Responsible and knowledgeable use of medication can eliminate as much as $300 billion annually in avoidable costs. PharmMD can help improve your member population health, reducing your overall healthcare expenditure. We call our proprietary solution Medication Risk Management (MRM).
PharmMD’s scalable and tailored solution provides the insight, visibility, and guidance you need to limit members’ ER visits and reduce hospital readmissions. Additionally, MRM can help minimize absenteeism and support a more productive workforce. Our performance-based partnership provides a lever to control your healthcare dollar.
MRM features a targeted intervention approach fueled by PhREDRxTM, our proprietary clinical rules engine, which incorporates and prioritizes real-time pharmaceutical and medical condition data. We use evidence-based guidance and consultation, our distributed clinical network, and multi-modal interventions to isolate and resolve gaps-in-care. Our robust analysis of claims data focuses on specific rule-set categories identified as the most likely to affect health outcomes.
Lower Operating Costs for Overall Medical Claims
Lower Risk Related to Chronic Condition Management
Easier Adherence Monitoring
Immediate Savings to Reduce Pharmacy Claims Spend
As the industry moves more towards outcomes-based results, PharmMD’s MRM solution is already geared to support. A key component of our MRM solution is the unique ability we have to provide a transparent and quantifiable ROI to each and every successful intervention. Additionally, our outcomes-based results are translated over specific timeframes that define the value to the acute, near-term, and chronic health problems that have been resolved. Combined with our unique performance-based pricing model, PharmMD provides a solution that fully aligns goals and objectives – the definition of a true partnership.
We quantify short-term savings by measuring the number of instances where a member/beneficiary adjusted his or her treatment regimen to a more cost-effective therapeutic alternative (conversion from brand to a generic or OTC). We determine the net change in the paid amounts driven by each of the unique drug conversions and combine them to determine the total short-term savings.
Near-Term: Medication adherence, compliance, and misuse can change the intermediate course of health in a matter of months, weeks, or even days. In our near-term savings analyses, we measure utilization reduction by isolating the closure of gaps that often yield emergency room visits, hospitalization, and re-hospitalization.
Long-Term: In addition to driving savings during the plan year, many of our interventions influence members in ways that change the trajectory of their long-term health. By steering members and prescribers toward alignment with evidence-based best practices, we help to ensure that they are maximizing the value of all available resources. We are able to combine the variables of time, statistical likelihood, risk factors, condition cost, and therapy cost effectiveness to determine the ultimate impact of gap closure.
Call us today to discuss our comprehensive strategy utilizing claims-based results necessary to quantify a true ROI.