Program shows early success delivering savings to members; providers able to give access to more affordable prescription options
BOSTON, June 2, 2026 /PRNewswire/ -- Blue Cross Blue Shield of Massachusetts announced one of the ways it is tackling the high cost of prescription drugs is by working with Gemini Health on an initiative designed to deliver savings directly to members.
Why it matters: Healthcare costs are rising at the fastest rate in two decades, creating a significant affordability challenge. Skyrocketing drug costs are a major factor, causing many individuals to skip their medications. In fact, nearly a quarter of every health insurance premium dollar is driven by the cost of prescription drugs.
- This program offers a tangible step in addressing rising costs by engaging with clinicians at the point of prescribing, giving them insight into affordable prescription alternatives tailored to the member's plan.
How it works: Gemini Health's solution integrates into a provider's existing workflow. When the provider prescribes a medication, the tool automatically identifies and displays lower-cost alternatives aligned with the Blue Cross formulary. This provides clinicians with immediate visibility into coverage and clinical requirements, enabling them to select cost-effective alternatives while minimizing administrative friction.
By the numbers: The first phase of the program went live in November 2025 for providers serving fully insured employer accounts. During its first four months, the tool sent more than 900,000 prescription alternatives for members to more than 100,000 providers.
What they're saying:
- Mary Beth Erwin, chief pharmacy officer at Blue Cross: "Our work with Gemini Health is a pivotal part of our strategy to address prescription drug costs head-on. By delivering real-time, cost-effective alternatives directly into the clinical workflow, we can guide our members to more affordable prescription drug options, creating transparency at the point of care to ensure they can access the medications they need."
- Edward Fotsch, chief executive officer at Gemini Health: "For too long, patients and providers have lacked the real-time robust services they need to optimize medication therapy and costs. We are very excited to collaborate with Blue Cross Blue Shield of Massachusetts in this new opportunity to deliver price transparency and choice for their members and their providers."
Looking ahead: In the coming months, the program will be expanded to include providers serving self-funded (ASC) employer accounts. Additionally, Blue Cross is co-developing a solution with Gemini Health that will deliver cost-saving information directly to members via text message at the time of prescribing, further increasing transparency and giving them the data needed to make informed decisions in partnership with their prescribers.
About Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Massachusetts (bluecrossma.org) is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We are committed to showing up for everyone like they're the only one and guiding our members to the exceptional healthcare they deserve – affordably, equitably and seamlessly. In keeping with our commitment, we are rated among the nation's best health plans for member satisfaction and quality. Connect with us on Facebook, Instagram, and LinkedIn.
SOURCE Blue Cross Blue Shield of Massachusetts