Insurers, PBMs Moving To Adjust Business Models Amid Shift to Private Exchanges

A rising trend among large employers to shift workers into private health insurance exchanges is forcing health insurers and pharmacy benefit managers to adjust their business models. Experts say that a significant shift to private exchanges could force PBMs to enter contracts with insurers to maintain a more direct relationship with consumers. Meanwhile, some insurers are preparing for the potential business shift by becoming investors in private exchanges, while others are building their own.

• "Analysis: Benefit Firms Create Tremors for Insurers in U.S. Health Care Shakeup" (Humer/Krauskopf, Reuters, 9/20).