Blue Cross and BCN to collaborate with OptumRx for pharmacy benefit management services

Blue Cross Blue Shield of Michigan, Blue Care Network and OptumRx will be working together to give members, health care providers and employers prescription drug benefit services that are expected to improve the pharmacy experience, drive better health outcomes and lower costs. The collaboration will take effect Jan. 1, 2022, for commercial individual and group members, and Jan. 1, 2023, for Medicare Advantage individual and group members.  

As a leading pharmacy care services provider, OptumRx will augment Blue Cross’ existing programs, bringing new tools and digital technology designed to better manage the overall drug spend and increase member engagement in pharmaceutical treatment. The OptumRx integrated health and wellness service platform complements Blue Cross’ integrated benefit solutions. Through this collaboration, OptumRx will support administration of pharmacy claims, manage rebate contracting with pharmaceutical manufacturers, provide mail-order dispensing and manage Blue Cross’ pharmacy networks.

“Holding the line on steadily increasing pharmacy costs and ensuring members have access to the prescriptions they need are top priorities for Blue Cross,” said Blue Cross President and CEO Daniel J. Loepp. “We’re confident our collaboration with OptumRx will help us move closer to reaching those goals through affordable, innovative solutions that improve care within our communities.”

The collaboration advances Blue Cross’ commitment to providing members with convenient and affordable access to prescription medications, with no disruption to current members, through a comprehensive retail and home delivery pharmacy network. Leveraging OptumRx’s expertise, negotiated contracts and network of more than 68,000 pharmacies, this collaboration will expand access and significantly improve prescription drug pricing and rebates, offering members and group customers more value and cost savings.

OptumRx will provide enhanced customer service technology integrated with member communications to ensure a smooth exchange of information. An updated website and new mobile app will also place individualized coverage details at each member’s fingertips for quick and convenient access to cost and benefit information. Blue Cross will continue to work closely with its current pharmacy benefit provider, Express Scripts Inc., to ensure a successful and seamless transition.

We’ll provide more details later in the year as we get closer to the transition date.