Intermediaries

In healthcare, intermediaries are entities that operate between two or more primary stakeholders—such as patients, providers, payers, manufacturers, and government agencies—to manage specific administrative, logistical, or financial functions. They are not directly involved in the delivery of medical care but play a crucial role in how care is accessed, paid for, and regulated. Examples include pharmacy benefit managers that manage drug formularies and rebates, group purchasing organizations that negotiate bulk purchasing for hospitals, and third-party administrators that handle insurance claims and benefits. In addition to describing the role of each of these intermediaries, we provide examples of how they impact cost and access as well as advice for working with them.