Claims-Level Visibility
for Employers, Health Plans,
and Payer Organizations
Private sector organizations need clearer visibility into PBM performance, claims spend, spread pricing, rebate validation, and reimbursement behavior. Stratos helps employers, health plans, and payer-focused organizations understand the financial performance of their pharmacy benefit through independent reimbursement analysis.
Built for the Organizations Funding the Pharmacy Benefit.
Self-insured employers
Commercial health plans
State Medicaid Organizations
Where Pharmacy Benefit Spend Gets Hard to See.
Plan cost is shaped by pricing, rebates, and reimbursement behavior long before it reaches a summary report. These are the pressures Stratos is built to bring into view at the claim level.
- Rising pharmacy benefit costs
- Spread pricing exposure
- Rebate validation uncertainty
- Limited independent PBM performance visibility
- Claims-level financial opacity
- Plan cost management pressure
See What the Plan Is Charged Against What the Pharmacy Is Paid.
Spread pricing and rebate value live in the space between those two numbers. Stratos reads the claims themselves, so plan sponsors can see the gap instead of taking a summary's word for it.
Independent Reimbursement Analysis of Your Pharmacy Benefit.
Stratos supports private sector organizations with claims-level reimbursement visibility, PBM performance visibility, rebate validation support, spread pricing analysis, payer performance analysis, and plan cost and financial accountability insight.
Claims-level reimbursement visibility
Financial performance read from the individual claim, not from the summary that describes it.
PBM performance visibility
Whether PBM activity and reported outcomes actually align with what the plan expects.
Rebate validation support
Confirmation that the rebates a plan is owed are calculated, passed through, and reconciled correctly.
Spread pricing analysis
What the plan is charged compared against what the pharmacy is reimbursed, quantified at the claim.
Payer performance analysis
How performance varies across payers and plans once the claims are grouped and measured.
Plan cost and financial accountability
Reporting clear enough for leadership and defensible enough to hold up under scrutiny.
Answers for Employers and Health Plans.
How can a self-insured employer tell if its PBM is using spread pricing?
A self-insured employer can detect spread pricing by comparing what the plan is charged against what the pharmacy is actually reimbursed at the claim level. Stratos Insights performs this independent, claims-level analysis to quantify spread pricing exposure and validate whether rebate and pricing terms are being honored.
What is rebate validation and why does it matter?
Rebate validation is the process of independently confirming that the manufacturer rebates a plan is owed are calculated, passed through, and reconciled correctly. Stratos helps private sector organizations validate rebate performance against expectations using claims-level data, so plan sponsors can see whether they are receiving the value their contract promises.
Ready to See How Your Pharmacy Benefit Is Actually Performing?
Start with an independent, claims-level look at reimbursement performance, in clear, defensible terms your team can act on.