Design, implementation, and evaluation of an integrated prescription drug program for NY State employees

The Foundation's Workers' Compensation Health Initiative is a program of demonstration and evaluation projects aimed at containing costs and improving the quality of care provided to injured workers.ONECARD Rx will allow New York State employees to use their existing health insurance prescription drug benefit for all of their prescription drug needs. This project will integrate the workers' compensation prescription drug program into the New York State Health Insurance Program's (NYSHIP) prescription drug plans, eliminating the separate and cumbersome workers' compensation claim reimbursement process. Specifically, this project will: (1) determine if the state can decrease its expenditure for workers' compensation prescription drugs through negotiated discounts, generic substitutions, and other managed pharmacy cost containment options; (2) determine if the state can decrease its total administrative expenditure for prescription drugs by eliminating paper processing of workers' compensation claims and creating one, integrated administrative process for health insurance and workers' compensation prescription drug claims; (3) increase the quality of care employees receive by using managed pharmacy benefits, such as adverse drug interaction detection and drug utilization review; and (4) evaluate the effectiveness of integration of health insurance and workers' compensation programs by measuring costs saved and costs avoided, identifying the impact of integration on health insurance costs and on the state's workers' compensation medical program, and studying the applicability of the project to other employers.

Grant Details

Amount Awarded $253,282.00

Awarded on: 10/25/1996

Time frame: 11/1/1996 - 7/31/1999

Grant Number: 30317