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Pharmacy Benefit Management
Healthcare analytics advance
population health and care
management effectiveness.
PBMs face an increasingly competitive marketplace, requiring unique strategies to lower costs while stepping up client acquisition and retention activities.
SCIO Health Analytics’ tools apply information intelligence to cost containment, payment integrity and utilization management.
SCIO Health Analytics provides innovative solutions that enable PBMs to:
- Demonstrate value of a care management program to health plans and members alike
- Expand into to other service lines such as population health and wellness management to maintain competitiveness
- Identify opportunities for managing costs and improving drug resource utilization
- Leverage and consolidate clinical outcomes data to locate areas for cost and quality improvement
- Ensure revenue integrity by paying pharmaceutical claims in a timely and accurate manner
Our suite of solutions:
Care & Risk Management
Delivering healthcare analytics tools and expertise to help improve member identification, facilitate program design and execution, enhance population health, and produce defensible ROI.
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Payment Integrity
Helping health payers control costs associated with third party liability, and incorrectly billed or overpaid health claims — to reduce overall health claim expenditures.
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Consumer & Employer
Providing actionable data to help plans and their customers identify the best opportunity for improved health and clinical outcomes, and achieve cost avoidance through the use of value based benefit designs and incentives/disincentives.
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Network & Provider
Analyzing the impact of changes in provider contracts, identifying high-trend providers, and delivering reports and recommendations to help network teams uncover opportunities for improving provider relationships and delivering better results.
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