Demand For DST's Medical Drug Management Service On The Rise As Health Plan Costs Increase

Specialty Drug Costs Expected To Increase By Twenty Percent Annually For Next Five Years

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Jun 19, 2013, 08:00 ET

BIRMINGHAM, Ala., June 19, 2013 /PRNewswire/ -- DST Health Solutions, LLC (DSTHS), a leading provider of technology solutions and services to health plans, integrated delivery systems, and health care providers, has announced that demand for its Medical Drug Management Service (MDMS) has jumped significantly.

A customizable solution used to clinically edit and automate the pricing of medical prescription drug claims, MDMS allows health plans to gain efficiencies by automating their medical drug claims processes. As specialty drug demand grows due to more individuals enrolling in Managed Medicaid and Medicare Advantage Plans, costs in the space are projected to increase by 20% annually over the next five years.

According to standard industry projections, most health plans are already overpaying between 15% and 20% on specialty and biotech medical drug claims[i].

"It's no surprise that specialty drug and biologic expenditures are becoming a major concern for health plans," says Steve Sabino, president of DST Health Solutions. "In an environment that demands new clinical competencies to avoid compliance errors, MDMS helps these plans evaluate the effectiveness of their policies and improve patient safety at the same time."

In addition, the DSTHS solution, by supporting medical policy and compliance issues, can reduce the potential sanctions and negative financial impact from increasingly frequent audits by the U.S. Department of Health and Human Services Office of Inspector General.

"In a market with few products that specifically address the potential for fraud, waste, and abuse surrounding specialty drugs and biologics, the DSTHS solution is unique in its added component of enabled clinical editing," says Tom Scully, Senior Counsel, Alston & Bird, LLP, and former CMS Administrator. "In this capacity, MDMS enables health plans to more efficiently manage medical drug claims."

According to Brett Skyles, CEO of Minnesota-based health care program Itasca Medical Care, MDMS provided the Itasca Medical Center an automated solution to more effectively manage the specialty drug claims processed under the medical benefit without disrupting its current operations.

"The identification of drugs coded or prescribed incorrectly has resulted in significant cost savings for IMCare," says Mr. Skyles. "We intend on fully leveraging all of MDMS's clinical editing capabilities in the future to help maximize the efficiency of our compliance and care management initiatives."

About DST Health Solutions
DST Health Solutions, LLC, a wholly-owned subsidiary of DST Systems, Inc., delivers systems and services that help improve efficiency, reduce operational costs, increase speed to market, and facilitate medical cost management and price containment. Clients include commercial health plans, consumer-directed plans, government plans (Medicare Advantage, Medicare Part D and Medicaid), and physician practices. DST Health Solutions' enterprise applications and outsourcing services include claims processing, member and provider management, benefit plan management, new product development, care management and medical management, and decision support/analytics. For more information, contact 800.272.4799, e-mail [email protected], or visit www.dsthealthsolutions.com.

About Itasca Medical Care
IMCare is a Minnesota health care program administered by Itasca County Health and Human Services with the goal of efficiently and appropriately improving access to quality health care and increasing both patient and provider satisfaction.

The information and comments above may include forward-looking statements respecting DST and its businesses. Such information and comments are based on DST's views as of today, and actual actions or results may differ. Future actions or results may be affected by a number of factors, including those set forth in DST's latest periodic financial report (Form 10-K or 10-Q) filed with the Securities and Exchange Commission. All such factors should be considered in evaluating any forward-looking comment. The Company will not update any forward-looking statements in this press release to reflect future events.

[i] Sources used in support of claims made in this press release obtained from American Medical Association, "New AMA Health Insurer Report Card Finds Increasing Inaccuracy in Claims Payment", June 2011.