Cutting Costs: CHG Healthcare Carves Out Specialty Pharmacy

Catalyst for Payment Reform

Pramod John & Anne Hopkins, CHG, Webinar, 11/12/2020

CHG Healthcare and VIVIO Health Inc tackle the perfect storm of challenges when it comes to specialty pharmacy: out-of-control costs, lack of clinical evidence, and limited use of outcomes data.

Back in 2016, benefits staff at CHG Healthcare found a $174K charge in the monthly claims spend report. It wasn’t a mistake; it was the actual price for a specialty drug being used to treat a rare medical condition. Forecasting further costs without evidence of effectiveness, CHG Healthcare partnered with VIVIO Health Inc. to implement a specialty drug carve-out plan that covers both pharmacy and medical benefit drugs. Since 2017, CHG Healthcare has saved a net $4.4M through the program even with zero out-of-pocket costs for plan participants paying for specialty medications. Hear directly from Anne Hopkins, Director of Benefits and Wellness at CHG Healthcare, and Pramod John, CEO & Founder of VIVIO Health Inc., on how a focus on outcomes and individualized care can lead to savings.

Cutting Costs: CHG Healthcare Carves Out Specialty Pharmacy – Catalyst for Payment Reform (catalyze.org)