In today’s market, Third-Party Administrators (TPAs) are expected to deliver more value than ever—whether that means reducing plan costs, improving client retention, or enhancing broker relationships.
But many TPAs are still overlooking a major revenue stream that requires no disruption to existing systems:
👉 Medical rebates tied to provider-administered drugs.
While pharmacy rebates are well known and often managed through PBMs, medical claims—such as infusions or specialty injectables—are typically left out of the equation.
The Overlooked Opportunity in Medical Rebates
Many high-cost medications are administered in outpatient clinics, infusion centers, or hospital settings and billed under medical claims. These include:
- Oncology infusions
- IVIG and immune therapies
- Respiratory treatments
- Inflammatory disease injectables
- Workers’ Comp-administered medications
PBMs generally do not process or track these claims, meaning TPAs—and their employer groups—miss out on potentially significant rebate dollars.
And with over 65% of U.S. employers self-funding their plans (KFF), the financial impact of missed medical rebates is only growing.
What’s in It for TPAs?
By partnering with VativoRx, TPAs can unlock rebate revenue across their book of business—without changing providers, PBMs, or billing systems. Our program creates strategic advantages across multiple areas:
- Offset client drug costs
- Boost client retention with new, measurable value
- Fund commissions or vendor relationships
- Lower internal expenses without raising fees
- Differentiate in the market and stand out in RFPs
Medical rebate recovery becomes a tool to both protect margin and enhance client relationships.
How VativoRx Helps TPAs Win
We make the rebate recovery process simple, scalable, and fully compliant. Our program identifies overlooked opportunities and routes eligible claims through our trusted upstream channels, ensuring nothing falls through the cracks.
Here’s what we offer:
- Proactive rebate monitoring
- Partnerships with trusted upstream channels
- Compliance-first operations
- Support for Workers’ Comp & employer-sponsored claims
- No disruption to existing PBMs, billing systems, or provider contracts
You send the data—we handle the heavy lifting.
Why Now?
Specialty drugs now account for over 50% of total drug spend (PSG). The more your clients rely on high-cost, provider-administered medications, the more urgent this opportunity becomes.
And with shrinking margins and rising expectations, TPAs can no longer afford to leave these dollars behind.
Closing: Let’s Turn Missed Rebates into Real Results
VativoRx helps TPAs unlock real revenue from claims they’re already managing—without added complexity. If you work with employer groups, Workers’ Comp, or self-funded plans, this is a conversation worth having.
💬 Let’s talk about what your book of business could be worth in rebates.
