Healthfirst

From where you sit in the organization, you probably realize health care is more complicated than it should be. Health plans partner with us because we have the scale, passion and commitment to help them grow in a rapidly changing and increasingly competitive environment. Our experts provide innovative, strategic solutions that align with your plan's unique priorities. We believe health is what makes progress possible. Let's embrace our relentless passion and define the future of health care – together.
Healthfirst
Fred Bendana
Fred Bendana
President, Health Plan Sales, Express Scripts
Considering your focus on delivering extraordinary care for your members and on being true partners in the health system, I’m eager to engage and work with Healthfirst to ensure you deliver on your promise of affordable care that fits every life stage. Our missions are very similar and I’m all in to collaborate and help co-design solutions that further your team’s commitments and strengthen your key role in the communities you serve.
Rachel Reese
Rachel Reese
Vice President, Health Plan Sales, Express Scripts
I am excited to dive in with the Healthfirst team to find opportunities for us to grow together and work toward improved health care for all. With the recent formation of our new health services portfolio, Evernorth, we are better positioned than ever to support you and your clients to create a better experience for your team, members and providers.
Lynn Mueller
Lynn Mueller
Vice President, Client Relationship Executive, eviCore
I appreciate the close collaboration and long-term partnership between Healthfirst and eviCore, and I’m excited about the expanded opportunities we can bring via Evernorth. I look forward to continuing our conversation on how we can drive additional value for Healthfirst and its members.

Diversity, equity and inclusion

We’ve long had a commitment to diversity, equity, and inclusion, but realize there is more work to do. We are excited about the opportunity to partner with Healthfirst, an established leader in diversity and health equity, in serving New Yorkers. We believe combining the knowledge and best practices of our organizations will lead to improved health and reduced socioeconomic healthcare disparities in care to the members you serve.
DEI
DEI solutions
Review our proposed solution to engaging Healthfirst's socially and economically disadvantaged members.
DEI white paper
Review our commitment to advancing belonging and health equity for everyone we serve.
We've enjoyed getting to know about your plan's opportunities and challenges. Learning that fraud, waste and abuse and CMS audit results are a strong focus for Healthfirst, we've gathered some materials we thought may be of particular interest to you.

Just in – and just for you

Protecting your plan against fraud, waste and abuse

Fraud, waste and abuse is a significant, and sometimes hidden driver of plan costs, which can occur at both the provider and member level, and impacts payers dramatically. To prevent cases of fraud, waste and abuse, our analytics team monitors patient and prescriber patterns to reduce waste, identifies situations of abnormal utilization or fraud, and intervenes to prevent or stop the misuse. In 2019 and 2020 alone, our solution yielded significant savings to our clients.
6K+ 6K+
substantiated cases presented to plans
4.8K 4.8K
referrals resulted
$262M $262M
Avoided up to $262M in related prescription costs
MEDICARE MARKET ANALYSIS: KEY INSIGHTS AND FINDINGS
We operate on a belief that insights can lead to better action, and our Medicare strategies will equip you with market analysis for growth planning and insight-driven conversations focused on enrollment trends, Star Rating trends, competitive market benefits and other aspects. These analyses can be done at the state level, service area level, or county level to meet your needs. This market analysis is a baseline version. With more data and information about your plan, these become more detailed and deep - adding in supplemental benefits analysis, Star Ratings opportunities and more.
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Medicare market analysis: key insights and findings
We believe that health care is the starting point of progress and potential. Through open collaboration and unbiased guidance, we strive to deliver flexible, focused solutions to help you achieve your goals.

Express Scripts is now part of Evernorth

Evernorth insights: Health Care in Focus

COVID-19 has challenged our health care system like no other. But we’re always looking ahead, identifying ways to redefine what’s possible. We polled consumers and plan sponsors across the U.S. to assess the state of health care in the years ahead.

Evernorth insights: Drug Trend Report

In the face of the COVID-19 crisis, we worked together with clients to solve urgent and emerging needs with innovation, agility and focus while delivering results. See a snapshot of what we were able to help our clients achieve.
DTR 3
Held unit cost increases to 0.9%
For the fourth year in a row, we limited the increase in drug unit costs to under 1%, despite an average increase of 4.3% in list prices for brand drugs, by leveraging therapeutic mix and supply chain.
DTR 1
Delivered $45 million in savings
Leveraging innovative clinical programs and leveraging data to inform key decisions, we realized significant savings for our clients in 2020.
DTR 2
Getting ahead of the growth in specialty
For the first time, spending on specialty drugs accounted for more than half of total drug spend (51%). Our solutions and capabilities helped our clients stay ahead of this growth.
DTR 4
Negative trend for 1/3 of our commercial clients plans
Even in 2020, one trend held. For plans that took advantage of opportunities to help patients use the right drug – in the right amount and from the right pharmacy – the result was lower spending.
Solutions and capabilities to help you

Stay ahead of the curve
Health Connect 360
The fix for fragmented care with outcomes aligned to your goals and Stars metrics
InMynd
behavioral health care solution to help your members access mental health support and treatment on their terms

Exploring America's State of Mind

Mental health conditions are the costliest health conditions in the U.S., costing the health care system more than $200 billion annually, and more than $193 billion in lost earnings per year.1 They’re the most common cause of hospitalizations for people ages 45 and younger, and 13% of mental health discharges are readmitted to the hospital within a month.2
1/5 1/5
America is in the grip of a mental health crisis. Nearly 1 in 5 U.S. adults experienced a mental health condition in 20183
8% 8%
From 2008-2018, the overall prevalence of mental illness increased 8%4
17.3M 17.3M
Nearly 17.3 million American adults experienced a major depressive disorder in 20175

Affordable, predictable and simple health care

Aligned with Healthfirst, we'll deliver world-class health services with a singular focus: To make health care more affordable, predictable and simple.
Affordable
We build on our leading, differentiated position to lower the total cost of care
Predictable
We take surprise out of the system and help people make informed health care choices
Simple
We make it easier for the people we serve to get the care they need
Thank you
If you have questions or need further information, I am here to help!
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Thank you