White Paper

How Pharmacy Benefit Managers Can Help Auto Insurers Navigate Rising Costs and Operational Challenges

Auto insurers have an opportunity to leverage PBMs to improve medical loss ratios, enhance claims outcomes, and provide greater transparency and control.

White Paper Summary

Auto insurance payers face a perfect storm of economic and operational challenges that are putting unprecedented pressure on their bottom line.

Economic Pressures Creating New Challenges

The current economic landscape presents multiple challenges that directly affect how auto insurers process and manage claims. Inflation continues to influence virtually every aspect of the claims process, while broader economic uncertainty adds complexity to claims management decisions.

“There are a host of challenges from both economic and health insurance perspectives that auto carriers face when managing claims. Economic uncertainty regarding impending tariffs may affect how claims are processed for patients. Payers are also still experiencing the impacts of inflation across goods and services,” said Shawn Waters, Director, Medical Clinical Ops at Optum.

Beyond inflation, the industry is grappling with supply chain shortages and bottlenecks with far-reaching effects. “The industry is still seeing challenges with supply chain disruptions, which relate directly to rising costs in vehicle repair and replacement. This is having a significant impact on obtaining auto parts and increasing labor costs,” noted Amy Santoro SVP, National Sales – Strategic Accounts at Optum.

The financial pressures extend beyond immediate repair costs. Interest rate fluctuations are creating additional challenges for insurers’ investment portfolios, while rising healthcare costs create challenges for the overall claims landscape. “Interest rate fluctuations are impacting insurers’ investments, resulting in negative effects on profitability and pricing strategies,” Santoro added.

To learn more about Optum, please visit their website.

The Optum workers’ compensation and auto no-fault division works to collaborate with our clients to deliver value beyond transactional savings while helping ensure injured parties receive safe and effective clinical care throughout the life of their claim. Our innovative and comprehensive cost management programs include pharmacy care services, ancillary benefit management, medical services, and settlement solutions.

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