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2017 BlueKC Approved Key Recommendations -
Savings Opportunities
Estimated Plan Cost
PMPM Savings
Description
Estimated
PMPM
Savings on
Blue KC
BOB
Disruption Time to Implement
Formulary Options
High Performance Formulary (HPF) HPF is a generics-based formulary that promotes
generics and low-cost brand drugs; Non-
preferred drugs are not covered
Requires group
level review
High
120 days
Benefit Options
Increase Member Cost Share
•
Increase copays
•
Add Copay for Tier 1, Coinsurance on Tier 2
and Tier 3 (option per script cap on T2/T3)
•
Add Stand-alone Drug Deductible
•
Add a Tier 4 for Non-Preferred Specialty
Drugs
•
Add 3 Tiers for Retail drugs and 3 Tiers for
Specialty drugs (Specialty has different
member cost-sharing than retail)
Requires group
level review
Varies
120 days
48