Choosing a pharmacy benefit manager (PBM) is about more than selecting which option is the most fiscally effective, it also plays an enormous role in the experience its employees and members receive.

According to Business Group on Health's 2026 employer survey, pharmacy accounted for 24% of employer health care dollars in 2024, and employers project pharmacy cost increases of 11 to 12 percent into 2026. These mounting pharmacy costs, coupled with an increasing demand for transparency, have led employers to look for PBMs that provide exceptional account support, proactive member service, and data-driven tools to help them make informed decisions that truly save plans money.

That pressure has led self-funded employers away from the largest, legacy PBMs. Nearly half of employers report they've turned away from the 'Big Three' in favor of alternative, modern PBMs.

The clearest differences between modern and legacy PBMs show up in three places employers can evaluate directly: account support, member service, and how costs are priced and reported.

White Glove Support: Setting the Standard for Modern PBMs

One of the most important criteria for employers when selecting a PBM is the level of account support provided. Strong account support strategy leverages proactive, high-touch service that anticipates client needs and resolves member questions before they affect the plan or HR team.

Legacy PBMs often fall short by offering a one-size-fits-all approach, which leaves employers to navigate the complexities of their benefits plan on their own. They may also struggle to understand the true costs of prescription drug benefits due to opaque pricing models and a lack of personalized support. Modern PBMs prioritize comprehensive and personalized account support, ensuring that employers always have a reliable point of contact.

What to Look For in Account Support

• Dedicated Account Managers: A designated resource who understands your unique needs and serves as a strategic partner, ensuring consistent communication and personalized guidance.

• Detailed Issue Resolution Process: A clear, transparent process for addressing account issues, supported by advanced tools that streamline communication and track progress.

• Response Time Guarantee: Modern PBMs commit to fast, reliable service, minimizing wait times and maximizing productivity.

• Intuitive Technology and Data Integration: Real-time data access through user-friendly portals empowers employers to resolve escalations quickly and make informed decisions.

These features set modern PBMs apart, providing a level of service that goes beyond traditional account management to deliver proactive and tailored support.

Elevated Member Experience and Service

While account support is crucial, a positive member experience is equally important when evaluating a PBM. Legacy PBMs often fail to provide the exceptional service and personalized care that today's members expect. Long wait times, limited access to plan information, and confusing benefit structures make it harder for members to use their coverage with confidence.

Modern PBMs set a new standard for member experience and service by prioritizing proactive communication, transparency, and personalized support. They empower members to easily manage their benefits, access critical information, and receive timely assistance through multiple communication channels. Responsiveness across those channels is something employers can measure directly when comparing PBMs.

Key Features of a Modern Member Experience

• Disruption Reports and Mitigation Plans: Proactively identify potentially impacted members and provide a clear plan for minimizing disruption, ensuring continuity of care.

• Member Satisfaction Tracking: Collect and analyze member feedback to continuously improve service quality and maintain high satisfaction rates.

• Multi-Channel Response Times: Guarantee timely support through phone, email, and digital platforms, ensuring members receive the help they need when they need it.

• On-Demand Technology and Data Access: User-friendly portals provide members with real-time access to benefits information, empowering them to make informed healthcare decisions.

By prioritizing these elements, modern PBMs enhance employee satisfaction and drive better health outcomes, setting a new benchmark for member experience.

Cost Efficiency and Savings Programs

Employers are under increasing pressure to manage rising healthcare costs, making cost efficiency a critical factor in choosing a PBM. Legacy PBMs often rely on complex pricing structures and hidden fees, which can drive up costs without delivering additional value. In contrast, modern PBMs provide transparent pricing and implement cost-saving programs that are aligned with the best interests of both employers and members.

What to Look For in Cost Efficiency Programs

• Clear and Transparent Pricing Models: Modern PBMs provide detailed breakdowns of costs, including administrative fees and drug prices, ensuring employers know exactly what they're paying for.

• 100% Pass-Through Rebates: Rebates and discounts are fully passed through to employers, reducing overall drug costs.

• Cost-Containment Initiatives: Programs designed to minimize spending, such as formulary management, utilization reviews, and low-cost alternative pathways.

• Specialty Drug Savings: Comprehensive strategies for managing specialty drug costs, including biosimilars and cost-effective sourcing options.

Modern PBMs apply these strategies to lower spend while maintaining care and access for members.

Data and Reporting: What Employers Should Expect to See

Reporting is where transparent pricing becomes something an employer can verify. A truly modern PBM provides claims-level visibility, so plan sponsors can see how prescription drug dollars actually flow rather than relying on summary figures alone during quarterly business reviews.

That visibility should include clear breakdowns of drug costs, administrative fees, and rebates, presented in a way that connects each dollar to a plan decision. Real-time access through portals lets employers review performance, spot cost-saving opportunities, and answer questions as they arise instead of waiting for periodic statements. For a closer look at how this differs from legacy practice, see our article on modern PBM reporting.

The SmithRx Difference: A Modern Approach to PBM Services

SmithRx stands out by delivering a modern PBM experience that meets the needs of both employers and members. Our approach focuses on proactive account support, seamless member experiences, and cost efficiency through transparent pricing and innovative savings programs.

Account Management Team

At SmithRx, each client is paired with a dedicated account manager who acts as a strategic partner, ensuring consistent communication and personalized guidance. Our proactive approach includes a response-time guarantee for 90% of communication, so employers always receive timely support. We provide transparent issue resolution with advanced tools that streamline communication and track progress. That focus shows up in our results: SmithRx clients gave us an average client satisfaction (CSAT) score of 4.7 out of 5 in 2025.

Support Team Excellence

Our support team pairs industry-leading, fast response times with clinical expertise. We proactively engage members to offer guidance and support before questions become obstacles. In 2025, SmithRx members waited less than 21 seconds on average to reach support. This approach minimizes disruptions and enhances the member experience.

Intuitive Technology and Data Access

SmithRx provides real-time data access through our user-friendly partner portal, empowering clients to make informed decisions quickly and effectively. Our technology enables employers to resolve escalations swiftly, optimize benefit strategies, and identify cost-saving opportunities with ease.

Cost Efficiency Through Connect 360

Connect 360, our suite of cost-saving programs, actively guides members to the most affordable medication options, ensuring they receive the care they need without unnecessary costs. We continuously seek new discounts and provide transparent reporting, so employers can see exactly where savings are realized.

This commitment to comprehensive account support, exceptional member service, and cost efficiency ensures that employers receive the best value from their pharmacy benefits plan.

Reader’s Note: Connect 360 has evolved. As of June 2026, we’ve officially updated Connect 360 to Drug Pathways, powered by our Drug Pathways Engine. SmithRx clients still get the exact same pass-through savings and white-glove member support. Now all of that is backed by terminology that reflects how our tech dynamically routes every claim to the lowest-cost option. You can learn more about our Drug Pathways Engine here.

Read the Drug Pathways Engine Update>

Frequently Asked Questions

What is the difference between a legacy PBM and a modern, transparent PBM?

Modern PBMs use transparent contracts, a fixed per-member-per-month (PMPM) administrative fee, and pass through 100% of manufacturer rebates. A PMPM fee is a set amount the plan pays for each covered member each month, so PBM compensation does not rise when medication costs rise. Legacy models may use spread pricing or retained rebates that reduce visibility into how prescription drug dollars flow. For more detail, see what a transparent PBM looks like.

What should employers look for in a PBM's account support?

Look for a PBM that provides dedicated account support that truly understands the plan, a clear issue-resolution process, a response-time commitment, and real-time access to plan data. Together, these give employers a reliable point of contact and the information needed to make timely decisions.

What should employers look for in member service?

Strong member service is proactive and available across multiple channels, with short wait times and self-service digital tools members can use for maximum flexibility.

Ready to Experience the SmithRx Difference?

Choosing the right PBM shapes both your pharmacy spend and the everyday experience of your team. At SmithRx, we provide modern solutions that empower employers and enhance member satisfaction, backed by proactive support and transparent savings.

If you’'re ready to take control of your pharmacy benefits and see how the modern PBM experience can transform your plan, let's connect.

Contact us today to learn more about how SmithRx can support your organization's goals.