The number of plan sponsors that will offer consumer-directed health plans that integrate pharmacy and medical benefits increased more than 16-fold, from 3 to 50, between January 2005 and January 2006, according to Medco Health Solutions. Medco says that the number of plan sponsors offering a pharmacy benefit in their consumer-directed health plans could reach 100 within the next 12 months.
The number of members enrolled in a CDHP with an integrated health savings account topped 2 million — more than one third of the entire U.S. CDHP market. Medco says this growth is fueled by the recent expiration of the IRS Transition Relief for HSAs. It is now required that the prescription drug benefit, along with the medical benefit, be considered as part of the high-deductible health plan.
In the past, there was a perceived lack of integration between the pharmacy and the medical side of the benefit. This is not the case anymore, according to Medco.
“The technology has advanced now to the point that we can provide real-time integrated exchange of data between the pharmacy and medical benefits,” says Tracy Grunsfeld, senior director of consumer solutions at Medco. “This gives our clients the best of both worlds — a seamlessly integrated health benefit for the consumer with a continued and dedicated focus on pharmacy benefits.”
Medco says that 50 percent of all health care transactions are pharmacy-related. Therefore, pharmacy provides the greatest opportunity to promote consumer-directed health plans. A well-managed pharmacy benefit is critical to a plan sponsors’ efforts to involve the consumer in the health decision-making process, and requires that medical and pharmacy providers be properly managed to provide an integrated benefit.
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