Powered by the strength of a unique Blue + Prime foundation, we’ve grown from a small pharmacy benefit manager (PBM) to a leading total drug management enterprise.
Building a trusted, transparent PBM
With for-profit drug makers dominating a fragmented pharmacy benefit management (PBM) market, Blue Cross and Blue Shield (BCBS) plans in Minnesota and Nebraska created Prime Therapeutics. Our transparent model, fully aligned with Blue Plan goals and member-centered priorities, attracts others. By 2010, Prime had 12 Blue Plan client-owners and 17 million members.
- 2000-2001: Blue Plans in North Dakota, Wyoming and Kansas join Prime as equity owners.
- 2004: Health Care Services Corporation (HCSC) joins Prime as an equity owner.
- 2006: Prime is the seventh largest PBM serving the new Medicare Part D program.
- 2006: Florida Blue joins Prime as an equity owner.
- 2007: Prime is among the first PBMs to earn URAC accreditation, enabling clients to delegate PBM functions to Prime.
- 2008: PrimeCares formalizes our support for our employees and communities.
Helping improve care, reducing cost through integration
Prime and our clients begin to realize the value of integrated medical and pharmacy claims data to help clients and doctors make better decisions that help improve outcomes and control costs.
- 2010: BCBS of Alabama joins Prime as an equity owner.
- 2010: Prime introduces “be well” for employees, offering wellness screenings, health coaching, classes and more.
- 2011: GuidedHealth®, a leading-edge clinical intelligence hub, helps members and clinicians make better decisions based on Prime’s unique pharmacy and medical data.
- 2011: Prime introduces CareCentered Contracting™, an innovative contracting program with drug makers. By the end of the decade, we’re an industry leader in value-based contracting.
- 2012: BCBS of North Carolina joins Prime as an equity owner.
- 2013: Years before the opioid crisis makes headlines, Prime and Florida Blue develop an award-winning controlled substance (CS) program that saves lives.
- 2014: Integrated care reduces medical costs by 11%, according to a joint study by the Blue Cross Blue Shield Association and Prime.
Moving ahead in a shifting landscape
As high-cost specialty drugs blur the line between the medical and pharmacy benefit, the Blue + Prime model thrives. Prime develops and delivers data analytics and drug management solutions that reduce the total cost of care. By the end of the decade, our integrated model includes 23 Blue Plans — 19 as owner-clients — with more than 30 million members.
- 2015: Prime’s award-winning Specialty Drug Watch List prepares clients for the impact of new, high-costs drugs using client-specific integrated data.
- 2015: Prime Analytics™ provides clients with on-demand access to daily reports and interactive dashboards to analyze drug spend and trend.
- 2015: Prime launches Best in Care™, a set of drug management programs for high-cost drugs.
- 2015: Prime is the largest PBM serving members of the (HIM) created under the Affordable Care Act.
- 2016: BCBS of Rhode Island joins Prime as an equity owner.
- 2017: To accommodate growth and improve efficiency, Prime breaks ground on Prime Landing, a state-of-the art corporate headquarters in Eagan, Minnesota.
- 2017: Cambia/Regence BCBS joins Prime as an equity owner.
- 2017: Prime earns National Committee for Quality Assurance (NCQA) certification for utilization management and health information products.
- 2018: Prime’s award-winning Controlled Substance Management Program contributes to a 79% decline in the number of high-risk opioid users over the previous five years.
- 2019: Specialty MonitorTM, a powerful analytics tool, gives clients self-service access to their integrated specialty drug data. Combined with our expert analysis, Specialty Monitor helps clients understand what’s driving spend and trend in order to make data-driven decisions.
2020 and beyond:
Empowering clients, providers and members
As others consolidate to capture market share and steer patients into their wholly owned channels, Prime remains fully aligned with our Blue Plan clients. Our unbiased, integration model, enables us to work with clients and local providers to develop tailormade solutions. With right-place, right-time information, clients, providers and members are empowered to make choices that improve experiences and outcomes.
- March 2020: As COVID-19 spreads, concern for employee health prompts Prime to be among the earliest companies to close facilities and move to a remote work model.
- April 2020: PreserveRxSM combines reinsurance through BCS Insurance with clinical services and outcomes-based contracts to preserve access to breakthrough gene therapies while protecting employer groups from unexpected health care bills.
- March 2020: Leveraging artificial intelligence technology from SAS, Prime’s award-winning enhanced fraud, waste and abuse (FWA) program saves clients $280 million in 12 months.
- August 2020: The Prime Together Foundation is created to address inequality and injustice in all its manifestations, particularly racism, poverty, health and hunger.
- October 2020: Capital Blue Cross moves from client to owner-client by taking an equity stake in Prime.
- May 2021: Insights+, a highly consultative data and analytics platform integrating medical and pharmacy data, succeeds Specialty Monitor and expands service to include select employer group clients.
- May 2021: The first phase of MedDriveTM, a first-of-its kind medical drug management program aligned with our Blue Plan clients, emphasizes biosimilars, predictive analytics and the combined strength of our clients to improve management of medical drug spend.
- 2021: Prime Landing reopens. An innovative Hub + Home strategy establishes Prime Landing as Minnesota’s in-person office hub. Some employees work primarily from home. Some work in a hybrid arrangement, with scheduled time both at home and in a Prime office.