Albany County partners with Health Insurance Solutions for prescription drug cost savings

In the heart of Albany County, a pivotal meeting unfolded as the Personnel Committee gathered to discuss a significant contract with Health Insurance Solutions Incorporated (HISSE). The atmosphere was charged with anticipation as committee members reviewed the potential benefits of this partnership, which has been in place since 2020, aimed at enhancing prescription drug management for county employees.

Shannon, a key representative, presented compelling data highlighting the financial impact of HISSE's services. The program has successfully reduced pharmacy costs from approximately $2,900 to $2,600 per covered life, translating to a remarkable savings of $1.4 million from 2020 to 2021 alone. This reduction was achieved without disrupting services for employees, a crucial factor for the committee's consideration.

The discussion revealed a three-phase approach to cost savings. The first phase focused on the top 29 most expensive specialty drugs, yielding an impressive $6.8 million in savings. Subsequent phases, including a rebate audit and ongoing management from 2022 to 2024, contributed an additional $9.5 million, culminating in total savings of $16.3 million since the partnership began.

As committee members engaged in a lively Q&A, concerns about the interface between HISSE and existing medical coverage arose. One member, having recently switched insurance providers, sought clarity on how HISSE would work alongside their new plan. Shannon assured them that HISSE collaborates with prescription administrators like Express Scripts to ensure seamless coverage and cost-effective solutions for employees.

Further inquiries delved into the specifics of medication coverage, particularly for those without generic alternatives. Shannon explained that HISSE employs a peer-to-peer process, allowing doctors to advocate for necessary medications based on medical documentation, ensuring that employees' needs are met without hindrance.

The meeting concluded with a sense of optimism about the potential for HISSE to continue delivering substantial savings and improved healthcare outcomes for Albany County employees. As the committee prepares to vote on the contract, the implications of this partnership extend beyond mere numbers, promising enhanced support for the health and well-being of the county's workforce.