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. While more information can be explored on the main HTA microsite, we wanted to provide HTA health plans with a deeper understanding of our health plan expertise and share materials prepared specifically for your plan.
HTA Health Plan
Health care is more complicated, more fragmented and more costly than it needs to be. We're changing all of that. Being part of the solution to transform health care as we know it – to make it more affordable, predictable and simple – is a vision we can all get behind. Working together, we can take on your toughest challenges, expose opportunities to reduce costs and increase profitability, and help you prepare for what’s next.
Medicare market analysis: Key insights and findings
We operate on a belief that insights can lead to better action, and our Medicare strategists will equip you with market analyses for growth planning and insight-driven conversations focused on enrollment trends, Star Ratings trends, competitive market benefits and other aspects of plans in San Diego County, or any county you may consider for expansion. 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.
>133K eligible lives are not enrolled in a MAPD/PDP plan
MAPD enrollment in San Diego county outpaced growth in new Medicare eligibles overall. And, the not enrolled population shrunk year-over-year which is rare nationally. Capturing newly eligible members who are shopping is key.
3 key issues revealed in social determinants of health analysis
A heatmap of the various census tracks within your county reveals preventative care, flu shot penetration rates and housing as key areas of concern for your population.
50%+ of the MAPD plans in San Diego county offer preferred pharmacy networks
This includes three of the five largest parent organizations in the county. A preferred pharmacy network, a performance-based network, or both, could generate value that can be re-invested into your program offering.
50%+ of the MAPD plans in San Diego county offer a $0 premium
Those plans had a growth rate more than two times greater than plans with a premium, in aggregate, last year.
Formulary: 2021 drug coverage and tier makeup
HTA health plan’s percentage of covered drugs is slightly lagging the top market competitors and is more generics-based.
High number of prior authorizations
HTA health plans have a high number of prior authorizations compared to top competitors, but a low number of step therapies.
As an Express Scripts client you will receive a strategist for each of your regulated lines of business. The strategist role is to align with your goals and focus on compliance, affordability, quality and growth relative to your respective lines of business. Your Medicare strategist will assist with bid submission in the form of market analysis and growth planning.
We support more than 6 million Medicare Part D beneficiaries
Healthcare reform compliance rate
of Medicare clients experienced negative trend in 2019
of MAPD members are in 4-5 STAR Part D plans
of Medicare plans we partner with beat industry growth trend
of regulated markets performance guarantees met in 2020
Client story: Growing one plan's Medicare business
We offer the guidance and support necessary to help our clients improve in quality outcomes and Star ratings.
Client story: Implementation and innovation success
Hear about a real clients' experience implementing their plan and their clients with Express Scripts.
Evernorth Digital Health Formulary
Making digital health solutions click for clients and members
Health Connect 360
The fix for fragmented care with outcomes aligned to your goals and Stars metrics.
Medical Drug Management
The end to frustrating, fragmented medical drug management is here.
A deeper dive into Health Connect 360: Med D Case Study
Our first-of-its-kind clinical model, Health Connect 360SM, is an outcomes-based approach that leverages industry-wide best-in-class services and allows you to place financial guarantees on the Stars metrics of your choice.
Innovation
Health Care Trend: Digital Health in the World of COVID-19
Pricing, Affordability & Value
Health Connect 360: The Fix for Fragmented Care
Pricing, Affordability & Value
The Right Tools to Manage Medically Billed Drugs
Industry Updates
2021 Medicare Star Ratings: By the Numbers
Pricing, Affordability & Value
Is Your Pharmacy Network-ing for You?
Patient Outcomes & Safety