Payor Analytics
Payors, Benefits Managers and Health Insurers are struggling to determine where they stand compared to the marketplace. The missing piece of your program and price optimization strategy is timely cross-sectional, market-based data. Payor Analytics provides the missing data in a powerful format so you can make better decisions regarding your clinical programs and your pricing strategy.
We combine our state-of-the-art pharmacy informatics and analytical tools with business process consulting to help our Payor customers improve their decision making process. Our proprietary database of nearly sixty-five million individual, de-identified pharmacy claims per month is the bedrock of our Payor Analytics business. Payor Analytics delivers actionable insight on current market conditions to assist you in accurately setting your prices, calculating reimbursements, updating formularies, constructing MAC lists and managing your drug programs and benefit designs more efficiently.
Generic Reimbursement Analysis will analyze your current rates in comparison to the marketplace and identify those opportunities where your reimbursements are clearly out of line, helping you manage your MAC pricing more effectively.
Market Segment Comparisons can create market segment sets and marketplace analysis for you based on size and type of payors, geography, and specific drugs where you have concerns.
MAC Opportunity Analysis, you can uncover opportunities to add products to your MAC list and decrease your drug costs.
Brand and Dispensing Fee Reimbursement Analysis can analyze your reimbursement rates comparing brand and dispensing fees to the marketplace, and identify situations where your reimbursements are higher or lower than the market.
Payor Market Analyzer is a decision support-based information manager designed to strengthen your competitive position by profiling your performance against the marketplace for numerous metrics.
