You don’t have to settle for a patchwork of benefits
Prescription drug coverage is an important part of your employees’ health care. It’s also a major cost concern for you, as an employer. By bundling your employees’ pharmacy and medical benefits, there are major advantages. An integrated approach drives bigger savings for your company and provides better overall care for your employees.
Improves health outcomes
Every day, our pharmacy team uses real-time data to get a complete view of our members’ health. This allows us to help members with certain health conditions find treatments that work best for them:
- Reviewing medical, pharmacy, clinical and therapeutic data, we have a complete picture of a member’s health.
- Combined data means local providers and Blue Cross and Blue Shield of Kansas clinicians can identify and close gaps in care and eliminate duplicative or wasteful care.
- Disease and case management programs can more accurately monitor a member’s condition to reduce adverse drug reactions, prevent hospitalizations, and avoid costly and unnecessary emergency room use.
Members with chronic illnesses enrolled in integrated pharmacy and medical plans experience slower medical cost growth compared with members covered by carved-out pharmacy plans.
Source: The American Journal of Managed Care, July 2021, Volume 27, Issue 7
Drives greater savings
Combined pharmacy and medical benefits result in overall savings and allow for greater insights into your employees’ total cost of care:
- Lower prescription costs. Blue Cross partners with Prime Therapeutics®, whose prescription costs are consistently 10-20 percent lower than national benchmarks.
- Lower medical costs. Bundling health and pharmacy also results in lower medical costs. In one published, peer-reviewed study, bundled pharmacy and medical plans generated the following results:
- Average savings of $148 per member per month
- Hospitalization rates lowered by 15 percent
- Emergency room use lowered by 7 percent
- Lower costs for chronic care. Bundling health and pharmacy has the biggest impact on members with chronic conditions, creating better health outcomes and reducing total costs for patients with the most expensive conditions:
| CONDITION | ANNUALIZED COST SAVINGS PER PATIENT |
| Asthma | $926 |
| Coronary Artery Disease | $4,351 |
| Chronic obstructive pulmonary disease | $3,177 |
| Congestive heart failure | $5,029 |
| Diabetes | $1,363 |
| Depression | $1,708 |
| Rheumatoid Arthritis | $842 |
Source: Prime Therapeutics, 2020
Creates a better customer experience
Combining health and pharmacy eliminates confusion and provides your employees with easier access to seamless care:
- For employers, it means one contract and one point of contact, so you can get the full picture of your employees’ benefits and utilization. It also helps you avoid contractual loopholes in carved-out drug plans that will ultimately cost you money.
- For your employees, it means one ID card, a combined out-of-pocket maximum, and one member portal, so all medical and pharmacy information is in the same spot.
- Bundling medical and pharmacy increases understanding, helps avoid confusion, and provides fewer barriers to care. Ultimately, this generates meaningful value for your employees.
Carving out your drug plan leads to:
- Disconnected health and pharmacy data
- Costly contractual loopholes
- Barriers to understanding and accessing care
- Duplicative and wasteful care
- Higher total cost of care
- Poor health outcomes
Learn more about how bundling your pharmacy and medical care drives savings and improves health outcomes at Bcbsks.com/value. For more detailed information, talk to your Blue Cross and Blue Shield of Kansas representative.
Sources: Prime Therapeutics, USI, AJMC