2017 BlueKC Approved Key Recommendations -
Savings Opportunities
Estimated Plan Cost
PMPM Savings
Description
Estimated Claim PMPM
Savings based on Blue KC
BOB
Disruption
Time to
Implement
Home Delivery Options
Select Home Delivery (SHD) –
Active Choice
Members must call ESI to elect
retail or mail after 2 fills at retail of
maintenance meds
$1.37 PMPM
Medium
120 days
SHD – Incentive Choice
($10 Copay Penalty)
N/A for HDHP plans
Members who remain at retail pay a
higher copay for their maintenance
meds
$2.19 PMPM
Medium
120 days
Exclusive Home Delivery –
(EHD)
Members must elect mail after 2
fills at retail or pay full cost of their
maintenance meds
$2.57 PMPM
High
120 days
Before implementing a home delivery program, please review benefit structure to ensure the appropriate member copays/coinsurance are in place for
mail and retail or the savings achieved through better mail pricing may be offset due to loss in member cost share. Estimated savings is based on a
minimum of 2.5 to 3x copay/coinsurance at mail (3 month supply) compared to retail (1 month supply). ESI can assist with group specific analysis for
savings and benefit structure.
44