Medications are the highest cost segment in healthcare
Members want to shop for medication where they already shop for care
Shoppers who can view medical and pharmaceutical care as they navigate for the rest of their healthcare will reduce the total cost of care for themselves, their employers, and their health plans. Medication is rapidly becoming the highest cost item for healthcare consumers. Three quarters of hospital and physician office visits result in a prescription and, independent of that, roughly half of people have used at least one prescription in the past 30 days. As demand for prescription medication increases to manage care alongside increasing cost of care in the United States, ensuring members have access to the most affordable medications is critical to help them manage healthcare expenses.
Delivered in partnership with Rx Savings Solutions, Sapphire’s Medication Finder helps members easily maximize their prescription benefit and improve adherence with a personalized approach. Proactive member engagement provides members the insight they need to make cost-effective prescription choices.
The Benefits
We believe allowing shoppers to view medical and pharmacy information in a holistic solution will deliver great utilization of both capabilities—reducing the total cost of care for consumers, employers and health plans.
- Rx Savings Solutions capability is fully integrated throughout our S365™ experience.
- Clear, concise and informative capabilities including a fuzzy matching search function, personalized savings card, and informational content help members quickly orient and make use of this high value capability.
- Seamlessly connected via SSO for a frictionless member experience.
Rx Savings Solutions Core Offering
The Rx Savings Solutions platform delivers ongoing review of claims, pricing engine, clinical recommendations, and a managed marketing program that includes:
- Managed member campaigns and savings alerts
- Members who have a savings opportunity are sent an email as soon as we process a new claim, and multiple alerts roll into one notification.
- No more than 4 emails sent in 30 days
- SMS messages are sent to opt-in members.
- Notifications are sent via direct mail to members who have a savings opportunity greater than $40 per fill, who have no email address on file, or who have not been responsive to emails.
- No more than 1 direct mail piece sent in 90 days
Now as a part of Zelis, we are poised to deliver on these promises as a strategic technology and strategy partner to heath plans, employers, third party administrators and their membership by bringing payers, providers, and consumers together into one efficient system.
For more information on how Zelis+Sapphire can help, contact your sales representative or Account Manager.