Pharmacy Benefit Management

Managed Care Connect

The PBM space today is challenged by new and complex drug products, rising drug prices, rebate inflation, multi-tier formularies, direct to consumer drug advertising, discount pharmacy cards and copay reduction programs.

Achieving high formulary compliance, and optimal member outcomes requires a multifacited approach that involves members, providers, plans and the managed care organization.

Implementing targeted interactive voice, SMS and e-mail messaging during the various stages of a members enrollment and therapy increases operational efficiency, patient outcomes and formulary compliance.

Managed Care Connect can help you:

  • Create value
  • Provide market differentation
  • Contain costs
  • Improve member outcomes

Formulary Pull Through Support

  • Reduce new client formulary disruption issues
  • Increase member formulary product pull through for quarterly formulary changes
  • Notify members when new therapies are introduced
  • Maximize manufacturer contracts

New Implementation Support

  • Welcome messages to increase PBM program awareness
  • Capture member communication preference
  • Reduce member and pharmacy support center call volume

Clinical Program Support

  • Enhance member satisfaction through Prior Authorization status notifications
  • Boost patient safety through additional medication recall messages
  • Provide additional notifications regarding therapeutic interchange programs

30-day to 90-day Adherence Conversion Support

  • Claim file analysis for member eligibility criteria
  • Mail service pharmacy support
  • 90-day at retail pharmacy support

Survey Support

  • Member satisfaction outreach and reporting
  • Client satisfaction outreach and reporting
  • Mail and/or specialty pharmacy surveys

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