Effective and efficient stakeholder engagement for better health outcomes
Physicians, pharmacists, patients, and clinical/pharmacy staff of payers are frustrated accessing too many portals and hard copy reports in order to obtain actionable drug utilization review (DUR) information. RxAdvance is able to deliver directly to each respective stakeholders' workflow in real-time, comprehensive patient specific (Patient-Rx360°™) and actionable drug utilization review (IntelligentDUR 360°™).
At RxAdvance we are able to communicate comprehensive patient specific (Patient-Rx360°) and actionable drug utilization review (IntelligentDUR360°Gateway™) information in real-time. Furthermore, RxAdvance pushes this information directly into the physician’s e-prescription / EMR workflow at the time of e-prescription or authorization request. Our Collaborative PBM Cloud™ and its IntelligentDUR360°Gateway™ enables a seamless transfer of information, different from antiquated, fragmented, and legacy systems utilized by other PBMs. IntelligentDUR360°Gateway™ extracts information from multiple components of Collaborative PBM Cloud™, analyzes, packages, and delivers actionable information into physician’s workflow as a single message in less than 2 seconds, as part of the benefit/formulary response (NCPDP SCRIPT 10.6).
IntelligentDUR360°Gateway™ will also alert the physician if the patient is MTM eligible enabling a physician driven Comprehensive Medication Review (CMR). IntelligentDUR 360°Gateway™ also communicates bonus compensation for completing the CMR. The fully automated CMR can be completed in less than 15 minutes with full resolutions, with payment queued up in real-time from RxAdvance. The CMR process can substantially improve overall patient quality of life and reduce avoidable medical and pharmacy costs ultimately leading to higher physician quality ratings. Physician will also be alerted with various pay-for-performance triggers, such as brand vs. generics, prescription planning, and coverage gap avoidance to improve adherence and reduce overall pharmacy costs at the point of care.
RxAdvance is able to bring to pharmacies real-time comprehensive patient specific (Patient-Rx360°) as well as actionable drug utilization review (IntelligentDUR 360°Gateway™) information. By integrating with the pharmacy software workflow, it not only saves time, but allows pharmacist to focus on patient care. The Gateway extracts information from multiple components of the Collaborative PBM Cloud™, analyzes, packages, and delivers actionable information packet into the pharmacist’s workflow as a single message in less than 2 seconds as part of the claim transaction response (NCPDPD.0). Through the IntelligentDUR360°Gateway™, pharmacists will also be alerted if the member is eligible for medication therapy management (MTM) with corresponding bonus compensation for completing the Comprehensive Medication Review (CMR). The fully automated CMR can be completed in less than 15 minutes, the pharmacist’s payment is then queued up in real-time from RxAdvance. The pharmacists will also be alerted when there are various pay-for-performance triggers at the point of sale to improve quality of care and reduce costs to the member or plan sponsor.
A core belief to RxAdvance is member empowerment, as a result, RxAdvance provides various tools to motivate members to engage in healthy behaviors as well as make available cost information so that members can make informed decisions that can reduce their pharmacy costs. Through RxAdvance’s interactive member mobile application, Advancemobile™, members are provided in real-time actionable alerts which will aid them in improving their health outcomes and reducing their out-of-pocket costs. The member application delivers comprehensive patient-specific actionable alerts relating to Adverse Drug Events (ADEs), cost savings opportunities, refill alerts, gaps in prescription, adherence pattern & monitoring alerts, and prescription planning & donut hole avoidance opportunities.
Using gamification, RxAdvance through the mobile application provides incentives and rewards members when they remain adherent to their medication and adopts a healthy lifestyle. In addition to the member mobile application, members can also access this information via the online member portal. Members can also reach our customer service representatives not only through our toll-free line but also through the live chat function within the mobile application. By educating the member, this facilitates the member to become engage with physicians at the point of care and pharmacists at the point of sale so that collectively they can make decision that results in the best health outcome for the member.
Health Plan Clinical/Pharmacy Staff
A Health Plan’s PBM occupies an integral position within the healthcare transaction cycle, critical pharmacy and member information is collected by the PBM. RxAdvance believes that by sharing both the information and the tools to understand the data, RxAdvance along with the Health Plan can work collaboratively to optimize pharmacy costs and improve member health outcomes. RxAdvance provides a variety of enhanced services such as benefit design and formulary modeling capabilities. This will allow Health Plans to make fully informed decisions. In addition, through the Collaborative PBM Cloud™, RxAdvance can provide information regarding optimal dosage, rebate maximization, adverse drug events monitoring and minimization, adherence rates, generic dispensing, and more. This collaborative environment will allow Health Plan and PBM’s clinical / pharmacy staff to work effectively in tandem.
Through our Collaborative PBM Cloud™ and its IntelligentDUR360°Gateway™, RxAdvance is able to deliver to the Health Plan’s clinician and/or pharmacist actionable information in real time. Access to the aforementioned services and information will allow Health Plans to better control and monitor provider contractual obligations, own the patient relationship, and steward the patient’s overall health outcomes. By utilizing a revolutionary approach, RxAdvance brings actionable quality and cost information into the Health Plan’s care/case/disease/utilization management workflow in real time allowing for both operational and financial efficiency.