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10 Questions to Ask a Hospice PBM Before You Sign

10 Questions to Ask a Hospice PBM Before You Sign
THE SHORT ANSWER

 Questions to ask a hospice PBM should cover pricing transparency, platform design, support responsiveness, and formulary control, since these are the areas where problems most often surface after a contract is already signed. Ask these questions during due diligence, not after go-live. BetterRX answers each one directly as part of The Better Way to Manage Hospice Medications.

Why Due Diligence Questions Matter More Than the Pitch

Questions to ask a hospice PBM matter because a sales pitch is designed to highlight strengths, and it is the CEO's job during procurement to surface everything the pitch does not mention. The gap between what a vendor presents and what a hospice actually experiences after go-live usually traces back to a question that was never asked clearly enough during due diligence.

This checklist is organized around the areas where that gap shows up most often: pricing, technology, support, and formulary control. Ask every vendor on your shortlist the same ten questions, and request the answers in writing wherever possible.

 

Who Should Be in the Room When You Ask These

These ten questions land differently depending on who is asking and who is answering. A finance leader should be present for questions one and two, since pricing and formulary change fees are ultimately budget questions. A director of nursing or clinical lead should be present for questions three, four, and five, since those determine what daily workflow will actually feel like for the team using the platform every shift. Bringing the right stakeholders into the same due diligence conversation, rather than splitting these questions across separate calls, makes it much harder for a vendor to give an incomplete answer to any one of them.

 

The 10 Questions

1. Is your pricing transparent and pass-through, or does it rely on spread pricing between what you pay and what we are charged?

2. Are there change fees for formulary updates, and how long does an update actually take?

3. Was your platform purpose-built for hospice, or adapted from a broader retail or PBM system?

4. Can our team order, approve, prescribe, and view reporting in one connected workflow, or will we use multiple portals?

5. What is your actual average response time for 24/7 clinical and technical support, and how is it measured?

6. How do you support multi-location standardization if we grow or acquire new sites?

7. Can you provide client satisfaction data with its source and survey methodology, not just a marketing claim?

8. What happens during onboarding, and how long does full go-live typically take?

9. Can we speak with reference clients of a similar size and geography to ours?

10. What is your data and EMR integration approach, and who resolves issues when they originate on the EMR side?

 

How to Document the Answers

Send these ten questions to every vendor on your shortlist in the same written format, with a request for written responses rather than a verbal walkthrough on a call. This does two things at once: it creates a paper trail you can compare side by side later, and it naturally filters out vague or evasive answers, since it is harder to be vague in writing than it is out loud on a demo call where a confident tone can substitute for a specific answer.

Red Flags to Watch for in the Answers

 

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Vague answers about pricing structure, or reluctance to put pricing in writing before signing.
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Satisfaction statistics presented without a named source, survey population, or methodology.
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Reluctance to provide reference clients, or only offering references hand-picked without your input.
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Support response times described only as "24/7" without an actual average time to answer.

 

 

Common Mistakes When Asking These Questions

A due diligence checklist only works if it's used consistently. A few habits tend to weaken it even when the ten questions are asked in good faith.

Asking the questions verbally on a single call and taking notes from memory afterward, instead of sending them in writing and requiring written answers.

Letting the vendor choose which reference clients to provide, rather than asking for references of a similar size and geography to your own organization.

Accepting "we're working on that" as a final answer to a pricing or formulary question without a follow-up deadline attached.

Moving straight from the demo to contract review without circling back to confirm every one of the ten questions actually got a specific, written answer.

 

How BetterRX Answers These Questions

BetterRX uses transparent, pass-through pharmacy pricing and does not profit from medication or delivery markups. Formulary updates happen directly in the platform in real time, at no charge, with ownership staying with the hospice. Intelligent Medication Management puts ordering, approvals, prescribing, and reporting on one connected platform, and per BetterRX’s 2026 Voice of the Customer survey, 98% of hospice clients say BetterRX has improved their nurses’ job satisfaction.


On support responsiveness, BetterRX's 24/7 pharmacist and tech support answers in about seven seconds on average, sourced from BetterRX’s 2026 Voice of the Customer survey, not an unmeasured marketing claim.

I tell other nurses all the time how fast and easy everything is — better than anything I've done before. It's exciting!"

- Registered Nurse

(Source: www.betterrx.com/testimonials) 

That kind of specific, attributed response is exactly what question seven on this list is asking every vendor to produce: not a number alone, but the source behind it and a real client willing to stand by it.

 

Turning Answers Into a Decision

Once every vendor on your shortlist has answered all ten questions in writing, compare the answers side by side rather than relying on memory from separate sales calls. This protects financial stewardship by locking in pricing expectations before signing, and it protects nurse satisfaction and patient care by confirming the support and workflow claims hold up before your team depends on them.

 

Using These Questions During Contract Negotiation

These ten questions are useful beyond the initial evaluation. Written answers to questions one, two, and five, covering pricing structure, formulary change fees, and support response times, belong directly in the contract or a signed addendum, not just in a sales conversation that is easy to forget six months later. If a vendor is willing to say something confidently in a meeting but hesitant to put it in writing, treat that hesitation as information.

It also helps to revisit these same ten questions at renewal time, even with an existing partner. Pricing structures, support staffing, and platform capabilities can all shift over a multi-year relationship, and a CEO who asks the same due diligence questions at renewal protects the organization from quietly drifting terms that were never renegotiated on purpose.

 

Frequently Asked Questions

  • Whether pricing is transparent and pass-through, since spread pricing is the factor most likely to create budget surprises after the contract is signed.

  • Verbal estimates during a sales pitch are not binding. Written pricing structures create accountability and make later comparisons across vendors accurate.

  • Vague pricing answers, satisfaction statistics without a named source or methodology, and reluctance to provide reference clients you can speak with directly.

  • BetterRX's 24/7 pharmacist and tech support answers in about seven seconds on average, per BetterRX's 2026 Voice of Customer survey.

  • No. Hospices update their own formulary directly in the BetterRX platform in real time, at no charge, and retain full ownership of formulary decisions.

  • Yes. Per BetterRX’s 2026 Voice of the Customer survey, 98% of hospice clients say BetterRX has improved their nurses’ job satisfaction.

  • Yes. Renewals are a natural checkpoint to confirm pricing, support performance, and formulary terms have not quietly changed since the original agreement.

NEXT STEP

Schedule a BetterRX consultation and get written answers to all ten questions before your next renewal.

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