Rising health care costs: 3 changes that may ease rising health care costs

We know rising health care costs continue to put pressure on employers. But businesses don’t have to face these challenges alone.  

As your local nonprofit health plan, Excellus BlueCross BlueShield is committed to improving access to quality care while helping employers manage costs. Supporting healthier members is one way to help make healthcare more affordable over time.

Here are three strategies to consider, plus programs available to many Excellus BCBS members.

1. Meet Members Where They Are

Easier access to care can help people address health issues before they become more serious. If your doctor isn’t available, our virtual care programs can connect eligible members to:

• Behavioral health
• Dermatology
• Physical therapy
• Urgent care

For Kelly, virtual physical therapy made a difference. “It has really helped. I’m back to walking and I don’t have pain anymore,” she said. 

Convenience can also help people manage chronic conditions. Through our REACH* Kidney Care partnership, members with advanced kidney disease receive personalized support from a multidisciplinary care team. For Janet, that support empowered her to pursue home-based dialysis. Early results show better health outcomes and about $2 in health care savings for every $1 invested.**

2. Look beyond the prescription

Prescription drugs are among the fastest-growing drivers of health care spending. Last year, Excellus BCBS pharmacy spending increased 35 percent to $1.16 billion.

Our programs help members get needed treatments while managing costs.  Examples include:

• Through Pharmacy Concierge, pharmacists review claims and look for opportunities to improve care and reduce unnecessary spending, including:
• Lower-cost alternatives when clinically appropriate
• Medication safety concerns
• Incorrect dosing

Last year, the program helped eliminate nearly $20 million in unnecessary spending. Medication decisions remain between members and providers.

• Treatment setting is also an important driver of healthcare costs. For select infusion and injectable therapies, including some cancer treatments, care can be safely delivered in lower-cost settings, such as the home.

 Our Site of Care Redirection program helps eligible members receive treatment in the most cost-effective setting without compromising quality of care. Since 2022, the Site of Care Redirection program has produced more than $33 million in savings.

3. Don’t overlook the basics

Annual checkups and health screenings can catch health issues early, when they’re often less expensive to treat. Preventive care usually costs members $0.

Reminders, targeted communications and education campaigns can help members better understand and use their benefits – helping them stay current with preventive care.

What you can do

• Visit excellusforbusiness.com to download toolkits, resources and prewritten educational emails to share with your teams.
• Share this flyer  to help your team feel more in control of health care decisions.
• Talk to your Excellus BCBS Sales Consultant for more information.

The way forward

Health care is becoming increasingly complex and expensive. Last year, Excellus BCBS paid nearly $7 billion in medical and pharmacy claims, with 92 cents of every premium dollar going to care.

There is no quick fix for rising healthcare costs. But helping members access care more conveniently, leveraging pharmacy benefits, and encouraging preventive care can help.

While providing this support is important, we also know more must be done.  Building on that progress will require stronger alignment between health plans, employers, providers, and community organizations, all working toward the shared goal of helping people stay healthy.

*REACH Kidney Care is an independent not-for-profit that offers kidney disease management support to Excellus BlueCross BlueShield members. **REACH Kidney Care dataBlue Shield Association