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Commission approves switch back to Blue Cross pharmacy carve-in after consultant review
Summary
After reviewing 2024 drug-spend and rebate estimates, the commission approved moving the county's pharmacy benefit from SaveRx back to Blue Cross Blue Shield effective July 1 to capture larger rebates and reduce administrative fees, the county's benefit consultant said.
Hamblen County commissioners voted to move the county's pharmacy benefit back to Blue Cross Blue Shield beginning July 1, after consultants described higher estimated rebates and lower administrative costs compared with the current carve-out provider.
Mark 3 consultants Bridal Easterling and John Manful told the commission they had negotiated leverage with Blue Cross based on other municipal business they represent in Tennessee. "When we looked at your spend for the last calendar year of 2024, the spend on pharmacy was just under $1,300,000," John Manful said. "Blue Cross estimated their rebates coming back to the county to be about $608,000. During that same period of time... SaveRx ... was about $380,000 in rebates coming back." Manful added the county would also avoid an administrative integration fee that had been charged to carve pharmacy out of Blue Cross.
The consultants said the change would keep pharmacy and medical on a single ID card, simplify administration and reduce per-member integration fees (cited as $6.50 per member, producing roughly $25,000 in fees under the prior arrangement). They also said they were coordinating prior-authorizations and transfer files to avoid disruption for members.
County representatives said communications to members would be sent by county HR (Wendy's office) and county administration (Amanda's office) to explain the change. Commissioners asked whether clinic operations or employee access would be interrupted; consultants and staff said the switch applies only to pharmacy benefits and should not change clinic operations.
The motion to return pharmacy to Blue Cross was made by Mr. Richardson, seconded by Mrs. Howe, and carried on a voice vote. Staff said they expect the transition to occur within days and to be effective July 1.
Why it matters: the change is intended to increase rebate revenue to the county and reduce ongoing administrative fees while attempting to avoid disruption to employees' medication access.
Ending: County staff said they will coordinate communications and prior-authorization transfers with SaveRx and Blue Cross to minimize interruptions for members during the transition.
