Healthcare is constantly evolving. Maintaining the status quo isn’t enough to stay ahead in the face of challenges that many community-based plans face. By putting innovation to work for health plans, patients and providers, we’re redefining how health care can and should function — now and in the future. This is your dedicated site to explore topics that may be of interest to you, as well as a destination for future materials.
A local focus with national expertise
Our commitment to health plans: Delivering best-in-class health services to make health care more affordable, predictable and simple
Affordable
Lowering costs for your plan while providing high-quality care for your members shouldn't require compromise. We have programs and tools to help you successfully manage costs while helping your members improve their health and well-being.
Predictable
The future of health care is looking at the whole person and managing care at the individual level. What if you had a more holistic view of each individual and your population as a whole - with guaranteed results on the clinical outcomes that matter to you?
Simple
Your members' needs may be complex, but their experience shouldn't be. We're committed to simplifying and personalizing engagement with members to ensure they have access to the clinical expertise and supportive care that will lead to better outcomes for all.
We partner with health plans of all different sizes. However, more than 50% of our health plan clients have less than 100,000 lives.
We care deeply about our health plan partnerships. Our health plan clients have worked with us for 11 years, on average.
Deep expertise in regulated markets
As a local health plan, you know and understand your market well. However, many of our clients rely on our unique resources, expertise and perspective as a result of helping a large portfolio of health plans just like yours. While you may be experiencing a certain regulatory change or challenge for the first time, chances are we’ve already helped another plan navigate a very similar challenge. Our job and focus is to help your plan be successful – from proven best practices and unbeatable expertise – and turn every challenge into an opportunity to help your plan.
Medicare drug trend in 2019
Medicaid drug trend in 2019
Of the Medicare members we support are in 4-star or better plans
higher cost of care for patients with both a mental health condition and a chronic disease compared to patients with only a chronic disease1
of health plans intend to increase fertility offerings within 3-5 years2
50 - 100 gene and cell therapies are anticipated to receive FDA approval by 20253
Explore additional solutions
inMynd℠
Advancing mental health through a holistic behavioral health care solution intended to help your members access mental health support and treatment on their terms.
Healthy Ways to Work
In a world dramatically changed by COVID-19, we’re helping our partners navigate new realities. Explore agile solutions focused on helping people return to a healthy, safe, and productive workplace.
Embarc Benefit Protection℠
Gene therapies have the potential to change lives, but even a single treatment can cost millions of dollars. Embarc Benefit Protection shields members from these high costs, so that people who need treatment can get it.
FamilyPath℠
By 2025, 10 million couples will have trouble starting a family. FamilyPath raises the bar for fertility health by providing more comprehensive, more flexible coverage and proactive care for growing families.
Digital Health Formulary
The Digital Health Formulary was built to evolve and expand into new clinical areas as solutions come to market. Its streamlined, rigorous review process enables us to bring your groups and members digital innovation faster than ever.
Trending topics and additional information
Drug Trend: Trend Contributors
What drives drug trend? Take a look at the top drug trend contributors from our 2019 Drug Trend Report.
Public Policy Analysis
View a report focusing on 2020 U.S drug pricing policy recommendations from Express Scripts.
5 Ways Health Care Will Change
We continue to keep a close eye on five trends that are making waves in health care, resulting in titanic shifts that plan sponsors seek expert help to navigate.
Navigating the Digital Health Landscape
As the country is faced with crisis, many plans are leaning in to digital and virtual strategies. Here are five factors to consider when navigating today's digital health landscape.
1 Milliman Research Report. Potential economic impact of integrated medical-behavioral healthcare
2 “Assessing Perception of and the Need for Enhanced Fertility Solutions,” Quantitative Research Study, Express Scripts, March 2020
3 www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-and-peter-marks-md-phd-director-center-biologic
2 “Assessing Perception of and the Need for Enhanced Fertility Solutions,” Quantitative Research Study, Express Scripts, March 2020
3 www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-and-peter-marks-md-phd-director-center-biologic