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 The State of Montana’s health plan was hemorrhaging money with a little over 60% of the costs coming from hospital care and pharmacy benefits. Enter Marilynn Bartlett, the Special Projects Coordinator for the State of Montana’s Commissioner of Securities and Insurance, with a radical plan: leverage Montana’s purchasing power to set hospitals prices and contract with a PBM who did not engage in spread pricing and who passed along rebates in full. Did Bartlett’s strategy pay off?