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Establishing In-House Data Analytical Systems
Organizations are focusing more on utilizing relevant internal data and multiple resources to develop in-house analytical expertise, versus outsourcing
Pro Pharma’s extensive data analytical expertise, programmers, and system methods and tools are available and have been expanded to assist clients with any of the following:
- Migrate customers’ existing applications to adapt seamlessly with Pro Pharma’s Suite of Management Tools™ to produce effective analytics in the customer’s host environment as they transition to their own in-house systems
- Develop the results of integrated health care data analytics for display and use on the web 24/7
- Advise customers on industry standards for Data Security Compliance
- Assist companies with building their internal analytics by providing coding, reporting dashboards and score cards and other measureable business intelligence tools
Craig Stern, PharmD, MBA, President of Pro Pharma states, “the key to implementing successful analytics is to integrate data from multiple sources, e.g. Pharmacy, Medical, Radiology and Laboratory, at a minimum to achieve relevant and verifiable outcomes to meet organizational goals and objectives. This will increase quality, manage utilization and thereby reduce overall costs and increase efficiencies.”
Pro Pharma’s Programmers will identify customer needs and customize analyses and reporting to provide “interactive and insightful” results to produce “out of the box” solutions at the customer level. Pro Pharma will help to validate the integrity of customer warehoused medical, pharmacy and other healthcare related datasets, so that analyses can be performed accurately and with valid and measureable outcomes/results, by focusing on graphical interfaces.
Pro Pharma facilitates expansion of in-house analytical capabilities which results in the following to:
- Provide Predictive Analytics to an integrated platform
- Eliminate and/or reduce redundancies
- Ensure national financial and clinical metrics and trends are incorporated
- Differentiate local capabilities versus statewide and nationwide trends for valid comparisons
- Validate that customer analytical warehouse data contains comparative numeric and other key indicators for organizational credibility
- Produce comparative reports for year-over-year performance and industry standards
- Provide valuable and useful tools for customer visualization, collaboration, alerts and notifications
In summary, states Carol Stern, CEO, “Pro Pharma collaborates with clients to design complete packages for planning, implementing and ongoing management and oversight of healthcare benefits to reduce overall operational risk and to add to their Business Intelligence Toolkit.”
About Pro Pharma Pharmaceutical Consultants, Inc.
PRO PHARMAis a multi-service, woman owned, privately held consulting firm offering a vast portfolio of services to public and private entities including self-insured employers, Taft Hartley Trusts and unions, public employers, for-profit hospitals and integrated health networks, health care insurance companies, worker's compensation insurers, small-to-medium sized HMO's, and physician groups.
Pro Pharma’s Consulting services are grounded in the use of data and the communication of that information to define benefit trends, drivers and other analytical indicators. PRO PHARMA markets Comprehensive Specialty Analyses™, JCode Calculator™, Invoice Screening ™, Pro Pharma Suite of Tools™, Rx MAC List™, Quality Management Program™, Treatment Calendar™, and Biotech Modeling™. The Pro Pharma directly markets its products in the U.S. and collaborates with partners to reach international markets
About Comprehensive Specialty Analyses™ (CSA)
CSA™ utilizes a multi-pronged approach to analyze pharmacy and medical encounter claims through problem flagging, feedback on performance, peer to peer comparison, and others parameters. Comprehensive Specialty Analyses™ specifically identify pricing differences, usage, trends, and actionable opportunities in the medical data that were not apparent in the past. In order to achieve these goals it is necessary to view the Medical Data from multiple perspectives, i.e., a 360 degree view that allows for seeing beyond the obvious of top drugs spend and top providers as well as compare and contrast it with the Pharmacy Claims Data
About JCode Calculator™
Pro Pharma has developed a Standardized Injectable Fee Schedule to assist with the management of claims payment. The advantage to this product is that it bases all Injectable reimbursement on AWP, WAC and ASP cost, and can be customized for drug category discounts or multiple discounts based on drug type or specialty. It includes at least one AWP for every HCPS Code and CPT code description;
About Invoice Screening™
About 10% of drugs spend is being paid from PBM Invoices, and should have been rejected by clients prior to payment. Pro Pharma’s Invoice Screening™ analyzes invoices against: formulary compliance, compliance with MAC pricing, eligibility, claims pricing, invalid claims, and excluded benefits, pre-payment as an Accounts Payable function. This ensures that clients only pay for valid claims, which saves time and dollars in the long run
About Quality Management Program™ (QMP™)
QMP™ is a multi-faceted approach that targets the pharmacy benefit cost and quality from multiple directions; namely, physician prescribing decisions, member demands, pharmacy oversight and patient education, HR rep education, and messaging to actives/retirees. The program is focused on providing patients and physicians specific tools designed to make more informed purchasing decisions that expand member co-pay dollars.
About Treatment Calendar™
Pro Pharma’s Treatment Calendar™ is a proprietary program comprised of Artificial Intelligence rule sets, which allow for quality and cost comparisons by peer-to peer, peer-to-best in class, peer to national norms, and peer to local norms.
Please visit the Pro Pharma Pharmaceutical Consultants, Inc. website for more information at http://www.propharmaconsultants.com
Carol Stern, CEO
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