TIER 1 · POST-CONTRACT-REVIEW · DECISION FRAMEWORK

Optimize Existing. Or Go to Market.

The Three-Variable Decision Framework PBS Uses After Every Contract Review.

A 2-page printable framework PBS uses to score the optimize-vs-go-to-market call after every contract review. Free download. Sent to your inbox.

Three-variable rubric: finding magnitude, negotiability, switching cost

Score template you can run with your benefits committee

Optimize path: redline agenda + amendment timeline

Go-to-market path: 4-6 month RFP backplan from effective date

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A complete audit framework you can run in half a day.

WHAT IS IN THE WORKSHEET

PASS 03

Switching Cost Analysis

Score the current PBM on willingness to move on each finding. Track recent responses contract history and prior amendment patterns. PBMs that haven't moved in three renewal cycles rarely move now. The score determines whether optimize is even a viable path.

PASS 01

Quantify the Gap

Total the dollar magnitude of audit findings from the per-mechanic toolkits. The contract review surfaces individual gaps; the Decision Framework converts the stack into a single number that drives the recommendation. Document the rationale for each gap.

PASS 02

Negotiability Assessment

ACTION PLAN

This Quarter's Action Plan

Score the three variables. If recommendation is optimize: schedule the amendment process using the Contract Amendment Letter Toolkit. If go-to-market: schedule the RFP using the RFP Scoring Methodology Audit. Either way: schedule the next twice-yearly Pharmacy Benefit Review.