Latest news with #BlueCrossBlueShieldofTennessee
Yahoo
3 days ago
- Business
- Yahoo
Prescription drugs are more expensive than ever. Here's how to beat the costs.
Today, we have a dozen new drugs that hit the market with manufacturer price tags at over $1 million for a one-time treatment. In Tennessee, where the average income per year is around $36,000, that's simply unaffordable. On behalf of its members, BlueCross BlueShield of Tennessee paid out $3.5 billion for drugs last year. The average member fills 18 prescriptions a year, with even higher numbers among our Medicare populations. It's our most widely used benefit, especially when considering the handful of doctor's visits an average member makes each year. On closer look, high-cost specialty drugs make up 55% of that spending but only 2% of utilization. These drugs are costly because of exclusive manufacturing rights as well as complex manufacturing processes. Many of them are 'biologics,' which are are made from living organisms. Some specialty drugs have helped improve disease outcomes and quality of life in meaningful ways, but let's be clear: While providing access to safe and effective drugs is core to our purpose at BlueCross, we also have to consider how they raise costs for everyone who pays for health coverage. That includes members visiting the pharmacy and Tennessee businesses who are paying for their employees' plans. But manufacturing fees aren't the only reason prescription drugs are more expensive than ever. First, drug prices have consistently outpaced general inflation. Since 1985, overall drug prices have risen at rates three times faster than inflation. By 2024, drug prices were more than 127% higher compared to the cost of all other commodities. So, it's no surprise that pharma leads the health industry with an average profit margin of around 15%, compared to 1-3% for not-for-profit insurers like us, and roughly 5% for carmakers. Opinion: Poor Tennesseans need affordable meds. This bill ensures they can access them. Second, drug companies spend billions of dollars every year on advertising and promotion, which drives up the use of pricey treatments. This kind of advertising is only legal in the U.S. and New Zealand, and it leads to patients pressuring their doctors for brand-name drugs they see in ads, even if they may not actually need them—or when lower cost alternatives that are just as safe and effective are available. Examining our health behaviors and culture towards disease management can help us understand how we, as individuals, can navigate high drug costs. Opinion: Here's how we can make prescription drugs more affordable for consumers For example, we're seeing increased rates of cancer, diabetes, obesity, and other acute and chronic illnesses. And we've almost doubled the average number of prescriptions per member since 2014. But while medication use is often the primary treatment for these conditions—and understandably so—most drugs work best in conjunction with lifestyle changes like exercise and diet improvement. In some cases, lifestyle changes can even reduce our dependence on medications. At BlueCross BlueShield, we encourage our members to become active consumers in their health care decisions, and we offer resources that can help. While we don't set the list price for drugs, we provide formulary and drug cost information so our members can compare drug prices the way they might with other goods. Research shows people might skip doses or avoid filling prescriptions if they can't afford them, so it's important to know all the options. We also provide information on and access to generic and biosimilar drugs that are lower-cost options, and just as effective. Choosing a generic and biosimilar over a brand name is the most effective way consumers can lower their costs—often by 80-85%. These drugs are highly regulated to be the same as their more expensive counterparts, and manufacturers often produce both the brand-name and generic or biosimilar drugs. Simply put, becoming informed consumers in our health care journey is crucial. By understanding medication coverage, comparing treatment options, and asking about the cost of medications, we can make informed choices that align with our individual financial and health needs. Natalie Tate, PharmD, is vice president of pharmacy for BlueCross BlueShield of Tennessee. This article originally appeared on Nashville Tennessean: How to avoid high prescription drug costs, and stay healthy | Opinion
Yahoo
25-04-2025
- Business
- Yahoo
Health technology should be as easy as email. Listen to consumer and adjust.
Now, patients want the option to visit their doctor in the comfort of their living room. They also want to manage their health plan as easily as they check their email. And many prefer personalized care and communication through a simple text message. At one time, these scenarios were simply a futuristic dream. But this shift clearly underscored the essential role that digital solutions play in meeting the evolving needs of consumers, especially when it comes to their health outcomes. For many companies, evolving to meet rapidly changing consumer expectations remains a challenge and requires a significant investment of time and talent. Here at BlueCross BlueShield of Tennessee, we know part of our role is to help our members get the care they need. So, this shift presented an opportunity to get to know our customers' expectations in greater detail. Our customers were eager to share what they wanted from our digital tools. Their interest in how their digital experience could help them along their journey towards better health was loud and clear. Over the last three years, we've seen big changes in how our members interact with their providers and health insurance plan. Telehealth usage has soared by an impressive 176%. This increase shows more people prefer remote consultations because they are convenient and safe, especially when balancing busy lives or during a personal health matter. Using mobile apps for self-service has also become the main way our members check claims and benefits. Members say they appreciate how easy it is to see if they've met their deductible or check the status of a prior authorization through their smartphones. This trend highlights the need for strong, user-friendly mobile apps that can handle many tasks efficiently. Opinion: Tariffs are kicking Americans in the teeth. Medicaid cuts make things worse. More and more of our members are turning to chat services for quick, real-time assistance without having to talk on the phone. This indicates the need for responsive and effective chat solutions that can address member queries promptly and accurately. Adoption of email and text messaging has also risen significantly across most of our customer segments, including seniors. They expect information to be easy to find and actions easy to take. We address this through user-centric design and conducting usability studies before releasing our designs. This ensures information is where users expect it to be, so they don't have to search for frequently used features. They want to choose how they hear from us. So, we provide a variety of digital channels. This includes email, text, push notifications, and in-app messaging, to meet members where they are. They expect us to know them. They've asked us to send timely prompts when it's time to get care. So, each message is customized to their health journey, ensuring a personalized experience. Their data should be secure and safe from cyber threats. We use multi-factor authentication (MFA) with the goal of trying to ensure the right people access the right data, making password resets and username retrieval more streamlined. At BlueCross, it's our job to help make health care more affordable for our members. Investing in good digital tools can enhance the user experience by streamlining access to information, facilitating convenient appointments, and offering personalized health prompts. This efficiency not only saves time for both patients and providers, but also lowers operational costs, which can be passed on as savings to our members. Simply put, secure and user-friendly digital tools help patients get timely care, ultimately leading to better health outcomes and quality of life. Barry Setlich is managing director of digital transformation for BlueCross BlueShield of Tennessee This article originally appeared on Nashville Tennessean: Health tech tools should be easy to use, safe for consumers | Opinion
