Tufts Health Plan Members to Receive Rebates on Medications

WATERTOWN, Mass., June 18, 2018 /PRNewswire/ -- In an effort to lower members' out-of-pocket costs, prevent barriers to care and improve medication adherence, Tufts Health Plan is pleased to begin passing on pharmacy rebates directly to commercial fully insured members on high-deductible Saver plan options beginning January 1, 2019. The rebates will be given at the time that the member fills their prescription at more than 68,000 participating pharmacies.

"This represents another step forward in increasing cost transparency and savings for our members.  When they are exposed to the cost of high cost drugs, it can be quite surprising for them," said Marc Backon, president of Commercial Products.  "While we can't control the prices manufacturers charge, by implementing point-of-sale rebates, we can help reduce the cost impact so our members can access the medications they need."

Prescription drug costs continuously represent a large portion of our nation's overall  health care spending. According to a Milliman research report, in 2017, pharmacy spending accounted for 17 percent of total medical spend.

Drug manufacturers pay rebates to pharmacy benefit managers, who then pass the rebates on to health plans. The rebate amount for a drug can vary widely depending on what type it is. Historically, Tufts Health Plan has used pharmacy rebates to reduce the premiums or administrative fees charged to employers, which, in turn, were passed along to employees in lower premium contributions.

"New brand-name drugs and therapies are emerging faster than ever at unimaginable prices, creating more of a burden for our members who need them, which may lead to untreated conditions, and higher medical costs down the road," said Miriam Sullivan, vice president of pharmacy and clinical operations. "Our goal is to help keep our members healthy and to remove any barriers they encounter when seeking treatment. We know this new program will help us with that goal."

In addition to being offered across all Saver products, the point of sale rebates will also be available for Tufts Health Plan's self- funded customers as an option.

About Tufts Health Plan
Tufts Health Plan is nationally recognized for its commitment to providing innovative, high-quality health care coverage.  Staying true to our mission of improving the health and wellness of the diverse communities we serve, we touch the lives of more than 1.1 million members in Massachusetts, Rhode Island and New Hampshire through employer-sponsored plans; Medicare; Medicaid and Marketplace plans, offering health insurance coverage across the life span regardless of age or circumstance.

We are continually among the top health plans in the country based on quality and member satisfaction:

• Our private HMO and Massachusetts PPO plans are rated 5 out of 5 and our Massachusetts Medicaid plan is rated 4.5 out of 5 by the National Committee for Quality Assurance.ⁱ
• Our Tufts Medicare Preferred HMO and Senior Care Options plans received a 5-star rating from the Centers for Medicare & Medicaid Services, the highest rating possible.ⁱⁱ

To learn more about how we're redefining what a health plan can do, visit tuftshealthplan.com/connections. Connect with us on Facebook, Twitter, YouTube and LinkedIn.

ⁱ The National Committee for Quality Assurance Private Health Insurance Plan Ratings and Medicaid Health Insurance Ratings 2017-2018. This rating references Tufts Health Plan's Massachusetts Medicaid plan.  Tufts Health Plan's Rhode Island Medicaid plan has not yet been rated. 
ⁱⁱ Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. For more information on plan ratings, go to www.medicare.gov. Tufts Medicare Preferred HMO plans received 5 out of 5 stars for contract years 2016 -2018.

Contact: Kathleen Makela[email protected]  
857-304-8293

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SOURCE Tufts Health Plan