Rivera joins the CCA for an Innovative Healthcare Solutions episode to discuss the future of pharmacy payment integrity

Pharmacy spend continues to climb and, with it, the need for greater visibility and control. In a recent episode of the Conference of Consulting Actuaries' Innovative Healthcare Solutions podcast, Rivera’s Jeff Baldetti, Vice President of Product Strategy, breaks down how pharmacy payment integrity is reshaping the way payers manage cost, compliance, and alignment with PBMs.

During the conversation, Jeff explains why traditional, retrospective reviews aren’t enough in today’s complex pharmacy landscape and how continuous oversight helps plans identify misalignments early, prevent costly errors, and ensure every pharmacy dollar is used as intended. He also touches on real-world examples, from insulin copay caps to GLP-1 utilization trends, and how actionable analytics can drive better plan decisions.

“It’s not about catching mistakes — it’s about making sure every claim processes the way it was meant to,” Jeff shared. “That’s where integrity meets impact.”

Watch the full discussion to hear how proactive pharmacy oversight is helping payers move from uncertainty to confidence.

Listen to the full episode: Watch on YouTube →