How has Express Scripts applied behavioral economics to its own workforce of 11,000 employees?
Michael Holmes: Before we rolled out Select Home Delivery, a program by which companies automatically enroll patients into our mail-order pharmacy service, we did it with our employees. The difference is our employees don’t have an opt-out feature because they like getting their prescriptions this way. WM: How else have you tried to lower your own health care costs? Holmes: One thing we found is that specialty drugs—or those drugs that have to be infused or injected—are much more expensive than oral solids. So we launched our Care Continuum program, which assures that the doctors are using the right dosage and that it’s safe. So for example, if the vial size for a drug is 50 milligrams, the doctor shouldn’t be billing the insurer for 100 milligrams. Specialty drug costs are expected to grow 25 percent by 2012, so this is one way we hope to reduce our costs. We rolled the program out nine months ago and we expect to save $2 million this year. WM: What are some of the major challenges yo
