Switching Pharmacy Benefit Managers (PBMs) might seem risky, but staying locked into a model that’s not working is a bigger risk.
For many HR and benefits leaders, the idea of changing your PBM brings to mind endless meetings, complex spreadsheets, and concerns about employee disruption. It’s no surprise that 70% of employers stick with the same PBM year after year, even as pharmacy costs continue to rise faster than any other aspect of health benefits.
But that fear may no longer be justified. A growing number of employers are proving that a well-executed transition can be faster, smoother, and less risky than expected.
According to Mercer’s National Survey of Employer-Sponsored Health Plans, more than 60% of large employers are actively evaluating PBM alternatives. Their top concerns include transparency, clinical flexibility, and greater control over benefit plan design: above all, less friction.
The industry is catching up. Independent PBMs are gaining traction by offering service-first models that prioritize speed, clarity and collaboration. In fact, the Drug Channels Institute recently added a dedicated section on independent PBMs to its annual industry analysis, “The 2025 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.” a signal that the market is moving.
The shift is clear: what once felt risky is now a strategic move.
And yet, the biggest obstacle isn’t complexity, it’s perception. This keeps too many HR teams locked into underperforming and often murky contracts.
With the right partner, PBM transitions can be fast and straightforward, with minimal disruption
A well-run PBM transition doesn’t need to take six months, or even three. Many organizations can implement new partners in under 60 days with the right level of focus, ownership, and process clarity.
Look for a PBM that uses a phased approach, assigns a dedicated implementation lead, and simplifies rather than bloats the planning process.
Here is what you should look for in a smooth PBM transition:
Step 1: Kickoff and discovery
Within days of signing, your new implementation team should analyze your current benefit design and surface differences immediately, before you’re deep into a project plan. Look for teams that will come prepared to your kickoff meeting, not just to take notes, but with a plan tailored to your situation.
Chelsey Barnes, Implementation Manager at True Rx, says, “Implementation is more than project management—it’s problem solving. The best partners ask the right questions up front, because benefit designs affect real people.”
Step 2: Design and configuration
After kickoff, benefit plan design should progress smoothly when managed by a focused, aligned team. Clear upfront understanding reduces rework, turning most adjustments into refinements rather than restarts.
“Follow-up meetings can help confirm details, but when the right questions are asked early, the process moves quickly and efficiently,” Barnes says.
Step 3: Member communications
The biggest risk in a PBM transition isn’t technical, it’s emotional. Employees aren’t just receiving new benefit cards; they’re facing changes that impact their health and routines. That’s why effective communication is just as critical as the transition plan itself.
Forward-thinking benefits leaders recognize that people need clarity at every step: what’s changing, why it matters, and how it affects them personally. A generic rollout won’t be enough. Communication must be personalized, timely, and grounded in empathy, especially for members whose prescriptions or care routines may be impacted.
This is where a Health Strategist approach proves essential. It starts by identifying at-risk groups and designing communication that addresses their specific concerns. It includes giving HR teams the tools and messaging to feel confident in the change. And when questions arise, it means showing up, whether that’s in an open enrollment meeting or a direct conversation with a concerned employee.
Even the best benefit design won’t work if people don’t understand or trust it,” says Barnes. “A Health Strategist sees communication as part of the strategy, not just the delivery.”
Step 4: Testing and peer review
Most PBMs accept that mistakes are just part of the process when implementing new clients. Not True Rx. “We’re obsessive, in a good way, about getting implementations right,” Barnes said. “Our goal is to make sure your team, and your employees feel nothing but confidence from day one.”
Post-launch, rigorous monitoring is essential. Reviewing claims multiple times daily during the first 30 days helps catch issues early and ensures accuracy, building lasting trust in the plan’s performance.
The real risk is standing still
HR leaders have enough on their plates. With health benefit costs rising, so is the pressure to try something new. But changing your PBM doesn’t have to be overwhelming.
Implementation shouldn’t be the hardest part of changing PBMs. When done right, it’s a straightforward, repeatable process led by a single accountable contact. Look for clear deliverables, transparent timelines, and partners who treat your team like an extension of their own.
