Re: Walgreens pulls out of Aetna managed care

[Guest guest]

Another example of the failures of the Illinois version of Managed Health Care.

This is a disgrace.

>

> Sobering news...how will this effect IPADD members? Where will you go to have

prescriptions filled now?

>

> Sent: Fri, November 4, 2011 10:01:00 AM

> Subject: Update from Aetna Better Health - Pharmacy

>

> All,

>

> As of January 1, 2012 Walgreens will withdraw from the national Express

> Scripts, Inc.(ESI) network. ESI is the Pharmacy Benefit Manager for Aetna

> Better Health and consequently, members will no longer be able to fill their

> prescriptions at the Walgreens pharmacy as of that date.

>

> Aetna Better Health recognizes the impact that this has and has developed a

> detailed outreach plan to minimize the risk of disruption for our members.

> This plan will provide assistance to those affected by this change well in

> advance of the January timeframe.

>

> ESI has identified approximately 6000 members who have received a prescription

> from Walgreens since May 1, 2011. We have developed a multi-tiered

> approach for notifying the 6000 members. The first step of

> notification includes sending out a letterthat lists their current Walgreens

> location and three alternative pharmacies and locations. Additionally, they

> will receive two automated phone calls alerting them. The automated phone

> calls will also have an option allowing the member to be transferred to ESI

> call center staff to assist with the transition.

>

> The second step is that ESI has identified approximately 600 members

> who are receiving 10 or more prescriptionsper month. ESI will contact

> them directly to either enroll in mail order or transfer to another drug

> store . For the remaining 5400 members, Aetna Better Health has a dedicated

> team who will proactively reach out to assist with the transition by enrolling

> them in mail order or identifying alternative pharmacies that are accessible

to

> the member. We will have direct access to top 10 pharmacy chains who are

> prepared to help in the transition by contacting Walgreens or the prescribing

> Doctor.

>

> It is our expectation that this individualized intervention with our members

> will provide the opportunity to answer any questions that they may have as

well

> as assist them in their transition with as little disruption as possible.

>

> Please feel free to contact me if you have any additional questions.

>

> Regards,

>

> Jacqleen Musarra

> Community Liaison Manager

> Aetna Better Health, Illinois

> One South Wacker Drive

> Chicago, IL 60606

> 312.821.0583

> MusarraJ@...

>

>

>

>

[Guest guest]

Walgreens has been negotiating with Express Scripts for nearly a year. Walgreen

says Scripts will not pay them enough and Script says Walgreen wants too much.

It affects a lot of insurances. It will affect all the military and federal

employee insurances. Don't know who is right, but Walgreens sort of threw up

their hands and gave up. Since it is a lot of business I suspect they would

have stuck with it if they could reasonably do so.

>

> Sobering news...how will this effect IPADD members? Where will you go to have

prescriptions filled now?

>

> Sent: Fri, November 4, 2011 10:01:00 AM

> Subject: Update from Aetna Better Health - Pharmacy

>

> All,

>

> As of January 1, 2012 Walgreens will withdraw from the national Express

> Scripts, Inc.(ESI) network. ESI is the Pharmacy Benefit Manager for Aetna

> Better Health and consequently, members will no longer be able to fill their

> prescriptions at the Walgreens pharmacy as of that date.

>

> Aetna Better Health recognizes the impact that this has and has developed a

> detailed outreach plan to minimize the risk of disruption for our members.

> This plan will provide assistance to those affected by this change well in

> advance of the January timeframe.

>

> ESI has identified approximately 6000 members who have received a prescription

> from Walgreens since May 1, 2011. We have developed a multi-tiered

> approach for notifying the 6000 members. The first step of

> notification includes sending out a letterthat lists their current Walgreens

> location and three alternative pharmacies and locations. Additionally, they

> will receive two automated phone calls alerting them. The automated phone

> calls will also have an option allowing the member to be transferred to ESI

> call center staff to assist with the transition.

>

> The second step is that ESI has identified approximately 600 members

> who are receiving 10 or more prescriptionsper month. ESI will contact

> them directly to either enroll in mail order or transfer to another drug

> store . For the remaining 5400 members, Aetna Better Health has a dedicated

> team who will proactively reach out to assist with the transition by enrolling

> them in mail order or identifying alternative pharmacies that are accessible

to

> the member. We will have direct access to top 10 pharmacy chains who are

> prepared to help in the transition by contacting Walgreens or the prescribing

> Doctor.

>

> It is our expectation that this individualized intervention with our members

> will provide the opportunity to answer any questions that they may have as

well

> as assist them in their transition with as little disruption as possible.

>

> Please feel free to contact me if you have any additional questions.

>

> Regards,

>

> Jacqleen Musarra

> Community Liaison Manager

> Aetna Better Health, Illinois

> One South Wacker Drive

> Chicago, IL 60606

> 312.821.0583

> MusarraJ@...

>

>

>

>

[Guest guest]

I would like to know WHY they pulled out. Seems having 6,000 customers pull out

at the same time would NOT be a wise decision.

They are supposed to get paid more promptly than Medicaid alone.

I have a good story about Managed care/Aetna Better Health.

I took Kim to the Ear Institute of Chicago on the way to Springfield 2 weeks

ago.

Two prescriptions were ordered. We needed to fill them before we came home in 2

days.

I called ABH to find out what to do. They said ANY CVS in the state would fill

the orders.

I was expecting a hassle when we got to the pharmacy in Springfield.

NO PROBLEM! IT was filled and taken care of in 20 minutes.