Priority Health makes prescription costs available, furthering transparency mission

Grand Rapids, Mich. - Nov. 29, 2017) Priority Health has integrated prescription costs into its Cost Estimator tool, as part of a continued effort to help members understand their health care costs.

To date, Priority Health is the only health plan in Michigan to provide one comprehensive experience with its transparency tool, offering cost information for health care procedures, services, and now, prescriptions. Members are able to understand what they will pay for a prescription and how they could pay less by switching to a lower-priced alternative or opting for home delivery. Members can also view their prescription cost by pharmacy location.

"We understand that cost is an important factor in making health care decisions. Empowering members to know their cost will help them in making informed decisions about their care," said Nathan Foco, senior director of market and sales intelligence for Priority Health. "We’re proud to offer a convenient, one-stop-shop for our members to gain access to cost information whether they're at the doctor's office, pharmacy or home."

More than 6,000 prescriptions were added to Cost Estimator, from pills to liquids and creams. When a non-preferred medication is priced through the tool, members have the option to view more affordable alternatives. Results are also shown for home delivery, through Express Scripts, as well as the nearest pharmacies. Prices are broken down by pharmacy location, using the member's benefits to determine their specific out-of-pocket cost.

"We expect to attract more members to Cost Estimator in search of prescription costs because pharmacy is our most frequently utilized benefit, with 80 percent of commercial members filling at least one prescription per year," said Foco.

Cost Estimator launched in 2015, providing Priority Health members instant access to cost information by facility for hundreds of health care procedures based on their individual health plan. Utilization has steadily increased to 10 percent of commercial members currently using Cost Estimator, which exceeds the industry average of 2 percent1. Earlier this year, some of the most searched and billed procedures were added to Cost Estimator. Priority Health also announced in its first two inaugural years, the Cost Estimator resulted in shared savings in excess of $6.3 million.

Members can access the tool by logging into their MyHealth account, then choosing the Cost Estimator tile.

1Increasing Transparency Tool Effectiveness, Quantum Health

About Priority Health:

Priority Health is an award-winning, Michigan-based non-profit health plan nationally recognized for improving the health and lives of the people it serves. It continues to lead the industry in engaging members in their health, delivering effective health and disease management programs and working with physicians to improve health care outcomes and performance. Priority Health is one of only 20 health plans nationwide offering wellness programs accredited by the National Committee for Quality Assurance, an organization which also rated it among the best health plans in the nation. The State of Michigan named the Priority Health HMO the benchmark plan for all individual and group HMO plans to model.

Priority Health offers a broad portfolio of health benefit options for employer groups and individuals, including Medicare and Medicaid plans. Its network of health care providers features 95 percent of practicing physicians available in Michigan and more than 900,000 health care providers nationwide.