers Compensation:
Active enrollees2,359
Retail network
Pharmacy locations40,392
Mail-order services
Percent of prescription volume10.3%
Generic usage
Percent of prescription volume41.3%
Staff
Total75
Professionals23
Includes: 4 registered pharmacists
PBM services since: 1995.
Parent: Yale New Haven Health.
Services: Retail pharmacy network, mail-order distribution, claims processing, online claims processing, concurrent utilization review, disease management, retrospective utilization review, benefit design consulting, formulary management/review, monitoring of physician prescribing practices, patient education, daily drug utilization review.
Formularies offered: Open, closed, restricted/customized.
Pharmacies contracted: Independently owned; retail chains.
Reports provided: Physician prescribing patterns, generic vs. name brands dispensed analysis, employee utilization, pharmacy utilization, therapeutic utilization.
Service area: Nationwide.
Billing methods: Capitated rate, fee per claim, per member per month. Volume discounts to employers.
Officers: Lily Khodadoost-Kamvar, director-clinical services; James Bigl, general manager, York; Michael Hajdun, director-operations, York.
Contact: Karen Bradbury, business development manager, 203-781-4875.