Comprehensive clinical solutions help you promote appropriate medication use by engaging employees and providers. Horizon Pharmacy + 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 improve care, costs and outcomes.1


Integration helps keep people safe from opioid overuse

For one large employer group, integrated data from Blue + Prime pharmacy claims helped decrease high opioid use for 1 in 3 employees — and even helped prevent one potential employee opioid overdose.2


Better employee experience and adherence potential after a benefit change

For employer groups looking to create the best possible employee experience when making benefit changes, Transition Fill offers a temporary fill or refill of a non-formulary drug within the first 90 days of a benefit change. With Transition Fill, you can help improve your employees’ experience and promote better medication adherence.


Safety and support for your employees

Horizon Pharmacy + Prime uses a multifaceted approach to help manage appropriate use of controlled substances. This program helps provide oversight of at-risk individuals, supports continued research and enhances monitoring of pharmacies and providers. It also provides education for your employees about the risks of controlled substances.


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.


Improved experience, significant savings potential

SmartRenew proactively identifies and renews eligible drug approvals (like prior authorizations, formulary and quantity limit exceptions) for employees before those approvals expire. This solution notifies employees of their continued access to their drug with no action needed from them. It also provides savings opportunities for employer groups by reducing clinical review costs.

Horizon Blue Cross Blue Shield of New Jersey is an independent licensee of the Blue Cross Blue Shield Association. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey.

1 Savings specific to health plan, not employer group

2 Prime analysis 2021