This is a summary of a piece published in Becker’s Hospital Review, Prescription for better care: Aligning medical, pharmacy benefits.
In a recently published op-ed, CarelonRx president Amy Mulderry highlights the increasing importance of integrating medical and pharmacy benefits as a strategy for improving outcomes and reducing costs in the evolving healthcare landscape.
Why integrated benefits matter for employers
As a pharmacy benefit manager, CarelonRx sees first-hand how aligned benefits provide a more holistic view of an individual’s health, allowing for early intervention and personalized treatment. This connected care approach enhances safety and adherence, reduces hospitalizations, and optimizes healthcare spending.
Mulderry emphasizes the impact of integration on medication adherence, referencing how critical an issue poor adherence is, linked to significant deaths and preventable costs annually in the U.S. When payers and providers have a shared view of pharmacy and medical data, it enables early identification of care gaps, which helps prevent costly complications and improves whole health outcomes.
Integrating pharmacy benefits for smarter savings
CarelonRx has examined how integration of medical and pharmacy benefits can lead to significant cost savings, citing study data showing more than $100 per member per month in medical spending, over $66 in inpatient costs, and above $50 in outpatient spending. This shows how benefit integration eliminates unnecessary expenses, enhancing care coordination and minimizing adverse interactions.
Mulderry explains that integrated benefits lead to a more patient-centered healthcare system. It enables care teams to focus on providing timely, appropriate care rather than navigating administrative hurdles. This collaborative connected care model seeks to improve patient experiences and set a foundation for a dynamic, responsive healthcare future.
Read the op-ed here:
Prescription for better care: Aligning medical, pharmacy benefits
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