Blue Shield of California’s Innovative Pharmacy Initiative Reaches $20 Million in Drug Cost Savings as It Continues to Transform Pharmacy Care

Blue Shield of California today announced the nonprofit health plan’s innovative collaboration with Gemini Health has resulted in more than $20 million in drug cost savings in the initiative’s first two years.

The collaboration between the nonprofit health plan and the San Francisco Bay Area technology company provides patient-specific benefit, formulary, and cost information on prescription drugs to prescribers at multiple points-of-care, including patient-doctor visits. The goal is to empower prescribers with real-time information about medications and any lower cost options so that they can discuss with their patients and collaborate to reduce drug costs. 

“Blue Shield of California seeks innovations that provide personalized health care options and to improve affordability for our members, and our collaboration with Gemini Health does exactly that through drug cost transparency for providers when they are evaluating and prescribing medications – when it matters most,” said Alison Lum, vice president of pharmacy at Blue Shield of California. “We are also expanding this initiative to include pharmacists and other health care providers in our network as we reimagine how health care is delivered for all Californians.”   

The initial focus to provide physicians with real-time prescription information and comparable lower cost alternatives through their electronic health record systems has resulted in strong provider adoption. Currently, more than 77,000 prescribers across California have access to this service, including some of the state’s largest medical groups – UCSF Medical Center, Hill Physicians Medical Group and Providence Medical Foundation.

“It has been gratifying to hear from physicians and pharmacists alike how these services simplify and empower their work by identifying patient-specific, cost-savings opportunities,” said Ed Fotsch, CEO of Gemini Health. “The technology also allows medical professionals to consolidate their work into easy-to-use interactive digital applications, integrated into their workflows to reduce administrative burden and focus on what they are passionate about – caring for their patients.” 

The services are now available to pharmacists so that they can also have the same real-time information as physicians to address medication management needs with patients, facilitating greater collaboration between providers and pharmacists. Raymond Chan, chief medical officer of EPIC Health Plan Inc. said, “The Blue Shield service helps to efficiently analyze a patient’s current medications. We can then interact with our physician colleagues and provide them with specific opportunities to lower costs for our patients. In addition, the detailed reporting makes it easier to measure the impact of our work and follow up on new opportunities.”

The majority of Blue Shield’s network providers groups employing pharmacists are using Gemini Health’s patented Drug Savings Reports™ service, and more are expected to enroll by the end of the year. These pharmacists now have access to patient-specific medication reports delivered through a secure portal where pharmacists can also document their activities related to existing medication taken by their patients. Experience to date has demonstrated that up to 40% of patient’s existing medications have a lower cost equivalent alternative.

“Seeing drug and lower cost alternatives at prescribing, at each patient encounter and on demand by our pharmacists allows us to use the technologies across the continuum of care to lower drug costs for our patients and their families,” said Christa Ellsworth, PharmD, Managed Care Pharmacists at Providence Medical Foundation in Anaheim, Calif.

Blue Shield’s collaboration with Gemini Health is another example of the health plan’s Health Reimagined effort, an ambitious vision to transform health care for individuals, families, and communities throughout California.

About Blue Shield of California

Blue Shield of California strives to create a healthcare system worthy of its family and friends that is sustainably affordable. Blue Shield of California is a tax paying, nonprofit, independent member of the Blue Shield Association with over 4.5 million members, over 7,500 employees and more than $21 billion in annual revenue. Founded in 1939 in San Francisco and now headquartered in Oakland, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid, and Medicare healthcare service plans in California. The company has contributed more than $150 million to Blue Shield of California Foundation in the last four years to have an impact on Californiacommunities. 

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CONTACT:    Jonna Constantine 
Blue Shield of California         
[email protected]     

SOURCE Blue Shield of California

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