ST. PAUL, Minn., Jan. 13, 2014 /PRNewswire/ -- In an effort to improve the quality and total cost of care for its members, Prime Therapeutics LLC (Prime) has entered into a collaborative arrangement with MDdatacor, Inc. The agreement will enable Prime to deliver enhanced drug therapy opportunities to health care professionals enrolled in a pay-for-performance network.
Prime will use medical and pharmacy claims data to generate drug therapy opportunities from its GuidedHealthSM clinical rules platform. The information is then integrated into MDdatacor's web-based physician portal - MDinsight. Within MDinsight, the data from both platforms will be combined to provide physicians with comprehensive, patient-centered data.
The portal will prompt physicians to work with specific patients regarding patient specific drug therapy management opportunities. Examples include but are not limited to the following:
- Identifying opportunities to manage pharmacy underutilization. This would include the identification of high risk members based on specific chronic conditions that are either not adhering to prescribed drug therapy or need additional drug therapy (i.e., gap in care). The drug therapy opportunity would not only alert the applicable physician to the adherence issue, it would provide a historical set of data such as the proportion of days covered along with claim history for an individual patient.
- Identifying members with a history of overutilization. This would include utilization patterns that point to potential misuse or abuse of controlled substances, patterns of off-label indications, polypharmacy and/or excessive duration of therapy.
- Identifying members with potential safety concerns such as direct medical contraindications to drug therapy (i.e., FDA MedWatch program).
- Identifying opportunities for the member to save money by providing generic and/or preferred drug alternatives.
"We are excited about the opportunity to enhance the delivery of critical drug therapy information at the point of care," said David Lassen, chief clinical officer at Prime Therapeutics.
This sharing of data helps improve care coordination, which will help result in better patient care.
"Providing accurate and timely medication use and adherence information to clinicians at the point of care will greatly improve patient compliance with treatment and result in improved clinical outcomes and lower healthcare cost to all," said David Hanekom, chief medical officer at MDdatacor, Inc.
MDdatacor enhances health care quality through the development of innovative technology solutions. MDdatacor's patented system is used to support quality improvement, health information exchange, clinical integration and patient-centered medical home initiatives. MDdatacor currently serves more than 7,000 physicians representing more than seven million patients, and supports programs for clients such as Wellmark Blue Cross and Blue Shield, Blue Cross Blue Shield of North Dakota, Blue Cross and Blue Shield of Nebraska, CareFirst BlueCross BlueShield, Excellus BlueCross BlueShield, MVP Health Care, and Summa Health Network.
About Prime Therapeutics
Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well. Prime manages pharmacy benefits for health plans, employers, and government programs including Medicare and Medicaid. The company processes claims and delivers medicine to members, offering clinical services for people with complex medical conditions. Headquartered in St. Paul, Minn., Prime serves nearly 25 million people. It is collectively owned by 13 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans. Prime has been recognized by Modern Healthcare as one of "healthcare's hottest companies for 2013."
For more information, visit www.primetherapeutics.com or follow @Prime_PBM on Twitter.
SOURCE Prime Therapeutics