Combining medical and pharmacy benefits may lower costs, improve outcomes, study finds

Group members of Highmark, a subsidiary of Blue Cross and Blue Shield, with integrated medical and pharmacy benefits saved an average of $150 to $230 per member, per year and had better health outcomes compared to those who used separate vendors, a study found.

An analysis of data from 2017-19 by HealthScape Advisors showed that group customers who used Highmark for both medical and pharmacy benefits also experienced 3.9 percent shorter inpatient hospital stays compared to those without integrated benefits, according to a press release.

"With a unified model, employers and individual members both enjoy a seamless experience that provides optimized care because clinicians have access to real-time medical and pharmacy data that offers a comprehensive view of a member's health status," said Jeff Bernhard, the company's senior vice president of commercial markets.

"The unified model also simplifies the prior authorization process, and provides single point of contact for all benefit needs," Mr. Bernhard said.

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