<img alt="" src="https://secure.heat6have.com/192007.png" style="display:none;">
Skip to the main content.
Sign In Schedule a Call

6 min read

How to Choose a Hospice PBM: A Step-by-Step Evaluation Framework

Picture of BetterRX BetterRX : Oct 13, 2026, 6:16:05 AM

hospicepharmacy VendorEvaluation BuyerGuide HospicePBM
How to Choose a Hospice PBM: A Step-by-Step Evaluation Framework
THE SHORT ANSWER

How to choose a hospice pharmacy benefit manager (PBM) comes down to evaluating a small set of operational criteria consistently across every option on your shortlist, rather than comparing marketing pitches one at a time. A structured framework beats a gut decision, because the choice affects nurse time, patient comfort, and predictable per-patient-day (PPD) pharmacy spend for years. Six consecutive years of BetterRX Voice of the Customer research point to three critical dimensions: nurse time savings and reducing medication delays, PPD cost management and clinical pharmacy expertise, and human-centered support. BetterRX built its platform around these same criteria as part of The Better Way to Manage Hospice Medications.

 

Why This Decision Deserves a Real Framework

How to choose a hospice PBM is a question hospice administrators typically face during a contract renewal, an EMR migration, or a period of rapid growth, and it is a bigger decision than it first appears. The partner you choose affects how fast nurses get medications to patients, how predictable your per-patient-day pharmacy spend stays, and how much administrative work your team carries every single day.

Too often, this decision gets made on a single sales conversation or a familiar name. A structured evaluation framework, applied consistently to every option, produces a decision that holds up months later, after the contract is signed and the relationship is what actually matters.

 

Who Actually Runs This Evaluation

In most hospices, this decision does not fall to one person. An administrator typically owns the process, but a real evaluation pulls in a director of nursing who understands daily workflow friction, a finance lead who understands per-patient-day economics, and often an IT or EMR administrator who understands integration requirements. Naming these stakeholders early, before demos begin, keeps the evaluation from becoming a single person's opinion dressed up as an organizational decision.

Step 1: Define What Your Organization Actually Needs

Before comparing vendors, get specific about your own situation. A single-site hospice with 30 patients has different needs than a multi-state organization standardizing operations across a dozen locations.

  • How many locations and patients does the platform need to support today, and in two years?

  • Which EMR does your team use, and does it need to integrate natively?

  • What has caused the most friction with your current pharmacy partner, if you have one?

  • Who on your team will use the platform daily: nurses, administrators, or both?

Step 2: Score Every Option Against Three Critical Dimensions

Once your needs are clear, evaluate every vendor on the same checklist so the comparison is fair. These three dimensions come from BetterRX's 2026 Voice of the Customer white paper, How to Evaluate Hospice Medication Management Software and Solutions.

Nurse time savings and reducing medication delays. The platform should return hours to patient care, not just digitize existing paper processes. Look for fewer steps and duplicate entries than your current process, approved orders reaching the pharmacy in minutes, not hours, and 24/7 availability for urgent medication needs. Ask how the vendor reduces phone calls and manual follow-up with pharmacies, and whether it can show client data on service failure reduction after implementation.

PPD cost management and clinical pharmacy expertise. Technology and clinical guidance should work together to manage PPD without compromising care. Look for transparent, pass-through pricing rather than spread pricing you cannot easily audit, real-time reporting down to the patient and drug level, and the ability to update your own formulary directly in the platform without change fees or delays. Ask whether nurses must switch between ePrescribe, PBM portals, and spreadsheets, and whether hospice-experienced pharmacists stand behind the software.

Human-centered support. Software alone doesn't fix medication management problems. Support during implementation, urgent situations, and ongoing optimization matters just as much. Ask how long it takes the support team to pick up the phone, how often Client Success Managers meet with clients, and how the EMR integration handles admits, discharges, and order updates between systems.

 

Step 3: Verify Claims Before You Sign

Every vendor will make claims during the sales process. Verify the ones that matter most before signing: ask for the pricing structure in writing, request a live demo using the actual workflow your nurses will use, and speak with reference clients of a similar size and geography. Ask for client satisfaction data, too. A credible survey covers a significant share of the vendor's client base, combines ratings with open-ended feedback, and comes with its methodology and response rate. Ask for results from organizations similar to yours in size. If a vendor won't share, that's a red flag.

It helps to treat verification as its own short project rather than a single follow-up email. Set aside time on the calendar for two or three reference calls per finalist, prepare specific questions in advance rather than open-ended ones, and ask reference clients directly whether the vendor's sales claims matched their day-to-day experience after go-live. A reference call that only asks "are you happy with them" rarely surfaces the specific friction points a more pointed question will.

 

 

How BetterRX Approaches This Framework

Built exclusively for hospice, BetterRX operates differently from the traditional PBM model. Intelligent Medication Management puts ordering, approvals, prescribing, and reporting on one platform, and BetterRX offers transparent, pass-through pricing with no markups on medication or delivery costs. Formulary updates happen directly in the platform, with no change fees and no phone calls required.

BetterRX publishes its own results against these three dimensions. Across 30+ evaluation areas, clients gave BetterRX 94% Overall Client Satisfaction (BetterRX's 2026 Voice of the Customer survey). By dimension:

Nurse time savings:

97.0% report measurable time savings, and 86.0% report medication service failures have decreased, with 41% reporting failures "significantly decreased."

PPD cost management and clinical expertise:

93.8% satisfaction for "Cost savings tools + resources to help achieve PPD goals" and 94.6% satisfaction for "Clinical expertise + education."

Human-centered support:

95.0% satisfaction for "Client Success Manager expertise," with an average of 7 seconds to access 24/7 pharmacist and tech support.

Sources: BetterRX's Voice of the Customer survey across six consecutive years; 7-second figure from the 2026 Voice of Customer Survey Results. Read the full framework, including a complete evaluation checklist, in the white paper "How to Evaluate Hospice Medication Management Software and Solutions."

Customer service is always excellent, the platform is easy to use, and it lets clinical staff quickly care for patients."

- Assistant Director of Nursing

That quote captures what Step 2 of this framework is actually trying to measure: not whether a vendor says its support is responsive, but whether clients experience it that way in practice. (Source: www.betterrx.com/testimonials)

 

Turning the Decision Into an Outcome

A structured evaluation protects more than the contract. It protects Patient Care by choosing a partner with proven fulfillment reliability, it protects Nurse Satisfaction by choosing a workflow your team will actually use well, and it protects Predictable PPD by locking in transparent pricing before problems appear on an invoice months later.

 

A Hypothetical Example: Applying the Framework at a Growing Hospice

Consider an administrator at a hospice preparing to open its third location and starting a PBM search. Step 1 reveals that the real priority is not pricing alone, since the current partner is already competitively priced, but workflow consolidation: nurses at the two existing locations are paying the "Toggle Tax," toggling between a PBM portal, a separate ePrescribe tool, and a spreadsheet for tracking refill timing.

Step 2 scores four vendors against the same three dimensions, and nurse time savings immediately separates the finalists from the rest: two vendors still require a separate ePrescribe login, while two offer a single connected workflow. Step 3 verification calls with reference clients confirm which of the remaining two actually delivers on that promise in daily use, rather than just in the demo.

The result is a decision the administrator can explain clearly to the board: not "we picked the biggest name" or "we picked the cheapest option," but "we picked the platform that solved the specific workflow problem slowing our nurses down, and we verified that claim with three reference clients before signing."

 

Red Flags to Watch For During Evaluation

A vendor that can't explain its pricing structure in plain language, or that resists putting pricing terms in writing before a contract is signed.
A platform demo that only shows the administrator view, with no walkthrough of what a nurse actually sees when placing an order.
Reference clients the vendor selects for you, rather than a willingness to let you choose which of their current clients to call.
Formulary changes that require a phone call, a change fee, or a multi-day turnaround instead of happening directly in the platform.
Client satisfaction figures with no source, or a vendor that won't share its survey methodology and response rate.

 


Frequently Asked Questions

  • Define your organization's specific needs first: location count, EMR, current pain points, and who will use the platform daily, before comparing any vendors.

  • BetterRX's Voice of the Customer research points to three critical dimensions: nurse time savings and reducing medication delays, PPD cost management and clinical pharmacy expertise, and human-centered support. Within those, compare pricing transparency, formulary control, EMR integration, and support responsiveness.

  • Request the pricing structure in writing, ask for a live demo using your actual ordering workflow, speak directly with reference clients of a similar size and geography, and ask for client satisfaction data along with its methodology and response rate.

  • BetterRX was purpose-built exclusively for hospice with transparent, pass-through pricing and one connected platform for ordering, approvals, prescribing, and reporting.

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

  • Yes. The specific needs identified in Step 1 will differ by size, but scoring every vendor against the same three dimensions works whether you operate one location or a multi-state organization. Ask each vendor for satisfaction data from organizations your size. BetterRX's results by segment: small hospices (11 to 30 patients) 96.6%, SMB (31 to 99) 93.8%, mid-market (100 to 399) 93.8%, and enterprise (1,000+) 97.7% satisfaction, per BetterRX's Voice of the Customer survey across six consecutive years.

NEXT STEP

See how BetterRX scores against your own hospice PBM evaluation checklist.

Schedule a Call