Applying peanut butter cup wisdom to pharmacy benefits

Medical and pharmacy benefits should work together like peanut butter and chocolate

Chocolate: the delight of royalty, the common man and kids of all ages for centuries. Peanut butter enjoys its own lofty love affair with our taste buds. Crunchy or creamy, we love it on apples, toast and crackers – heck, who hasn’t pulled the old peanut-butter-on-the-finger trick once or twice? Put these two simple wonders together and they work on a whole new level. They’re so much more than they were separately, demonstrated by the esteemed place the peanut butter cup enjoys in our candy universe. There’s a lesson to be learned from this venerable combination in the world of health and pharmacy benefits.

Pharmacy benefits are often the first and most widely used benefit an employer offers, and it goes without saying that the medical plan is the foundation upon which the entire benefit package is built. But not allowing them to work together is like scooping out the peanut butter from the chocolate and eating each separately.

Integrating your medical and pharmacy plans delivers smarter care, lower costs and better outcomes for your employees and their families. Working together through seamless data flow, your medical plan can identify who hasn’t refilled a prescription or obtained needed lab tests, who’s eligible for a disease management program, who’s at risk for a hospital readmission, or even who might be struggling with an opioid addiction. An integrated health/pharmacy plan can deliver real-time, actionable data to physicians at the point of clinical interaction, helping them prescribe more effective, more affordable drugs and financially rewarding them for following evidence-based prescribing guidelines.

Integrated plan designs enable better health outcomes at notably lower cost. Let me give you some examples. A recent examination of Anthem’s integrated medical and pharmacy programs found that they delivered:

  • 24 percent fewer hospital admissions for heart failure and 19 percent lower costs.
  • 14 percent fewer admissions for asthma and eight percent lower costs.
  • 32 percent higher overall compliance with prescribed medication therapy.
  • 10 percent lower overall hospital stays.

These and other data points bear out that integrated pharmacy-medical plans offer profound opportunities to improve their members’ health, simplify the health care experience, and lower costs. Together, they work on a whole new level.

Turns out there’s much we can learn from the wisdom of the peanut butter cup.

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