Quality has never been more important, especially when it comes to healthcare. All health plans and employee benefits plans face more challenges than ever to meet the quality performance requirements brought about by regulatory obligations, the individual needs of your members and rising CMS standards that demand higher quality – all while balancing your own financial health. Inspired by Fred McWhorter, a pharmacist for over 50 years, and founded by his brother, successful healthcare innovator, Clayton McWhorter, we have a decade of increasing success behind our products and services; continued innovation is our mantra. You may choose one solution at a time, or put the member medication management process in PharmMD’s hands. Our dedicated clinicians will be your pharmacy quality connection across patients, pharmacists, and physicians for a healthier world.

“…I like vendors who can provide both Part D Stars and MTM because they offer a much more coordinated and efficient process for member engagement.”

Director, Health Plan Pharmacy Department

The importance of pharmacy quality cannot be understated. Over 40% of a plan’s bottom line will be driven by not only the medication costs (which has traditionally been around 20%), but also by the management of population health with medications. Identifying risk earlier in the management process, along with the direct correlation to Quality Bonus Payments, brings an additional 20% of the healthcare spend into focus for plans.

ongoing arrowPast performance is not an indicator of future success in the world of pharmacy quality. Historically, pharmacy quality was relegated to pharmacy departments who often operated in their own silo. Efforts to impact your pharmacy quality measures now need to involve senior leadership oversight and the strategic deployment of additional resources to improve the members’ health. With the Quality Improvement measures being five times weighted, an improvement over the past year is critical. One plan that utilized PharmMD’s StarMTM solution jumped a ½ Star in 12 months on Part D because the five times weighted Quality Improvement measure carried them with a 5 due to their investment in improving their members’ pharmacy quality experience. Invest strategically and implement early for the best success.

  • Faster – Real-time analytics, High member adherence
  • Easier – PharmMD coordinates call prioritization and clinical intervention. We are the experts
  • Lower Operating Costs – No overhead, scalable workforce to level of excellence desired
  • Higher Revenue – Performance-based results, tactical and timely approach in converting member adherence
  • Less Risk – Less member abrasion, performance-based results, fine-tuned call decision tree and call escalation

PharmMD offers the right combination of resources that creates the greatest lift for your plan’s pharmacy quality scores. Align the incentives of both the internal and external resources to produce real results or risk not getting paid. One industry expert recommended that no partner should be selected if they will not put their fees at risk on the front end. In a world where performance determines a payer’s success, it should also determine a partner’s success as well!

We are here to help. We exist to create a healthier world through the most effective use of the right medication. From health plans to stand-alone employers, we know your members and employees count. You can count on PharmMD to deliver the right medication at the right time for your health and theirs.

Key Services

  • Performance-based, Part D Star Compliance & Improvement
  • Member Outreach & Management utilizing Scalable Clinical Network
  • Outsourced Medication Therapy Management (CMRs)
  • Audits/Analytics/Outcomes-driven Reporting
  • Drug Therapy Problem Identification, Intervention & Resolution