Proactive Strategies

Leveraging automation and machine learning, we proactively recommend strategies to improve business outcomes and optimize members’ cost experience and connected health behaviors.

For example:

  • Imagine your biggest financial and clinical concerns. Now, imagine you can select those triggers and thresholds, and automated processes monitor your data in real time, alerting you whenever those triggers fire or thresholds are crossed. A new diabetic patient is identified. A high-dollar claim is submitted. A rejected claim threshold is crossed. And you know instantly, with a link right to the details.

  • What about the old “quarterly review” process which brought you, or your downstream clients, ideas on optimizing your plan—add a new step therapy, lift an unproductive PA, make a network optimization. Now imagine, you don’t have to wait: with real-time data and advanced logic, RxIQ brings you these insights automatically, anytime. You can course-correct faster to optimize your performance.

  • Now imagine you’re a member embarking on your new benefit year: You have a new prescription and wonder what it costs.

    Simply access your member portal, with a quick and secure multi-factor log in. Your drug as prescribed is a brand so you’re worried about the cost. When you look it up you see the price you’ll pay at the counter, accounting for your deductible and other accumulator statuses, as well as the price for the generic alternative. (Maybe you should talk to your doctor about generic alternatives?)

    And the member support doesn’t end there—how about more cost effective therapeutic alternatives? What about proactive notifications on expiring PAs, a refill alert? Members could also receive a message from their plan sponsor, or a notification from their employer’s diabetes management program that they have support services available? Yes, please.

What else would you like to learn about today? 


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