1 Connected Benefits Study Summary
The results of BCBSTX’s Integrated Pharmacy study are the product of a robust analytical exercise. The study was conducted across five markets: Illinois, Texas, Oklahoma, New Mexico, and Montana. In aggregate, 545 findings were identified as statistically significant and favorable for carve-in (connected) groups. The study population consisted of 1,530 carve-in groups and 514 carve-out groups, with 2.6M and 4.5M members within each population, respectively, in 2021. The methodology and results of this study have been reviewed and validated by Scott Allen, a credentialed health care actuary who is a Fellow of the Society of Actuaries and a Member of the American Academy of Actuaries.
Results may vary and performance may be driven by client-specific benefit design and program engagement.
2 Prime Therapeutics internal data from self-funded ASO book of business client data, 2021. Savings may differ depending on current benefit design.
3 Medication Finder data based on Rx Savings SolutionsTM fiscal year 2021 analysis of members who chose a suggested lower-cost prescription option.
4 Member Rewards - Rx may not be available for all groups.
Prime Therapeutics LLC (Prime) is a pharmacy benefit management company, contracted by BCBSIL to provide pharmacy benefit management and related other services. BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics LLC.