SOLUTIONS FOR HEALTH PLANS
Use predictive analytics and smarter interventions to improve medication use, reduce drug-related medical costs, and realize more value from prescription medicines.
We focus on some of health plans’ greatest challenges. See our solutions to improve quality, reduce medical cost, and maximize drug value.
How It Works
Getting started is easy
Your claims along with our proprietary data and analytic models power the analytics engine and can be deployed in a matter of weeks.
- Getting started is easy
Smarter analytics yield better outcomes
Our custom-developed engine runs proprietary RxAnte analytic models that power our software-as-a-service solutions and orchestrate interventions.
- Smarter analytics yield better outcomes
Tailored to your goals
Our solutions are configured to your organizational goals and deliver near-real time analytics and intelligent, prioritized member lists to maximize program effectiveness.
- Tailored to your goals
Drive successful Medicare Part D, HEDIS, or internal quality initiatives using our best-in-class medication performance improvement solutions.
RxAnte quality improvement solutions proactively identify members at risk of medication non-adherence, misuse, or overuse before the problem sets in.
A few clinical areas in which we’ve developed solutions include:
- High cholesterol
- Chronic heart failure
- Opioid abuse
When you partner with RxAnte, our experienced client services team works alongside you to align our solution to your program goals, manage ongoing performance and intervention deployment, and facilitate collaborative program evaluations to identify opportunities for continued success.
Together, we solve the key challenges of designing a successful quality improvement program:
Our predictive analytics are more than 90% accurate at identifying members requiring future intervention, and our innovative workflow solution, RxEffect©, enables users to take action to improve adherence.
Interventions are deployed at the moment most likely to create a positive impact on the member.
Avoid over - or under - investing in program resources by using our prospective simulations to make informed capacity decisions.
Our engagement center is purpose-built to create meaningful behavior change with member populations.
For plans seeking to address the challenges of avoidable readmissions and rising cost of care, RxAnte delivers analytics-driven solutions designed to proactively identify opportunities to improve prescribing and appropriate medication use in order to reduce related medical costs.
The RxAnte medical cost solution is powered by our Value of Future Adherence (VFA®) score, which estimates future medical cost savings from perfecting medication adherence.
The VFA® Score:
- Is based upon prevalent chronic conditions with a medication use component
- Incorporates information about all of a member’s relevant conditions/medications
- Represents the cost savings possible (in one year) that is associated with adherence to therapy
The below chart demonstrates the opportunity for a health plan when focusing on just the top 10% of total avoidable costs.
The transition to value-based care doesn’t exclude prescription drugs. Now more than ever, it is important for health plans to measure and maximize the value of prescription drugs. RxAnte solutions help health plans take action on:
- Drug formulary placement, prior authorizations, and step therapy.
- How to design, deploy and measure drug-related quality improvement programs for maximum impact.
- The comparative effectiveness of drugs within a therapeutic category.
- Identifying drugs that may be ideal candidates for value-based contracts.
The RxAnte Difference
Why is RxAnte the leader in medication performance improvement solutions for health plans?
- Configurable to improve quality, lower cost, or both
- Targeting based on predicted risk, urgency and receptivity
- Calibrated to your unique population each day of the year
- Full transparency on predictive accuracy and performance
- Secure web portal to monitor the effectiveness of interventions
- Current performance visualizations and year-end estimates
- Delivery of prioritized workflow of attributed members for care managers, providers or pharmacies with RxEffect
- Superior clinical pharmacy call centers to engage members and prescribers
- Digital interventions to increase cost-efficiency
- BYO interventions
- Strategic support for designing a program to achieve your goals
- Dedicated account team to help you get the most from RxAnte
- 2x yearly program reviews to evaluate program and discuss next year’s approach
- Complete end-to-end solution
- Incorporates your existing capabilities
- Performance-based pricing
Playbook for Success: Winning at CMS Star Ratings Medication Adherence MeasuresCheck It Out
Best Practices from the Front Lines: Engaging Providers to Improve Medication UseCheck It Out
National Pain Report: Can We Predict Who Is At Risk For Opioid Dependency?Check It Out
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Think RxAnte might be right for your organization? Let’s get in touch.
Not Just for Health Plans
RxAnte offers solutions specific to the needs of health care providers, including an innovative platform that monitors, prioritizes, and informs patient outreach to ensure proper patient medication use.Tell Me More
For Pharmaceutical Manfacturers
RxAnte offers solutions to manufacturers seeking to drive innovative contracting with real-world evidence to demonstrate the true value of medications.Tell Me More