AccountableRx Services

Complete pharmaceutical care management

The focus on accountability in today’s health care environment requires payers and providers to continually assess and improve prescribing and coverage practices.

The AccountableRx™ suite of services provides you with a value-based approach to pharmacy program management — a modular plan for controlling pharmacy costs while maintaining positive patient outcomes.

Pharmacy expense analysis and management

After conducting a comprehensive analysis of your pharmacy spend, our pharmacists develop a targeted proposal. Whether we recommend incremental or sweeping change, implementing them will result in a more fiscally and clinically effective pharmacy management program. This service includes multiple components:

• Data analytics
• Formulary management
• Medication reviews
• Drug monographs
• Specialty pharmacy management
• Support for pharmacy & therapeutics committees and drug utilization review boards
• Prior authorization review
• Clinical call center services

Medication adherence strategies

Adding medication adherence strategies to your pharmacy program can help you better serve patients. Individualized medication management interventions developed as part of this component of the AccountableRx™ suite put the patient at the center of pharmaceutical care management decision.

Experienced both with general populations and high-cost, high-risk patients, the AccountableRx™ team offers medication management services designed to improve adherence, enhance outcomes, and lower costs. We apply our understanding of coverage limits — and our ability to nimbly navigate the health care system — to multiple aspects of your pharmacy program, with particular emphasis on the following:

• Medication reviews performed by board-certified pharmacotherapy specialists, who are trained to effect behavioral change through motivational interviewing
• Built-in feedback loop, enabling pharmacists to recommend medication changes directly to a member’s provider
• Integrated role for pharmacists on the core care coordination team

Program integrity

The program integrity component of the AccountableRx™ suite identifies abuse activities often overlooked by the standardized processes of large-scale software solutions. We include pharmacy costs and controls that are essential to a strong, effective program integrity effort.

With this program integrity service, you can identify the following:

• Prescribing outliers
• Misuse of third-party override practices
• Inappropriate billing practices
• Aberrant distribution or billing of specialty drugs and lack of inventory control
• Unusual prescribing patterns for disease-specific drugs