Employer-sponsored insurance plans with fully-integrated medical and pharmaceutical benefits can lower medical costs and reduce hospitalization and emergency room visit rates, according to a report from Blue Cross Blue Shield of Minnesota and Prime Therapeutics.
The report, published July 19, reviewed data for 490,000 Blue Cross members enrolled in self-funded plans over a two-year period. The paper compared members in plans where employers chose integrated pharmaceutical and medical contracts with members whose pharmacy benefits were managed through a separate vendor.
Integrated benefits saved $422 per member per year, the report found. Members in plans with integrated benefits had 17 percent lower hospitalization rates and 13 percent less emergency room visits than those with separate pharmacy benefits.
For members with chronic conditions, medical costs were 21 percent lower in integrated plans, and hospitalization rates were 22 percent lower than for members in plans with carved-out pharmaceutical benefits.