Medication Therapy Management (MTM) for Health Plans

Aprexis takes the pain out of member identification and program selection. A health plan can quickly select a program it wants to implement and identify members that are appropriate to target for the program. Once the population is identified, member information is sent to the network of participating pharmacies for intervention, performed at the member’s local pharmacy. Access to real time reporting allows the health plan to quickly see the impact of each program it creates.

Member Identification

Aprexis understands the complexity that often comes in knowing which members to target. Providing health plans with a platform that facilitates the process makes deciphering member identification easy. Our straightforward system enables the plan to quickly specify the member characteristics it wants to focus on for a specified program. This feature enables health plans to make important decisions as they consider the best care for their members.

Program Creation

Creating programs, whether transactional or clinical, requires Aprexis’ systematic approach that allows specific member characteristics to be selected in order to display information needed to aid the health plan in developing appropriate programs of care for its members. Once a program is created, Aprexis technology aligns the health plans and participating pharmacies in working together to implement the program thereby achieving better outcomes for plan members.

System Administration

Evaluating program efficacy from relevant perspectives, and easy access to a billing function that facilitates invoicing from the pharmacy to the payer, are essential in a successful system. And with Aprexis’ tools, health plans have access to program data to validate the delivery of services, and can be tied to measurement of improved clinical outcomes. This is a valuable asset for health plans as they strive to maintain their reputation for quality within the healthcare arena.

Pharmacy Network Services

In addition to software services, Aprexis provides a unique offering in its Pharmacy Network Services. Together, these services guarantee an active network of participating pharmacies and appropriate training of all platform users, at both the health plan and the pharmacy. The combination of programs and services enables health plans to provide full medication management across its membership.