ORANGE, Calif. (July 9, 2019) Providence St. Joseph Health and Blue Shield of California are teaming up to help patients save hundreds, if not thousands, of dollars a year on prescription drugs.
Providence St. Joseph providers are now using the new Drug-Cost Transparency ServicesTM, developed by Gemini Health LLC, and offered to Blue Shield of California plan members. Blue Shield is making the service available through its innovative collaboration with Gemini Health at no additional cost to providers.
After a successful pilot program with Providence St. Joseph Health providers in Orange County, the service is now available to nearly 800 prescribers within the health system’s offices in Northern and Southern California.
The providers and their patients already are seeing significant savings results. In the first two months since the program’s expansion, the initiative is expected to deliver $100,000 in annualized savings in patients’ out-of-pocket costs based upon switches made from existing medications to lower cost clinically equivalent alternatives.
Norman Rosen, M.D., a family practice physician with St. Joseph Heritage Medical Group, said he already has helped dozens of patients reduce their costs for prescribed medications with less expensive, but equally effective medications.
“I am committed to delivering high quality medical care, including using affordable and effective medications,” Rosen said. “With this new service, I have been able to save patients from $10 a month to a yearly savings of several thousand dollars by using medications that are therapeutically equivalent to those previously prescribed.”
He added: “Many of my patients are concerned about the rising costs of prescription drugs. I worry they might decide to do without medication because they can’t afford it, with serious consequences.”
How Gemini works
Through its collaboration with Blue Shield, providers can see the nonprofit health plan members’ plan and benefit-specific information on the actual out-of-pocket costs for the patient, as well as the total cost for the member’s current medications.
In addition, Gemini’s technology also identifies dose-matched clinically equivalent alternative medications which are lower-cost based upon the member’s insurance. The information is delivered to prescribers each time a Blue Shield member is seen for care by Providence St. Joseph providers, who can view the drug cost information within their electronic health record (EHR) system. The service also is unique because it addresses the costs of both new and existing prescriptions, noting all savings options for clinically equivalent but more cost-effective medications. This information is not currently available through standard e-prescribing technology.
“Our nonprofit mission is to help ensure Californians have access to quality health care at an affordable price, and that includes prescription drugs,” said Terry Gilliland, M.D., Executive Vice President of Health Care Quality and Affordability, Blue Shield of California. “The collaboration with Gemini and Providence St. Joseph Health is an example of making that vision a reality by using latest technologies to solve one of the thorniest problems in our healthcare system – skyrocketing drug costs.”
The service also can reduce pharmacy call-backs to the provider’s office to resolve drug coverage issues and thereby enhance provider productivity, while helping to identify the treatments with the lowest out-of-pocket costs to improve patient satisfaction and adherence.
Today, most healthcare providers prescribe medications in a cost-information void. The lack of drug cost transparency and decision-support drives up costs particularly for the chronically ill and seniors who on average fill more than four prescriptions each month,” said Edward Fotsch, M.D., CEO, Gemini Health. “The new Drug-Cost Transparency Services can make a real impact in helping patients have access to prescriptions they need at more affordable cost.”
About Blue Shield of California
Blue Shield of California strives to create a health care system worthy of our family and friends that is sustainably affordable. We are a not for profit, independent member of the Blue Cross Blue Shield Association with 4 million members, 6,800 employees and more than $20 billion in annual revenue. Founded in 1939 and headquartered in San Francisco, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare health care service plans in California. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have an impact on California communities.
For more news about Blue Shield of California, please visit news.blueshieldca.com.
About Providence St. Joseph Health
Providence St. Joseph Health is a national, not-for-profit Catholic health system comprising a diverse family of organizations and driven by a belief that health is a human right. With 51 hospitals, 829 physician clinics, senior services, supportive housing and many other health and educational services, the health system and its partners employ more than 119,000 caregivers serving communities across seven states – Alaska, California, Montana, New Mexico, Oregon, Texas and Washington, with system offices in Renton, Wash., and Irvine, Calif.
About Gemini Health LLC
Gemini Health LLC delivers drug and alternative cost transparency to prescribers to reduce drug and administrative costs for patients, providers and payers. The Gemini Drug-Cost Transparency ServiceTM delivers decision support for busy prescribers integrated into Electronic Health Record workflow, including actual patient-specific costs of drugs selected by a physician, as well as lower cost alternative drugs and pharmacies when applicable, based upon the patient’s pharmacy benefit, formularies, and related health plan coverage details. Gemini is working with key provider and payer partners, with a focus on Blue plans, including in California with Gemini’s lead partner, Blue Shield of California. For more information, visit www.gemini.health.
 Indirect costs to physician groups may be associated with resources needed for EHR integration and provider training.