Heritage Christian Services, Inc. Saves $105,207 in Pharmacy Costs
February 24, 2024The rising costs of prescription drugs are quickly becoming unmanageable for self-funded employers and their employees. With the forecasted growth of prescription drug spending over the coming years¹, many employers are now looking for aggressive measures to control these rising costs.
In addition to the strain on employers, a recent Kaiser Family Foundation survey showed that 29% of Americans reported not taking their medicines as prescribed, due to cost ². This could mean not picking up a prescription, cutting pills in half, or skipping doses. Lack of medication adherence leads to poor health outcomes, including emergency department visits, hospitalizations, and surgeries, all further contributing to cost.
Providing the benefits your employees need can feel overwhelming and costly, especially as the operating and overhead costs to run a business continue to inflate. So, it’s important to find programs that benefit both the business and employees.
Heritage Christian Services, Inc.
Heritage Christian Services, Inc. is a human services agency based in upstate New York that serves thousands through short- and long-term care services and community programs. Heritage Christian Services has more than 1,000 employees in their health plan and strives to provide a comprehensive and affordable benefits plan to their team.
To manage costs, Heritage Christian Services decided to self-fund its health care and prescription insurance coverage. A self-funded arrangement is one where a group uses its own funds to pay for health claims as opposed to a fully insured arrangement where groups would purchase full coverage through a commercial insurer.
As a self-funded arrangement, Heritage Christian Services chose to enroll in Pharmacy Concierge.
When medical and pharmacy are integrated, our clinical team has access to the “whole picture” of a member’s medical conditions and prescriptions, creating a built-in protection to not only reduce pharmacy expenditures, but identify gaps in care, reveal duplicative treatments, and provide protection against adverse drug events.
With Pharmacy Concierge, the clinical team at Excellus BCBS reviews every one of Heritage Christian Services’ prescription claims to identify potential cost-savings. When we identify a cost-saving opportunity, we reach out to the provider, and suggest a less expensive, but equally effective alternative. Most often, providers agree, and the savings are impressive for both the member and the group. Consider that half of all Americans take at least one prescription, and close to a quarter take three or more prescriptions³. If a portion of these prescriptions can be converted to a less expensive alternative, the savings add up.
The Result: Reduced Risk and Controlled Spend.
In 2023, Heritage Christian Services saved $105,207 ($8.47 Per Member Per Month) in pharmacy costs — giving them a 384% return on investment (ROI), almost four times more than the guarantee. ⁴
One of the larger costs Pharmacy Concierge identified for this group was an employee prescribed two high-cost diabetes medications. Our team was able to engage this member’s provider and transition them to a single, combination medication which will save Heritage Christian Services more than $67,000 annually.
Dan Ross, VP of corporate compliance and risk management at Heritage Christian Services, Inc., shares his thoughts:
“The Pharmacy concierge program has saved Heritage Christian thousands of dollars in prescription management. It is a great asset with minimal risk. As a non-profit organization, it is essential that we are good financial stewards and utilize our funding efficiently.”
Dan continued. “This allows us to turn savings around and reinvest in our workforce through wage increases and more. Enrolling in the program was simple. When Heritage Christian launched the Pharmacy Concierge program, Excellus BCBS handled all of the heavy lifting and ensured that materials were updated and distributed. ”
For more information or to request a savings estimate, please reach out to your account manager.
1 US Healthcare Spending to Hit $6.2 Trillion by 2028; Growth Set to Outpace GDP, n.d.
2 Poll: Nearly 1 in 4 Americans Taking Prescription Drugs Say It’s Difficult to Afford Their Medicines, Including Larger Shares Among Those With Health Issues, With Low Incomes and Nearing Medicare Age | KFF, 2019
3 Macpherson, C. (2022, February 2). International drug sourcing can help lower pharmacy costs — and boost health outcomes.
4 2023 Health Plan Data