The vision
A large health plan believed employers gain value by offering their employees an integrated medical and pharmacy product instead of stand-alone medical and pharmacy benefit plans. However, the health plan needed data to quantify specific savings to both substantiate its hypothesis and deliver a defined value proposition for employer groups.
Co-creating the solution
The health plan partnered with HealthScape Advisors, a Chartis Company, to perform a value analytics study of its integrated product. Using historical claims data and internal metrics, the study showed a statistically significant correlation between integrated benefits and a lower total cost of care. Benchmarked against competitors, this data helped the health plan effectively market its products to prospective employers.
HealthScape Advisors also helped the health plan identify additional ways to integrate pharmacy data in its day-to-day operations, increasing impact and driving further cost savings.
Believe in better
The health plan now has both clear market-facing proof points to attract and retain new business and targeted areas for operational improvement. The health plan is further integrating pharmacy data into its operations, aiming to improve product design, member experience and engagement, and clinical outcomes. Downstream impacts may include more insightful analytics, improved care and utilization management, payment integrity, and more.
