Creating a better future with Highmark

Your established strategic partner for over 25 years

We have partnered together to make health care better for Highmark clients and members.
-5.5% -5.5%
Total gross cost of non-specialty net of rebates PMPM drug trend for 2019!
1000+ 1000+
Approximate benefit attributes that Highmark controls directly via the Automated Group Load. Allows systematic creation of / requests for / changes to benefit designs. Zero restrictions on the number of unique benefit designs allowed.
50+ 50+
Approximate Highmark custom projects/initiatives supported each year. 100% under budget (projected cost communicated to Highmark) since 2017. Supported by two unique roles created specifically for Highmark (Business Systems Implementation Manager and Senior Account Manager of Project Alignment).

Committed to continued growth for Highmark

With Highmark, Express Scripts' Market Development support has evolved at a challenging and strategic pace to be the success it is today. Over the years, our priority has been growth strategies to help to solve the key areas standing in the way of your organization’s growth. Market Development partnered with Highmark on: the first strategic pricing workshop in 2018, the first broker and pricing workshop in 2019, as well as, finalist presentation collaborative evaluation to ensure consistency and efficacy in the current market. Our alignment to Highmark growth is apparent in key wins such as Allegheny County Schools Health Insurance Consortium (ACSHIC). We are adding traction with team support, additional training modules, and competitive intel to help ensure you win new business now, and years to come.
$250,000
New! Annual Market Development fund
Express Scripts is committed to winning new customers with Highmark by funding $250K for winning and retaining clients initiatives.
$3 PMPM
New! Investing in your growth
Express Scripts Market Development is committed to fund $3 for every net new life Highmark adds to its book, to invest in new clients and members.
$155M in additional revenue
Market Development in action
As of Q12020, Highmark has generated $155 million in additional revenue from Pharmacy since implementing Market Based Pricing four years ago.

Click the link below to access your personalized growth report to learn about more of the outstanding work our teams have accomplished together.
Value of integration
Aligned in the battle against carve-out
We are always looking for additional ways to help you tell your story. Our new Value of Integration research paper is the first of many to come to help ensure you have the best ammunition to tell your carve-in story and keep your edge.
Tim Harlan headshot
Tim Harlan
Sr. Director Market Development
I love the trust we have together and how you challenge us in a collaborative way. Highmark is always at the top in terms of best practices – this has helped us both grow and advance. We couldn’t be more grateful for the partnership we have forged with you!

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Unmatched expertise to support your Medicare population

For Highmark Senior Markets, Express Scripts offers industry-leading regulated markets expertise and compliance support to help you compete and win. Our heavy investment in regulated markets backed, by a staff of dedicated experts specialized in these markets, provides an extra layer of support for you and your account team to stay compliant and cost-competitive in these highly complex markets. The regulated markets team has industry-leading insight and the ability to influence the Medicare benefit via our business relationships with health plan industry associations, the National Council for Prescription Drug Programs (NCPDP), Express Scripts’ trade associations, and other relevant groups.
$27M $27M
in approximate Direct and Indirect Remuneration (DIR) from tailored regional network support in 2019, and trending towards $40M for 2020 based on Q1, 2020.
99.99 99.99
percent prescription drug event (PDE) acceptance rate; above 2019 industry average of 99.94 percent.
$54M+ $54M+
in pharmacy savings from 2016-2019 through successful RationalMed interventions.

Empowering you to make health care affordable, predictable, and simple

We are committed to continuing to partner together to improve the health care experience for everyone, so Highmark can make innovative leaps in the industry.
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New! $2M Innovation Council
Express Scripts is investing in our partnership to create and fund a joint Research and Innovation Council focused on initiatives that benefit the shared goals of our organizations of improving patient care and reducing costs.
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$4.9M in savings opportunities
Via the successful launch of MediCUBE®, in combination with a dedicated academic detailer, who over the past six months identified these savings opportunities within the FIPR, Population Health and Clinical UM areas.
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$998 per claim savings
In 2020, Highmark has delivered an average of $998 per claim savings with $60k* in total savings for your four enrolled ASO clients.
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$2.4M in payment to Highmark
From enrollment in the suite of value-based SafeguardRx programs in 2019.
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Ensuring Highmark members have affordable access to vaccines
Providing members with convenient, reliable access to vaccines can help save lives and reduce the chance of spreading diseases to others, saving both your members and your plan in downstream medical costs.
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Real-time benefit access for physicians
Improving digital engagement with physicians working with Highmark is crucial. Giving physicians visibility into their patients' formulary coverage, medical costs and therapeutic options help them make the best clinical and cost efficient prescribing decisions.
Access to critical pharmacy insights
Trend Central is a self-serve plan management and reporting tool giving Highmark near real-time access to pharmacy data with a wide variety of key performance indicators and interactive dashboards to help you make informed decisions.
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Access to critical pharmacy insights

Memorable moments

We've shared a lot of great memories together over the years. Take a look at a few of our favorites.
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Flexible industry leading solutions

Learn more about flexible industry leading solutions designed to help you solve challenges in the most needed areas of health care.
Tim Wentworth
Tim Wentworth
President, Health Services
I am so proud of the accomplishments our two companies have achieved together over a relationship that spans over 25 years, and am excited to think about what’s next for us, as we continue to drive innovation in health care with flexibility and dedication. We have established a strong foundation, and it is my sincere hope that we can continue to build upon that.

Ensuring you’re prepared for the future

Today, we stand ready to help you deliver sustained health care affordability by providing an offer that delivers significant value to Highmark of over $445 million over the life of the deal.
Innovation Roadmap
Looking ahead, there is tremendous opportunity to affect change in our industry while tackling some of the greatest health care opportunities. We are laser-focused on creating innovative solutions that tackle these difficult challenges. Take a look at the Innovation Roadmap for more insights into what’s coming next.
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Commitment to staying on the cutting edge
We are always exploring new technology and ideas to continue bringing you the best in health care. In a rapidly changing industry, this is crucial. It ensures that you have access to the latest advancements so you can lead the market with your innovative health care strategies.
Meeting the demands of diabetes care
Beginning July 1, 2020, we are expanding our Patience Assurance Program beyond insulin by including additional diabetes therapies. To ensure Highmark receives the best value from implementing this program, funds collected from these programs will not be included in the calculation of rebates and rebate guarantees.
COVID-19: keeping you informed
Check our latest COVID-19 book of business insights and visit our COVID-19 Information Center for resources, information, and helpful links to keep you up-to-date and informed of this rapidly evolving situation.
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COVID-19

What the Highmark + Express Scripts relationship means to us

Lynda biking with Jim photo
Lynda Saxon, RPh, Senior Director
Riding a tandem bike with my husband you have to always be in sync and in balance to be successful together. That's a perfect analogy on how I feel about my relationship with Highmark. I enjoy when we are in sync and both striving for a common goal and then we achieve it, together, it's exciting.
Cindy mountain photo
Cindy Karrer, Senior Account Executive
As an advocate for Highmark, I will drive to the highest level to ensure support and solutions that meet your goals, with no mountain too high to try!
Michael Grkman family photo
Mike Grkman, Senior Account Executive
As a musician, I enjoy working in harmony with Highmark in delivering the right strategy for Medicare members.
Lou Durigon family photo
Lou Durigon, Operations Director
I view us as one large team that spans across both organizations. The connections (and friendships) established over the years fosters a true partnership.
Denise Cabrey and her dog
Denise Cabrey, RPh, Senior Clinical Account Executive
Relationships are what matter most in business and in life. Anticipating the needs of Highmark is important to me as part of our relationship, as it impacts your members and your results.
Rhonda, Darin and Trooper photo
Rhonda Wassom, RPh, Senior Clinical Account Executive
My compassion for rescuing animals matches my sincere desire to support Highmark in serving their Senior Market membership.
Katie Rummel family photo
Katie Rummel, Clinical Account Executive
Family is everything. I am super excited to now be part of the Highmark/Express Scripts family!
Brian Old photo
Brian Old, Market Development Director
I am excited to innovate and partner with Highmark for success, no matter where the journey takes us!
Erin Mason home teaching
Erin Mason
It has been an exciting journey collaborating with Highmark teaching the new tool (MediCUBE) and building valuable cost saving projects across 7 teams.
Want to learn more?
If you would like more information about anything on this site or have any questions, please click the button below to reach out to your account team.
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