Why it pays to integrate pharmacy benefits

If you are an employer with a self-funded health plan, consider integrating pharmacy and medical benefits that are designed to achieve better outcomes for your employees, simplify administration for your HR staff, and help control costs—including specialty drugs.

Lowering claims costs

A comparison of employees who have a chronic condition and integrated pharmacy benefits versus those with the same condition covered by outsourced pharmacy benefits shows striking results.

Medical costs for employees with:

• High cholesterol – 19% less per month
• Asthma – 13% less per month
• Depression – 7% less per month
• Diabetes - 6% less per month   

Based on BCBSRI analysis of 2019–2022 (excluding 2020) medical spend for all fully insured and self-funded Commercial segments. Comparison is provided for informational purposes only and is not intended to represent or guarantee that any individual employer group will achieve savings in the amounts provided.

Prescription savings program       
MedsYourWay® automatically provides members the lowest available price of applicable discount cards for eligible medications—no coupons or other cards needed. And those medication costs will count toward their deductibles.

Controlling specialty drug expense

BCBSRI’s comprehensive specialty drug strategy includes:

• Specialty drug sourcing – beyond traditional channels
• High Touch Rx™ – designed to eliminate duplicate therapies    
• Value-based contracting – can improve quality of care and cost effectiveness
• Biosimilar strategy – helps increase access to more affordable treatments
• Synergie Medication Collective℠ – leverages the strength of group purchasing

FlexAccess™       
Your employees will receive assistance signing up for specialty drug copay assistance programs (like manufacturers coupons). FlexAccess helps members get the benefit of copay assistance while helping to keep Rx costs low.*

*This program is available to self-funded groups for additional fees.

Improving health outcomes

It’s worth repeating: Integration enables a more holistic approach to employee health and well-being. For example:

• It’s easier to identify over- or under-utilization of medications, which provides a greater opportunity for more timely and effective interventions.
• Gaps in care can be identified and closed more effectively, which can support better outcomes and lower overall costs for care.

Simplifying benefit administration

Employers who carve out pharmacy benefits often discover—too late—that administering those benefits is complex, in terms of policies, service, pricing, and formularies. For someone without the right experience and expertise (not to mention, the time), it can be overwhelming.

That’s where BCBSRI comes in. Our team has that expertise and is committed to looking out for the best interests of you and your employees.

Plus, when benefits management is centralized, you work with one account team, and your employees have one member ID card to use and one phone call to make when they need help.

Real-life savings

Learn more about the benefits of BCBSRI pharmacy coverage, including a real-life savings example. Read “Quality, simplicity, and savings.”