Pharmacies and PBMs face a myriad of changes that are driving reinvention of business operating models—regulatory and demographic changes, consumerism, technological advances, shrinking margins in core revenue streams and commoditization of services. The best way to deal with these changes is by being able to rapidly build distinctive capabilities and optimize existing operations.
Team should help retail, specialty and mail order pharmacies and PBMs understand the impact from fast-paced industry developments and rapidly respond to changing market dynamics.
Regulatory Compliance >
Team should help healthcare organizations evaluate the impact of regulatory requirements and implement supporting solutions to help ensure compliance.
- Medicare Part D compliance
- NCPDP D.0 compliance
- Controlled substance dispensing
- Patient compliance
Health Intelligence and Analytics >
- Analytics strategy
- Process innovations
Investigative Services >
Enabling organizations to identify and resolve intentional and unintentional errors or verify the absence of both is critical. With significant dollars being lost to fraud and abuse each year, investigation and recovery efforts are critical to an organization’s overall financial health.
Operational Improvement >
Team should help healthcare organizations drive cost reduction and revenue enhancement through improved efficiency and effectiveness and process transformation.
- Best-in-class series (Claims, Enrollment, Medical Management)
- Product evaluation and selection
- Operational readiness (BPS)
- Customer engagement
- Customer experience
- Customer retention
Implementation Services >
- systems modernization
- Administrative, claims management, clinical and electronic health record implementations
- Custom development and maintenance
- Systems integration and program management
- ERP and CRM systems
- Data warehouses
- E-health, self-service applications and portal development