Implementation Timeline
| Phase | Timeline | Key Activities |
|---|---|---|
| Planning | Months 1–2 | Implementation team; project plan; risk assessment |
| Configuration | Months 2–5 | Formulary setup; network configuration; system testing |
| Communication | Months 4–6 | Member communication; ID card distribution; pharmacy notification |
| Testing | Months 5–6 | End-to-end testing; claims processing testing |
| Go-live | Month 7 | Plan effective date; member support; issue resolution |
| Post-go-live | Months 7–12 | Performance monitoring; issue resolution; optimization |
Member Communication
Member communication is the most important implementation activity. Members need to know: (1) when the new PBM takes effect; (2) how to find their new ID card; (3) how to find in-network pharmacies; (4) what changes are being made to the formulary; and (5) who to call with questions. Communicate early, clearly, and through multiple channels.
Formulary Transition
Pro Tip
Formulary transitions are the most disruptive aspect of PBM implementation. Members who are taking drugs that are not on the new formulary — or that are on a different tier — need advance notice and a transition period. Implement a 90-day transition fill policy — allowing members to continue their current medications at current cost-sharing for 90 days after the transition — to minimize disruption.