Benefits leaders are the unsung heroes of corporate America — ensuring that thousands of members can access their benefits quickly and seamlessly. Unfortunately, the pandemic has only made their jobs more challenging.
As the mental health crisis continues to worsen, budgets tighten, and new services hit the market at staggering rates, the task of evaluating mental health benefits is more overwhelming than ever. Fortunately, there’s a faster (and easier) way to cut through the noise: working with your pharmacy benefit manager (PBM) to offer safe and effective digital therapeutics for mental health.
You can now offer digital therapeutics for mental health and other chronic conditions through your PBM — enabling you to support your members in need, faster and easier than ever.
By opting for coverage on the PBM formulary, evaluating, contracting, and billing can be managed as easily as medications. Each digital therapeutic offered through this channel undergoes a rigorous evaluation process ensuring that they have proven clinical outcomes, adhere to strict privacy and security regulations, and will help drive down health care costs. Meaning you have 1, 2... or 10 less hoops to jump through in order to offer your members a safe and effective non-drug alternative for mental health.
Gone are the days of redlining 50+ pages of MSA’s and SOW’s — you need only update your existing agreement to elect and offer select digital therapeutics through your PBM service.
Implementation and enrollment for digital therapeutics for mental health is also much easier, taking advantage of pre-existing PBM systems (i.e. no need to collect and send eligibility files). This allows members to access care throughout the clinical care pathway, whenever they need it most.
Instead of dipping into a tightening wellness budget, you can pay for digital therapeutics for mental health via your existing PBM invoice, drawing from the pharmacy budget if you choose. Claims are processed just like a medication on the formulary, and you’re only billed when a member signs up to use the therapeutic.
In this time of heightened need, it has never been more important to provide access to evidence-based care quickly and easily. All of the above allowed one client to offer proven digital therapeutics for mental health in just ten days:
“With the growing number of solutions in the market, securing the necessary budget and the contracting process can both be burdensome. With only a one-page amendment and streamlined billing through the pharmacy budget, we were able to get the approvals we needed to launch in just 10 days - it was a simple process.”
— Lynne Haney, benefits manager at AmeriGas
In June 2019, Sleepio became the first digital therapeutic to be offered and billable via a pharmacy benefit manager (PBM). With the addition of Daylight one year later, we’ve expanded this industry-first way to provide and pay for evidence-based digital therapeutics.
We believe that the future of mental health care is one that increases access and creates less friction for benefits teams. With the way this changes contracting, coverage, and reimbursement, we hope you’ll join us in our mission to help millions back to good mental health — faster and easier than ever.
Read more about our partnership with a leading pharmacy benefits manager (PBM) in our press release.
Disclaimer: In the US, Sleepio and Daylight have not been cleared by the FDA for use in diagnosis or treatment of a disease or condition, such as insomnia disorder, generalized anxiety disorder, or major depressive disorder. Users are directed to not make any changes to their prescribed medication or other type of medical treatment without seeking professional medical advice.