The Optimize™ telepharmacy offering surveils medication adherence across medical, specialty and pharmacy data to identify Drug Therapy Problems (DTP) that yield near-term cost savings.
Optimize™ MTM is AdhereHealth’s comprehensive medication management solution for Medicare Advantage Star Ratings Comprehensive Medication Review (CMR) completion. Offered as a software-as-a-service (SaaS) model for providers and retail community pharmacies or technology-enabled services via AdhereHealth’s nationwide clinical team, Optimize MTM can increase Star Ratings and ensure regulatory compliance with CMS, allowing clinicians to focus on member health and wellness – not administrative tasks.
Optimize MTM proactively monitors eligibility data, medical claims and pharmacy claims to identify MTM eligible patients. By combining data-driven technology and clinical insights, the solution is tailored to meet your specific needs and program submission criteria.
Available as a software-as-a-service (SaaS) or technology-enabled service using AdhereHealth’s nationwide clinical network, Optimize CMM uses predictive analytics and omni-channel patient/provider outreach to decrease avoidable medical spend through utilization and specialty pharmacy costs. Using pharmacy claims, medical claims and eligibility data sets, Optimize CMM identifies and addresses Drug Therapy Problems (DTP) that result in medical loss ratio (MLR) improvement. The solution reviews all medications in a holistic patient profile – prescription, nonprescription, alternative, traditional, supplements, vitamins, samples – with each at-risk patient to improve health, address potential issues and increase continuity of care.
By proactively engaging with patients to manage adherence and pharmacy needs, AdhereHealth can provide a significant return on investment (ROI) for health plans while improving clinical quality and patient experience.
Ready to learn how AdhereHealth’s integrated solutions can improve medication adherence, value-based outcomes, and patient experience?
Optimize™ for Self-Insured Employers is a proactive intelligent clinical workflow that enables employers to guide highly specific patient interventions and provider engagement. Using dozens of data sources, the solution helps reduce unnecessary medical costs related to drug therapy problems (DTP). This solution is powered by Adhere Platform™ analytics that integrate real-time input with national benchmark data and our analytics-guided clinical decision support software. This advanced data-driven solution has more than a decade of quantifiable outcomes bolstered by fully guaranteed program performance.
Analytics engine targets care gaps in medical claims, pharmacy claims and lab data.
The Adhere Platform™ groups identified patients by provider to maximize the impact of each engagement.
Each provider's office receives a list of their identified patient's care gaps via system-generated fax and our clinical team follows up with provider via phone to discuss care gaps and suggest resolutions.
Providers resolve care gaps directly with their patients.
Employers can save millions with a 4:1 ROI
Optimize™ identifies and resolves medication adherence gaps
100% provider-centric outreach programs available
1 in 6 patients have existing drug therapy problems (DTP)