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How a Rebate Strategy Can Ease Margin Pressure in 2025

Healthcare costs are rising—and margins are shrinking.

In 2025, health plans, TPAs, MSOs, and provider organizations are facing new financial headwinds.

Industry forecasts project healthcare cost trends to rise 7–8%, with employers bracing for spikes in pharmacy spending. Meanwhile, the Medicare Physician Fee Schedule was cut by 2.83%, putting further pressure on providers managing fee-for-service revenue.

Amid this, rebate strategy is emerging as a critical but often overlooked financial lever—especially for risk-bearing entities covering physician-administered drugs.

Here’s what’s getting in the way:

  • Manufacturer requirements are complex and constantly evolving
  • Internal teams are understaffed or lack the tooling to manage quarterly submissions
  • Rebate compliance requires precision—and the cost of disqualification is high

VativoRx helps organizations unlock value from medical rebate programs without adding internal burden.

  • We provide preliminary opportunity assessments without PHI
  • We request only minimum necessary PHI during onboarding, in line with HIPAA
  • We manage the mapping, submissions, and compliance checks
  • Your team stays focused—we handle the rebate lifecycle

In a year where CFOs and leadership teams are being asked to do more with less, rebate recovery shouldn’t be an afterthought. It’s a strategic lever that can make a difference.

Subscribe on LinkedIn to The Rebate Report for more insights, or connect with us directly to explore what your rebate opportunity could look like.

Sources:

PwC: Behind the Numbers – Medical Cost Trend 2025

AMA: 2025 Medicare Physician Payment Schedule

Unlock Hidden Revenue: The Shift to Medical Rebates for Specialty Drugs

Health plans are facing increasing pressure to manage the skyrocketing costs of specialty medications. Specialty drugs, while representing a small fraction of total prescriptions, now account for a substantial share of overall drug spending. As health plans work to balance financial sustainability with member access to high-cost therapies, one growing trend is the increased use of medical-benefit rebates over traditional pharmacy rebates. 

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