Medication Optimization for Self-Insured Employers

This document is a guide detailing AdhereHealth's medication optimization solution aimed at self-insured employer groups. It addresses the rising pharmaceutical and medical claims expenses in healthcare delivery, which current Pharmacy Benefit Manager (PBM) solutions do not fully mitigate. The guide outlines how the medication optimization solution identifies and resolves drug therapy problems (DTPs) to improve medical loss ratios beyond what PBMs offer. By aligning pharmacy and medical claims, the solution enables the identification of medication and treatment gaps, facilitating pharmacist outreach for a comprehensive patient profile review. The document presents various features of the solution, including a proprietary rules engine for identifying at-risk patients, omnichannel program options, and interactive dashboards for tracking cost reductions. It emphasizes the potential for significant cost savings through proactive DTP identification and switching to lower-cost drug alternatives, ultimately driving better health outcomes while reducing overall medical and pharmacy costs.