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BCBSNC Invests in Prime Therapeutics
Prime Therapeutics (Prime) will administer pharmacy benefits for Blue Cross and Blue Shield of North Carolina (BCBSNC) commercial customers staring in April next year. The companies say the move will result in lower pharmacy costs for BCBSNC customers and more flexibility regarding services and programs.
Prime Therapeutics (Prime) will administer pharmacy benefits for Blue Cross and Blue Shield of North Carolina (BCBSNC) commercial customers staring in April next year. The companies say the move will result in lower pharmacy costs for BCBSNC customers and more flexibility regarding services and programs.
Prime is a privately held pharmacy benefits management (PBM) company that is owned by nine Blue organizations representing 12 plans. BCBSNC intends to purchase an equity interest in Prime Therapeutics so it will have input and insight into Prime Therapeutics’ operations, and will be better able to coordinate pharmacy and health management programs.
BCBSNC expects the investment to help them lower costs in preparation for future healthcare changes.
“We will be able to utilize resources through Prime to offer products that meet the needs of our ASO (administrative services only) customers as well as our underwritten membership at a lower administration cost,” says BCBSNC’s Director of Pharmacy Programs Estay Greene.
Prime Therapeutics serves nearly 19 million customers across the U.S. via claims processing, formulary management, mail service, pharmacy network management, manufacturer trade contracting and clinical programs. BCBSNC serves more than 3.7 million members, including approximately 900,000 served on behalf of other Blue Plans.
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We conducted our annual State of the Industry survey in the early part of November 2023. The survey had 432 respondents, of whom 56% self-reported working for a payer organization (pharmacy benefit manager, insurer or self-insured employer), 34% for a provider organization and the remainder for government or an unspecified “other” category.
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Doug Chaet of Value Evolutions Discusses Value-based Payment Models, Where They Stand and More
September 29th 2022In this episode of Tuning In to the C-Suite, Managing Editor of Managed Healthcare Executive, Peter Wehrwein, speaks with President of Value Evolutions and MHE Editorial Advisory Board Member, Doug Chaet, FACHE, about value-based care's current standing, the status of select payment models like bundled and episodic, and more.
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