Comprehensive clinical solutions help you promote appropriate medication use by engaging employees and providers. Blue Cross and Blue Shield of Minnesota and Prime’s clinical programs support adherence and help eliminate gaps in care. And by getting your employees the medication they need, when they need it, our solutions help improve employee safety, decrease waste and connect the employee experience from beginning to end.


Better medication management decisions

GuidedHealth helps your employees and their providers make better decisions when it comes to managing their medications, looking at integrated pharmacy and medical claims to address overuse and underuse opportunities, as well as medication safety. These programs provide actionable, clinical intelligence to providers, employees and plans to help improve care, costs and outcomes.


Safety and support for your employees

Preliminary data from the Minnesota Department of Health showed a 35% year-over-year increase in the total number of overdose deaths involving opioids in 2021.1 Using pharmacy and medical information, Blue Cross and Blue Shield of Minnesota and Prime take a multifaceted approach to help manage appropriate use of controlled substances, including opioids. Our Controlled Substance Management program helps provide oversight of at-risk individuals, supports continued research, enhances monitoring of pharmacies and providers and provides education for your employees about the risks of controlled substances. Today, we see up to a 54% reduction in members identified as outliers, resulting in $0.07 PMPM savings per quarter.2 We are also developing new predictive modeling that will allow us to identify high-risk members even sooner.


Designed for increased efficiency and a better prior authorization experience

PA Notify is a proactive notification that alerts prescribers of an expiring drug approval, helping ensure your employees get the medicine they need with no gaps in care. PA Notify helps improve employee satisfaction, reduce appeals and grievances and enhance efficiency for providers.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

Prime Therapeutics LLC is an independent company that provides pharmacy benefit management services for Blue Cross® and Blue Shield® of Minnesota.

1 DeLaquil, M., Wright, N., Giesel, S. (2022). Statewide Trends in Drug Overdose: Preliminary 2021 Update, Data Brief. Minnesota Department of Health.

2 Prime internal data 2022