Pittsburgh, PA based Gateway Health Partners is the largest independent provider of rebates and formulary management services in the United States. The firm provides flexible, transparent, unbundled, and à la carte cost management solutions for rebates and retail pharmacy networks. Gateway functions on three critical pillars, Clarity, Expertise, and Insights.

The enterprise offers end-to-end solutions that promote and support clients extensively. The company has established strategic relationships with many Pharmacy Benefit Managers (PBMs), employer groups, and health plans. The relationships have been instrumental in enabling the company to develop solutions that control costs through innovative services and technologies.

Gateway Health Partners has won accolades for its ability to tackle industry-specific challenges.

Formulary and rebate management can be very complex, while transparency and predictability can be a real problem. Gateway believes trust, predictability, and transparency are fundamental to a strong client relationship. Clients must be able to trust their partners to be predictable, delivering the same high-quality service each and every time. Transparency is equally important when it comes to pricing structures and reporting. For these reasons, PBMs, health plans, and large employer groups are intensely looking for solution partners who can navigate these complicated spaces while offering the expertise and flexibility necessary to meet their specific needs.

Gateway addresses challenges within the market by working as an extension to its client organizations, listening, researching, negotiating, and creating customized, tech-forward solutions to meet their needs. 

The Gateway Portfolio

Gateway Health Partners offer clinical program support, including P&T support. Clients are able to come together and discuss different clinical initiatives and opportunities in the market. Additionally, Gateway delivers advanced data that ensures informed decision-making. Another feature is customized reporting and pricing for custom quotes and tailored data to strengthen RFPs for its clients.

“Our product, the ProOptimizer allows clients to automate submission and drive compliance with respect to contracts with pharmaceutical manufacturers. Further, the NetOptimizerRx solution is a consulting service that revitalizes retail networks and data analytics on contract management. Also, we offer comprehensive consulting services,” says Ashley Beatty, President of Gateway Health Partners.

A PBM enterprise encountered problems while capturing the changes in retail pharmacy network contracts. The client shared with Gateway a list of risks due to inappropriate records of their client contracts. Gateway installed the NetOptimizerRx contract management tool to enable them to leverage the sophistication of robust reporting on a bi-weekly basis to track, manage, and mitigate risks proactively for any contracts with pharmacies or clients. This tool can be deployed by any health plan or PBM that has downstream client contracts as it provides robust reporting on a regular basis, giving them time and flexibility to make adjustments as required.

The Gateway Medical Rebate program helps clients receive rebates for 89 medically administered medications across 26 therapeutic categories. It is common for prescribers to administer drugs for osteoarthritis, rheumatoid arthritis, cancer, cancer treatment support, and many other conditions outside of a hospital. These medications are billed through the medical benefit. Also, these medications are managed usually by a medical policy governing their use and are paid without cost-saving strategies.

The Unique Feature

Gateway is way ahead of its contemporaries in the industry. There are many pharmacy management providers in the market. However, majority of them lack the expertise in formulary and rebate management space and often deliver a ‘one-size-fits-all’ approach for their solutions. Gateway Health Partners is different because the company offers best-in-class services and cost-containment solutions that are flexible and customizable to specific needs. In other words, Gateway is a growth engine for its customers. Besides, the firm partners with clients to create opportunities to improve their go-to-market strategies.

Strategies for the Future

“These are exciting times for Gateway as we continue to grow our company and expand our footprint in the market. Firstly, we aim to maintain our position as the largest independent provider of pharmacy management services. We are committed to offering more comprehensive services to our clients. Lastly, as the market continues to evolve, we are mindful of leveraging new opportunities to progress as a pure cost containment solutions provider. Building trusted partnerships will remain a priority,” concludes Beatty.