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County consultants recommend keeping Highmark for medical, switching pharmacy benefits to Capital Rx to curb drug-cost growth
Summary
BeneTech consultants told the Board that self-funding has unlocked claims data and rebates and recommended Highmark Blue Shield for medical coverage and Capital Rx for pharmacy services; consultants said the county—ould save about $400,000 by capturing higher rebates and adopting a transparent NADAC model.
BeneTech consultants told the Board of Supervisors that the county should retain Highmark Blue Shield for medical coverage while switching its pharmacy benefit manager to Capital Rx, a move the consultants said could slow the county rug-cost trend.
At a presentation that opened the meeting, Darren Mosher of BeneTech reviewed an RFP that drew seven medical carriers, eight pharmacy benefit managers and nine dental carriers. Mosher said the county—enefitted from moving to a self-funded model in June 2023 because it produced detailed claims data and drug rebates that had previously been retained by carriers: "since you guys have been self-funded, you've gotten over $2 million back in drug rebates," he said.
Why the switch? Mosher told supervisors the county—aces outsized drug-cost pressures.…
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