
09/05/2025
As more hospitals, MSOs, and provider-led health plans step into risk-bearing models, one question keeps surfacing: Are they leaving rebate dollars behind?
Too often, rebate strategies stop at the pharmacy benefit, while medical benefit drugs like infused therapies and oncology treatments remain overlooked. For provider-led health plans, that means:
1- Untapped revenue
2 - Distorted net cost visibility
3 - Weakened leverage in negotiations
In this edition of The Rebate Report, we break down the risks and how strategic rebate management can help provider-led plans close the gap.
Have you explored the rebate potential in your medical claims? Drop a comment, we’d love to hear your perspective.
https://www.linkedin.com/pulse/provider-led-health-plans-leaving-rebate-dollars-behind-3fw3e
Hospitals and health systems are increasingly moving beyond care delivery into risk-bearing models, from Medicare Advantage plans to delegated risk through ACOs and MSOs. While this shift can strengthen financial sustainability, it often exposes a critical blind spot: rebates tied to drugs billed un