PlotIT Case Study: Blue Cross/Blue Shield of Michigan

With prices for prescription drugs (like every area of health care) rising steadily, it is imperative that the health care industry find ways to control costs while maintaining high quality patient care. A success story in this battle involves community pharmacists in the state of Michigan, and a health insurer, Blue Cross Blue Shield of Michigan (BCBSM).

BCBSM recognized its common interest with Michigan pharmacies in keeping costs low and quality high. To address these issues, BCBSM created the SCRIPT_ program. SCRIPT (short for Systematic Cost Review In Pharmaco-Therapy) is a system designed to track the payment of BCBSM prescription drug benefits statewide, with an eye toward controlling prescription-benefit costs while maintaining quality. SCRIPT is a part of BCBSM's $650 million Prescription Drug Program (PDP), which collects and analyzes an enormous amount of detailed data about the rising cost of health care in the state of Michigan. PDP has been on-line since 1969, and for the last seven years has documented double-digit percentage increases in the cost of prescription drug claims.

SCRIPT reviews and analyzes the huge PDP database (more than 5.2 million prescription claims quarterly), and pulls out relevant data on the four "cost drivers" of prescription drugs: pharmacies, prescribers, recipients and pharmaceutical manufacturers. At the end of each quarter, SCRIPT looks at claims submitted from 2,300 Michigan pharmacies, and compares each pharmacy's cost and utilization to a set of comparative quartile criteria. This comparative information, in graph form, is then sent to pharmacies whose costs place them in the top quartile (e.g., top 25% of the group). Thus, these pharmacists can see, graphically, where they stand in relation to all other pharmacies in the state. SCRIPT gives them a perspective for making make informed therapy and business decisions about drug purchasing, generic drug dispensing, etc.

However, when BCBSM first brought SCRIPT on-line, it was soon apparent that the tools for producing the final graphs were inadequate. The graphing tools could not create the type and number of graphs that were needed. BCBSM employees had to resort to rubber-stamping an arrow on each graph to represent an individual pharmacy's position in relation to the quartile standards. And with six graphs for each of the 560 upper-quartile pharmacies, the process was imprecise and far too time-consuming.

BCBSM statistician Rodger Epp went looking for a solution. A colleague in the Statistics Department at Michigan State University told him that a possible answer was in his own back yard. A Michigan company - Scientific Programming Enterprises (SPE) - had developed an advanced scientific graphing tool called PlotIT®. Epp purchased a copy.

"Once we installed PlotIT, I knew our production problem was solved," Epp says. "PlotIT has the speed and the power we need to efficiently produce the SCRIPT graphs. We can now easily share the useful and precise information with Michigan pharmacies on benefit cost and utilization."

SPE's staff worked closely with Epp to design a special "Box and Whisker" diagram that defines the quartile range, then marks the individual pharmacy along that range with an
arrow. Unlike the rubber-stamp method, PlotIT places the arrow for each pharmacy exactly where it belongs.

"Greater accuracy is just the beginning," Epp says. "PlotIT has reduced the staff time involved for graph production down to just about zero. Its batch-processing feature established the graph production process on our PC. SCRIPT brings the numbers in from the database, and PlotIT turns finished graphs out from our printer. All we have to do is make sure the printer's paper tray is stocked!

"The bottom line is that PlotIT made SCRIPT a viable program for BCBSM," Epp says.
"SCRIPT and PlotIT provide data which BCBSM and Michigan pharmacies use together to more effectively manage the cost and quality of prescription benefits."

Contact:

Rodger H. Epp
Blue Cross Blue Shield of Michigan
(313) 225-0698

Scott Eisensmith
Scientific Programming Enterprises
(517) 339-9859

# # #