Pharmacy Benefit Managers (PBMs) play a key role in the healthcare industry, managing pharmacy products and facilitating real-time interactions among stakeholders. In recent years, PBMs have expanded beyond their core functions to adapt to evolving market dynamics. Key trends include regulatory changes, increased consumer focus on health management, and widespread technology adoption. In this report, we explore key themes in the PBM marketplace, highlighting common use cases, benefits, challenges, and emerging technologies and opportunities. The report aims to help providers understand the intricacies of pharmacy benefit management and guide enterprises in formulating the right PBM strategies. Scope Industry: healthcare Geography: global Contents In this report, we examine: The role of PBMs and value chain functions Key trends and demand drivers Challenges in adopting technology and associated trends Use cases that leverage AI and automation Investment priorities Membership(s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management

The Medicare Prescription Payment Plan (MPPP), part of the Inflation Reduction Act, aims to smoothen Out-of-Pocket (OOP) prescription costs for Medicare beneficiaries by spreading upfront expenses over 12 months. To implement MPPP effectively, health plans and Pharmacy Benefit Managers (PBMs) must adopt advanced technology solutions, including automated billing tools and member self-service portals. This transition from manual processes to tech-driven methods ensures accurate billing, seamless data exchange, timely reporting, and proactive member communication. Health plans and PBMs must invest in automated tools to meet regulatory requirements and enhance member experience. This report explores MPPP’s objectives and key roles and considerations for health plans and PBMs. It highlights essential components for successful MPPP implementation, such as billing tools, self-service portals, and customer support. Scope Industry: Healthcare Geography: North America Contents In this report, we: Explain the MPPP objectives Highlight key roles and considerations for health plans and PBMs to implement MPPP Detail essential technology solutions required, including automated billing tools, reporting tools, customer service portal, and member self-service portals Outline key performance indicators to assess the effectiveness of implementing MPPP Membership(s) Healthcare Payer and Provider Information Technology Sourcing and Vendor Management

The global payment collection services market is facing various challenges, such as geopolitical and economic uncertainties, marked by increased consumer indebtedness, regulatory measures, and regional conflicts. Recent events such as the Credit Suisse collapse have heightened the demand for effective collection services to restore customer trust and fortify financial security. In the UK and Ireland (UK&I), the combination of rising inflation and economic downturn highlights the vital role of collection services for businesses striving to maintain financial stability in difficult circumstances. Customer vulnerability further complicates payment collection services, with a notable increase in arrears and individuals experiencing financial difficulties. In January 2024, UK household debt reached GBP1,838.7 billion, with the UK household debt-to-income ratio peaking at 124% in Q4 2023, highlighting significant strain on households. Additionally, 67% of UK adults fell into potentially vulnerable categories outlined by Consumer Duty regulations. These statistics reveal a stark reality, indicating a notable rise in vulnerable customers. This increase is evidenced by a surge in household debt, rising mortgage arrears, and alarming rates of daily insolvency declarations and property repossessions. These economic hardships profoundly impact individuals' mental well-being, contributing to increased levels of stress and anxiety. It is vital for enterprises to provide tailored guidance, empathetic customer service, and support through various channels. Empathetic customer support builds trust between creditors and debtors, easing the burden on vulnerable customers and helping them manage their financial responsibilities more effectively. In this viewpoint, we explore the payment collections market and the regulatory landscape in the UK&I. It provides guidance for enterprises on understanding customer vulnerability, delivering empathetic customer service, and evaluating the impact of emerging technologies, such as generative AI, in the collection services sector. Scope: Industry: all Geography: UK&I This report is based on primary and secondary data collection, conversations with market participants, and fact-based research Content: In this viewpoint, we examine: Trends in the UK&I payment collections market Customer vulnerability and current state in the UK&I Regulations governing payment collections in the UK&I Key considerations for selecting the right provider Generative AI’s impact on the payment collections market Membership(s) Customer Experience Management (CXM) Services, including Contact Center Outsourcing CX Excellence Outsourcing Excellence

The Pharmacy Benefits Management (PBM) industry is experiencing significant changes, including increased regulatory scrutiny surrounding pricing transparency and rebate-sharing rules, which are disrupting traditional business models. The rise of specialty drugs is also impacting profitability. Furthermore, the growing adoption of value-based contracting is prompting PBMs to eliminate data silos within their organizations to improve treatment outcomes and detect fraudulent activities. As a result, PBM operating models are shifting and there is a greater emphasis on digitizing operations to improve drug utilization, integrate data, and develop advanced analytical capabilities. In this viewpoint, we examine the evolution of PBMs, their role in the US pharmaceutical industry, and the key trends and controversies surrounding PBM operations. We also explore potential solutions for addressing PBM challenges and how third-party providers can help alleviate them. Scope Industry: healthcare Geography: North America Contents In this report, we: Examine the role of PBMs in the US healthcare ecosystem Discuss the key trends and challenges facing the PBM industry Explore the evolution of the PBM landscape and the role of third-party providers Membership(s) Healthcare Payer and Provider Business Process Sourcing and Vendor Management