Integrated Data Warehouse & Portal Technology. Mesfin Tegenu, President
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- Lester Roberts
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1 Integrated Data Warehouse & Portal Technology Mesfin Tegenu, President
2 Our Mission To help our customers, doctors and patients use effective medication therapy to improve health and wellness. Business Model Pharmacy and Medical Innovation and Integration Best in Class Service and Results Integrity and Professionalism Personal Touch Web-based Tools that improve efficiency Collaboration with Health Plans Full Disclosure
3 PerformRx Service Offerings Administrative/ Operations Claims Processing Rebate Contracting and Administration Clinical Prior Authorization Formulary Management Informatics/ Technology PerformMAX Single Sign On Quality URAC PBM Accreditation URAC DTM Accreditation Pharmacy Network Management PerformPRO Integration Throughout Business Model Quality Monitoring Custom MAC Management DUR Reporting HEDIS Best Practices Specialty Pharmacy Informatics STARS Resolution Center Services Implement Collaborative Care / Best Practices Model Trending PQA Implementation Pharmaceutical & Therapeutics Committee Integrated Data Warehouse Fraud, Waste and Abuse Account Management Consultative Services Customized Solutions Patents/Trademarks
4 Quality Utilization Review Accreditation Commission (URAC) Pharmacy Benefit Management In process for Drug Therapy Management Residency Accreditation (Nov 2010)
5 Key To Clinical/Financial Management Integration Drug Therapy Management Case/Care Management Medical Management
6 Looking to the Future Embrace Managed Care Principles Pharmaceutical cost-containment approaches Pharmacy Cost Savings Cost Containment Dispensing fees Optimize Generics and other lower-cost alternatives Reduction in the rate at which drugs are prescribed Use a PBM that reaches your Goals Integration and Quality Collaborative Care Models Disease management and Case management programs
7 The PerformRx Approach Integrated Data Warehouse Drug Therapy Management Portal Technology
8 To meet Health Plans Evolving Needs
9 Integrated Technology Platform
10 Functionality Overview True Data Integration HIPAA Compliant Role Based Cost Effective Dynamic & Adaptable
11 Prescriber Portal
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13 Drug Interaction Alert Details
14 Online Pharmacy Prior Authorization Submission Improved turn around time Improved information accuracy Self service capabilities
15 Client Portal Access to True Integrated Data Vehicle for Collaboration, Communication and Coordination of Total Patient Care Single Sign On to Specialized PerformRx Solutions Robust, Dynamic and Customized Reporting
16 Search Diseases: Member List
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18 Target Population Focused Interventions Collaborative Model Reporting Integrated On Demand Reporting Fill Gaps of Care Quantify Savings Actualized
19 Reporting
20 On-Demand Report: Disease State
21 Report Builder Manager
22 Opportunity Analysis
23 Analysis - Diabetes Mellitus Potential Medication Related Problems Associated with Hospital-Related Expenses August 2009-July % 26% 7% 24%
24 Analysis - Heart Failure Potential Medication Related Problems Associated with Hospital-Related Expenses August 2009-July % 29% 29% 29% 2%
25 Results Make the Difference Optimization Diabetes Therapy Asthma Therapy Therapeutic Class Medications for Elderly Action/ Adoption Rate ACE/ARB/ 9% Adoption Appropriate Therapy/ 6% Adoption Various Classes/ 5.6% Adoption Remove medication + Impact Hip Fracture Costs / 64% Adoption Impact Medical Impact $4,050,000 Re-Admit Rate $539,640 $503,664 Greater than $23,616,000 TOTAL $28,709,304 Optimize Clinic Visits Optimize Clinic Visits Hospitalization Information based on 100,000 life group. Specific results for your organization may vary based on program parameters and data evaluation
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