How we view health holistically

  • Seeing pharmacy as part of whole health
  • Looking at total cost
  • Closing gaps in care
Making Costs Clear

Seeing pharmacy as part of whole health

In a world of disjointed care and benefits, we look at patient health holistically across the care continuum. We’ve found a total health focus can lead to savings and reductions in big ticket costs, like ER visits and hospitalizations. Silos belong on farms, not in healthcare.

A total health approach can lead to employer savings of $60 - $108 PMPY*

*2014-2016 internal data; analysis, 2018. Savings result from integration of our medical and pharmacy benefits. Results shown do not represent a guarantee of outcomes; group-specific results and cost savings will vary.

Making Costs Clear

Looking at total cost

Focus only the pharmacy benefit and you’ll miss the total picture. In fact, 26% of total pharmacy costs occur under the medical benefit.* So when we build our formularies and clinical programs to help patients improve their health, we’re looking at total costs, not pharmacy costs in isolation. And we share our total view insights with you. Pretty smart, huh?

42% of specialty drug spending is billed under the medical benefit

* 2018 Commercial business. IngenioRx 2018 Drug Trend Report: Taking a Total View

Closing gaps in care

Closing gaps in care

We identify patients who could use extra support and make it our top priority to manage their health. Our outreach includes improving medication adherence, preventing potential drug safety issues and closing gaps in medication therapy. We send over 2.5 million care gap messages annually. Result: those we contacted were almost 35% better at taking medications as directed.* We’re there to mind the gaps, wherever they are.

Closing gaps in care resulted in $27M in pharmacy savings and $115M in medical costs avoided*

*Results based on 2017 clinical and cost-of-care programs for Commercial business.