Quantum Well being, a healthcare navigation firm, launched its new Premier Pharmacy navigation resolution to assist scale back prescription drug prices for self-insured employers, the corporate introduced Tuesday.
Quantum Well being, based mostly in Dublin, Ohio, provides care navigation and coordination companies for employers, together with claims help, level resolution referrals and utilization administration. Helps greater than three million members and 500 employers.
The brand new Premier Pharmacy resolution depends on the corporate's medical pharmacy staff. The answer has a member identification characteristic, which makes use of claims and different information to seek out extra treatment intervention choices. It additionally has a value-based intervention function, offering protected and efficient therapeutic alternate options to costly medicines. Moreover, members obtain ongoing schooling and help from the pharmacy help staff, and Quantum contacts suppliers to tell them of latest prescriptions for members.
“Once we take into consideration what we're uniquely certified to do, it's these complicated issues as a result of we now have individuals educated in healthcare,” Scott Doolittle, Quantum Well being's chief monetary officer, stated in an interview. “We’ve individuals who perceive pharmaceutical advantages and medicines. We’ve pharmacists on workers. We additionally sit on the intersection of the supplier and member expertise. “So we’re dealing with the entire incoming quantity from suppliers and dealing with members to verify they get the care they want.”
The Premier Pharmacy resolution builds on the corporate's current core navigation and specialty pharmacy companies. This consists of utilization administration companies, which assess the necessity for therapies, and the corporate's site-of-care program, which determines probably the most cost-effective location to manage a specialty treatment (as price varies by location).
Prescription drug prices are a significant problem for employers proper now. About 92% of employers are involved about high-cost medicines within the pipeline and 91% are involved concerning the general pattern in pharmacy prices, in accordance with a 2023 survey from the Enterprise Group on Well being. The survey additionally discovered that pharmacy prices accounted for 24% of complete employer well being spending in 2022.
“The purpose of this product is to supply one other method to assist our prospects fight the rising pattern with one thing that’s sophisticated to handle however really makes quite a lot of sense,” Doolittle stated.
The launch of the Premier Pharmacy resolution by Quantum Well being comes after a sequence of bulletins made by the corporate. In March, the corporate launched a navigation providing for Medicare Benefit plans and a partnership with Vanderbilt Well being Affiliated Community. It additionally not too long ago expanded its Complete Care Options Platform, a platform of advantages options that its employers can contract with, to incorporate Progyny and Kindbody.
Different firms that provide well being navigation companies embrace Accolade and Well being Pleasure.
Picture: cagkansayin, Getty Photos