Pharmacy based risk prediction is a highly effective way for plan sponsors to get started with risk and intervention services. Pharmacy data for a population is analyzed and specific disease states and their prevalence are identified, as are potential gaps in care. This analysis is used to calculate a plan’s exposure to potential healthcare costs.

After this identification process, specific intervention strategies are implemented. These range from Medication Therapy Management (MTM) programs to improve and maintain compliance to passive and moderately active Disease State Management (DSM) interventions, which can include web portals, letters, phone calls, email and other outreach methodologies.

Plan sponsors are provided with an Annual Savings and Value Reports as a measurement tool. This report documents programs conducted on the plan’s and patient’s behalf, quantifies costs savings and projected cost avoidances and other metrics such as patient-reported health status and absenteeism.

For more information, please contact us.