Public Sector

Independent Visibility for
Public Accountability

Public sector stakeholders are under increasing pressure to understand how PBM activity, reimbursement behavior, and claims-level economics affect public budgets and taxpayer dollars. Stratos helps public entities build an independent fact base around reimbursement integrity, below-cost claims, PBM reporting, and financial accountability.

An independent claims-level analysis, not PBM-supplied summaries. The Stratos discipline
Who We Support

Built for the Offices Accountable to the Public.

Attorney general offices

Offices of inspector general (OIGs)

Insurance commissioners

State associations

Public employee health plans

Key Challenges We Address

Where Public Pharmacy Spend Gets Hard to See.

Reimbursement and PBM activity shape public program spending long before it reaches a summary report. These are the pressures Stratos is built to bring into view at the claim level.

  • PBM reporting without independent validation
  • Below-cost claims
  • Opaque rebate structures
  • Spread pricing concerns
  • Rising prescription drug spend
  • Public and legislative scrutiny
  • Stewardship of taxpayer dollars
An Independent Fact Base

Built for the Scrutiny Public Spending Invites.

Public pharmacy spend is examined by boards, commissioners, and taxpayers. Stratos analyzes the claims themselves, so the picture holds up when someone asks how you know.

Independent claims-level analysis for public sector pharmacy spend
How Stratos Helps

Independent, Claims-Level Reimbursement Analysis for Public Funds.

Stratos provides independent, claims-level reimbursement analysis to help public sector stakeholders better understand reimbursement integrity, PBM reporting patterns, below-cost claim activity, pricing and rebate visibility, and the governance and financial accountability tied to public funds.

Reimbursement integrity

Whether reimbursement behavior across the program actually aligns with expectations, tested against the claims themselves.

PBM reporting patterns

What PBM-supplied summaries show, and what the underlying claims-level activity shows alongside them.

Below-cost claim activity

Where pharmacies are reimbursed below acquisition cost, and how that activity accumulates across a program.

Pricing and rebate visibility

How pricing and rebate structures behave in practice, quantified from claims rather than described in summary.

Governance and financial accountability

Reporting clear enough for leadership and legislative audiences, and defensible enough to hold up under scrutiny.

Taxpayer stewardship

An independent fact base for decisions about government budgets and the public dollars behind them.

Frequently Asked Questions

Answers for Public Sector Stakeholders.

How can a state agency independently verify PBM reimbursement?

A state agency can independently verify PBM reimbursement by analyzing claims-level data rather than relying solely on PBM-supplied summary reports. Stratos Insights performs this independent, claims-level analysis for public sector stakeholders, examining reimbursement behavior, below-cost claims, and rebate and spread pricing patterns to build a defensible, independent fact base.

What are below-cost claims and why do they matter to public budgets?

Below-cost claims occur when a pharmacy is reimbursed less than the acquisition cost of a drug. At scale, patterns of below-cost reimbursement can signal reimbursement integrity issues that affect pharmacy sustainability and public program spending. Stratos helps public sector stakeholders identify and quantify below-cost claim activity within their programs.

Ready to Build an Independent Fact Base Around Public Pharmacy Spend?

Start with an independent, claims-level look at reimbursement performance, in clear, defensible terms your office can act on.