Blue Cross Blue Shield Plan News Roundup: August 2023

Amerigroup, a subsidiary of Elevance Health serving Medicaid and Medicare enrollees, will begin rebranding as Wellpoint in January 2024, to reflect the company’s evolution to support whole health. Wellpoint’s suite of health benefits is designed for consumers at any stage of life offering access to simple, supportive health solutions to help foster whole person health, including services from in-home wellness visits and transportation to the deployment of mobile medical clinics in low-income and rural communities.

VCU Health and Anthem Blue Cross and Blue Shield in Virginia have renewed a new multi-year agreement with the health system’s hospitals, facilities and physicians in Anthem’s network guaranteeing continued access for Anthem members. The negotiation included plans to implement digital connectivity between the two organizations that will simplify system requirements and streamline business processes.

Blue Shield of California announced a new pharmacy care model that is designed to fix problems in today’s broken prescription drug system. The nonprofit health plan is transforming how medications are purchased and supplied to its 4.8 million members by selecting organizations that share Blue Shield’s vision for more affordable and transparent pharmacy services.

• Amazon Pharmacy will provide fast and free delivery of prescription medications, complete with status updates, as well as upfront pricing and 24/7 access to pharmacists.
• Mark Cuban Cost Plus Drug Company will establish a simple, transparent, and more affordable pricing model, reducing surprise drug costs at the pharmacy pick-up counter.
• Abarca will pay prescription drug claims quickly and accurately while continuing to evolve its technology platform, Darwin, to support new, simplified payment models.
• Prime Therapeutics will work with Blue Shield to negotiate savings with drug manufacturers to move toward a value-based model that aligns drug prices to patient efficacy and health outcomes.
• CVS Caremark will provide specialty pharmacy services for members with complex conditions, including education and high-touch patient support.

A Capital Blue Cross program designed to lower the cost of expensive specialty drugs, including those for rheumatoid arthritis, psoriasis, and Crohn’s Disease, has saved participating Capital employer groups about $4.5 million in the first quarter of 2023 and cut eligible individual drug costs by about $3,000 per person. The program, called FlexAccess™, leverages saving opportunities to reduce out-of-pocket costs for Capital members who rely on these specialty medications.

CareFirst BlueCross BlueShield (CareFirst), the largest not-for-profit health plan in the mid-Atlantic region, and Ryse Health (Ryse), an operator of specialized cardiometabolic health clinics, announced a first of its kind quality improvement partnership serving individuals with uncontrolled type 2 diabetes in CareFirst’s commercial networks. The program will pair Ryse providers with CareFirst members in Washington, D.C., Maryland, and Northern Virginia with uncontrolled Type 2 Diabetes. Ryse will combine a mix of in-person and virtual care interactions to help patients control their HbA1c and blood pressure and conduct timely diabetes-related health screenings so early detection and interventions are available.

When Blue Cross and Blue Shield of Louisiana officials announced earlier this year they had agreed to be acquired by Elevance Health, the state’s philanthropic community cheered a plan to create a $3.2 billion foundation with the bulk of the proceeds. The Accelerate Louisiana Initiative will have a mission to improve the lives and health of the people of Louisiana and could potentially transform a state with some of the worst health outcomes in the U.S. Accelerate Louisiana will be what’s known as a conversion foundation, which is formed when a nonprofit organization like Blue Cross sells to a for-profit company.

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced that its industry-leading Blue Premier program improved quality of care for patients and saved nearly $164 million in health care costs in 2022, helping curtail the impact of medical cost inflation for members and small and large businesses. The total savings since the program was created in 2019 has reached close to $650 million, according to an analysis from Blue Cross NC.

Takeaway: AMI’s annual Blue Cross Blue Shield Plans Report AMI’s Plans Report provides profiles on each of the 34 BSBS plans as well as the BCBSA organization