At Premera, every decision starts with our members. As a not-for-profit health plan, we don’t answer to shareholders. We reinvest every dollar into improving care, controlling costs, and strengthening the communities we serve.
Healthcare is expensive, and we take seriously our responsibility to make each dollar work harder, ensuring access to quality care at a fair price.
Affordability
| 2 minute read
Discover how biosimilars are helping lower prescription drug costs…
Affordability
| < 1 minute read
As part of our commitment to making healthcare more…
Affordability
| 2 minute read
Biosimilars are helping lower prescription drug costs while delivering…
As a not-for-profit health plan, Premera directs 91% of premiums to member care, including prescriptions, hospital visits, doctor appointments, labs, and more. The other 9 cents cover operating costs and taxes. That means 0 cents goes to operating profit.
At Premera, affordability is at the heart of everything we do. Costs rise because of drug pricing, workforce shortages, systemic waste, and not having access to affordable care. Here’s how we’re tackling each challenge.
Brand-name and specialty drugs are a top cost driver.
Promote safe, lower-cost alternatives like generics and biosimilars—often as much as 40% cheaper. These are medications that are highly similar to an existing biologic drug and work the same way, with no meaningful differences in safety or effectiveness. We also supply members with tools to spot savings.
Workforce shortages make primary care and behavioral health care harder to get and more expensive, while aging populations and increased demand drive further strain.
Invested $30 million to expand the primary care workforce in WA and AK. Partnerships with Kinwell primary care clinics in WA improve access and are expected to reduce total cost of care by 4%.
Up to 25% of healthcare spending is wasted on duplicative tests, low-value care, and red tape.
Cut waste by preventing billing errors, fighting fraud, and using prior authorization to avoid unnecessary or duplicative treatments.
Affordability is the top reason people postpone care, leading to worse outcomes and higher costs down the line.
Offer options for members to seek care from high-quality, lower-cost settings that have proven results, such as Centers of Excellence providers or ambulatory surgery centers. This helps reduce costs while improving health outcomes.
Premera advocates for policies that help control costs across the healthcare system, including:
