Specialty Care Management
The development of clear clinical criteria is imperative to identify appropriate choices for high cost specialty drug utilization. The EmpiRx Health Specialty Care Management Program provides customized patient care plans designed by our skilled specialty pharmacy care team to support accurate implementation of evidenced-based clinical programs. Each patient is monitored individually to ensure their medication and dosage is appropriate and that patients are adherent to their prescribed therapy. Extensive communication initiatives and ongoing personalized and compassionate member engagement ensure member satisfaction with positive health outcomes.
- Patient-focused and personalized outreach and education
- Extensive consultation to ensure members are well informed about their current therapy and potential risks
- Monitor medication adherence, treatment compliance and gaps in care to increase treatment efficacy
- Enhanced Prior Authorization process that engages the provider to ensure appropriateness
- Identify lower cost alternatives that may be available
- Robust specialty pipeline monitoring and utilization management
- Flexible suite of clinical programs to manage appropriate dose, quantity, adherence, and duration of therapy
Our high-touch concierge service model effectively manages specialty drug claims to educate members about the most appropriate form of therapy.
Through the combination of evidence based clinical decisions, superior service, and proactive oversight, the EmpiRx Health Specialty Care Management Program delivers cost savings while minimizing noise and maintaining member satisfaction.