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Pharmacy Benefit Manager

Operate a smarter business with pharmacy benefit management analytics

Overview

Optimize pharmacy care and payment of prescription drug claims. See how FICO helps pharmaceutical benefit managers improve administration of prescription drug programs through sophisticated pharmacy benefit management analytics solutions.

FICO Healthcare Analytics

FICO® Medication Adherence Score

Product overview

Medication adherence is closely linked with clinical outcomes. As reported by the Center for Disease Control (CDC), one half of US patients stop taking their medications within one year of being prescribed. The FICO® Medication Adherence Score identifies patients at risk for non-compliance so the chain of healthcare providers can proactively take actions to improve adherence levels through interaction and better decisions on treatment design. Not a retrospective of what happed and what should have happened that places healthcare providers in a reactive mode, but an intelligent analysis and prediction of future risk of non-adherence.

By identifying each patient’s propensity toward medication adherence over the next 12 months, this fully HIPAA-compliant solution helps direct activities to patients at highest risk of noncompliance, improving program efficiency and maximizing results.

FICO® Propensity Scores for Health Care

Product overview

Medication adherence is closely linked with clinical outcomes. As reported by the Center for Disease Control (CDC), one half of US patients stop taking their medications within one year of being prescribed. The FICO® Medication Adherence Score identifies patients at risk for non-compliance so the chain of healthcare providers can proactively take actions to improve adherence levels through interaction and better decisions on treatment design. Not a retrospective of what happed and what should have happened that places healthcare providers in a reactive mode, but an intelligent analysis and prediction of future risk of non-adherence.

By identifying each patient’s propensity toward medication adherence over the next 12 months, this fully HIPAA-compliant solution helps direct activities to patients at highest risk of noncompliance, improving program efficiency and maximizing results.

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Analytics help a major PBM improve patient engagement and operational efficiency

Health care costs are risking rapidly in the United States. Not only does the US spend much more per capita on health care, but it also has one of the highest spending growth rates. With both public and private health expenditures outpacing other developed countries, and lower comparable quality.  By using a FICO model to better predict the propensity of any patient to receive their medications by mail, a leading PBM was able to convert more patients to its mail order pharmacy.