Chamber Series | Part 1 of 6
We know the upward trend of health care costs is expected to continue, impacting employers and individuals alike. High prescription drug prices, increases in outpatient procedures, and more members needing high-cost hospital care are challenging health plans, employers, patients, and the entire health care system.
This increase in the cost of care and demand for medical care is leading to premium rate increases and higher out-of-pocket costs for individuals and employers nationwide. We understand the burden of this and that it can be difficult to manage. It’s important for us to find solutions that prioritize the wellbeing of employees while also addressing the financial strain caused by these escalating expenses. So how can you make sure your employees are being taken care of, and what is Excellus BCBS doing to help combat these costs?
First, it’s our mission to help people in our communities live healthier and more secure lives through access to high-quality health care that’s as affordable as possible. It’s what guides everything we do and every decision we make. Because of that, we spend almost all of your premium dollars on member care.
We also believe that cost should not compromise outcomes. That’s why we have created a variety of innovative programs that focus on the quality of care while also helping to manage rising costs. Programs that take affordability into account and make the entire experience easier for everyone to help manage costs related to medications, chronic conditions, overall wellbeing, and more.
Over the next six weeks, we’ll share with you some resources and programs to help your business and employees improve the quality of their care, contain costs, and get the most value from your plan.
First Up: Pharmacy Programs
We are seeing increases in high-cost specialty medications, including cancer therapies. Specialty drugs are high-cost medications that often treat rare, complex, or chronic conditions. These drugs often require special handling and are obtained at specialty pharmacies.
Through our pharmacy programs, we focus on clinical expertise, adherence and safety, a deep knowledge of new drugs approved or in the pipeline, and strong relationships with pharmaceutical manufacturers to build out our innovative cost savings programs for you and your employees. We have a range of programs available for self-insured and fully insured employers* aimed at keeping costs down, such as:
- Pharmacy Concierge: Focusing on proper medication and safety with no member disruption, our clinical pharmacists work behind the scenes with a member's prescriber to find pharmacy cost savings opportunities and help improve patient outcomes.*
- Specialty Drug Benefit Optimization: The goal of the program is to drive affordability by reducing spend for specialty drugs that can be converted from the medical benefit to the pharmacy benefit at a lower net cost.
- Site of Care: This program provides outreach to members who are currently receiving certain infusion drugs at high-cost facilities and aids in transitioning the members to home infusion or lower cost facilities.*
Our Customer Care team is also available to help members to find cost-effective medications when possible. Read more about an Excellus BCBS member’s story.
Actions you can take to help control costs:
- Download our pharmacy savings toolkit where you can access ready-to-use educational resources and prewritten emails for sharing with your employees. It’s designed to promote dialogue and help you and your employees navigate Excellus BCBS’s pharmacy programs that can drive down pharmacy costs and help improve outcomes.
- Please don’t hesitate to reach out to your account manager or broker for more information on these programs.
- For more helpful content to educate and engage your employees in their health care, visit ExcellusForBusiness.com.
*Embedded for Fully Insured groups, Buy-up for Self-Funded groups.
Next in the series we have more on increases in outpatient surgeries, especially on hips, knees, and other musculoskeletal conditions.
Read Our Chamber Series | Part 2 of 6
