Articles

Predictive analytics models have a number of cost-saving applications in the world of workers’ compensation prescription management.

These models are used operationally in helping to identify patients for home-delivery fulfillment programs which are less expensive than retail, saving money on the cost of prescriptions. Algorithms assist in routing claims to the most appropriate case handler based on claim complexity or personnel experience, which increases operational efficiency. Read more...

Frequent mergers create a confusing experience for workers’ comp carriers and claimants. By rolling all of its services into a single platform, Optum is proving the IT investment can pay off. Read more...

The pharmaceutical industry has been making regular appearances in the news cycle recently. Coverage of America’s opioid epidemic and ongoing discussion around drug price transparency have kept prescription medication a headline topic. Pharmacy benefit managers (PBMs) are central to that conversation. Read more...

The drive to reduce opioid use for pain management is sparking an increase in durable medical equipment (DME) and ancillary services to manage pain. With the growth of DME and ancillary, challenges with rising costs and utilization concerns can be expected ― the kind of challenges that sparked pharmacy benefit management programs (PBM) to manage financial and clinical outcomes for pharmacy usage. Read more...