Avera Health Plans “Goes Live” in Record Time with RxAdvance, New Pharmacy Benefit Manager

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- Avera Health Plans' new pharmacy benefit manager (PBM), RxAdvance, announced record-time implementation of comprehensive, innovative PBM services for the insurer's members. The "go-live" occurred on January 1, less than two months after signing the contract (see also RxAdvance).

Leveraging its proprietary platform, the fully integrated Collaborative PBM Cloud™, RxAdvance is delivering transparent overall pharmacy and avoidable drug-impacted cost savings, while streamlining specialty drug spending and supporting better clinical outcomes.

"Our experience during the implementation and, continuing now, has been very collaborative, productive and pleasant, especially compared to past PBM implementation challenges and configuration struggles with some of the large Pharmacy Benefit Managers," said Avera Health Plans' director of medical management, Christine Lounsbery.

"The flexibility of the RxAdvance Collaborative PBM Cloud™ platform, coupled with a strong RxAdvance implementation team, allowed us to accomplish our goals. We configured our complex benefits, formulary, and clinical rules at a very granular level. As a result, we are promoting optimal drug dispensing at the point of sale, eliminating Adverse Drug Events (ADEs) and lowering costs for both specialty and non-specialty drugs," added Lounsbery.

"Going forward, RxAdvance provides Avera Health Plans with dynamic and fully user-configurable solutions, enabling our clinical and pharmacy staff to make on-going desired configuration changes in real-time even during pharmacy peak hours," explained Lounsbery.

Using the Collaborative PBM Cloud™, RxAdvance delivers actionable intelligence to prescribers at the point-of-care, to pharmacists at the point-of-sale, proactive member engagement through mobile cloud and health plan clinical/pharmacy staff engagement through their workflows.

The Collaborative PBM Cloud™ also facilitates pass-through pricing, low administrative fees, complete transparency, granular benefit design, intelligent clinical rule configuration for optimal drug utilization, unlimited formulary tier design and superior member experiences.

"Avera Health Plans has fully embraced RxAdvance's modern PBM cloud platform. Together, we are creating a new industry model of PBM-plan sponsor collaboration and partnership, which reduces overall pharmacy costs, avoidable drug-impacted medical costs and specialty drug spending," said Ravi Ika, Founder & Chief Executive Officer of RxAdvance.

"By lowering costs and improving quality, and demonstrating that PBM conversion does not have to be risky, complex, and time consuming with modern cloud platform architecture, RxAdvance is redefining the PBM value proposition for plan sponsors," added Ika. About Avera Health Plans Avera Health Plans was created in 1999 to be a health plan that offers more than just traditional health insurance coverage to the employees of Avera Health. Avera Health Plans now provides the most cost-effective, innovative health plans for 85,000+ members. Avera Health Plans is on the Marketplace providing plans that reflect some of the lowest monthly premiums for South Dakota and provides tax credits and financial assistance with monthly premiums or co-pays. Avera Health Plans is headquartered in Sioux Falls, SD. For more information about Avera Health Plans visit www.AveraHealthPlans.com. About RxAdvance RxAdvance is a national full service PBM (Pharmacy Benefit Manager), bringing superior clinical, pharmacy, and financial outcomes to plan sponsors through Collaborative PBM Cloud™. Built on a unified data model and clinical intelligence, RxAdvance's PBM standard services include benefit design, artificial intelligence (AI) driven formulary design & modelling, claims processing, customer services, retail pharmacy network management, clinical services, and rebate management & modelling. Our market differentiation includes drug utilization review at Point of Care (PoC) and Point of Sale (PoS), medication therapy management (MTM), medication adherence management (MAM), coverage gap prediction and prescription planning, optimize untapped generics usage, prevent adverse drug events (ADEs), fraud, waste and abuse management, advanced analytics and cost management, and effective specialty pharmacy management. RxAdvance enables actionable intelligence between prescriber, pharmacist, patient, and payer. Our best in class people, process and technology are aligned to support all plan sponsors - health plans, Accountable Care Organizations (ACOs), State Medicaid programs, employer groups, and unions. We provide contractually guaranteed savings in administrative costs, ingredient unit costs, and rebate revenues. For more information, visit www.rxadvance.com. View source version on businesswire.com: http://www.businesswire.com/news/home/20160121005976/en/

Keywords for this news article include: RxAdvance, Legal Issues, Managed Care, Investment and Finance.

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