RxAdvance Won Avera Health Plans’ Pharmacy Benefit Management (PBM) Contract to Reduce Overall Pharmacy Costs, Avoidable Drug-Impacted Medical Costs, and Optimize Specialty Drug Utilization.

Business Wire

SOUTHBOROUGH, Mass.--(BUSINESS WIRE)-- RxAdvance today announced that Avera Health Plans has awarded multi-year pharmacy benefit management (PBM) services contract to RxAdvance. This contract establishes RxAdvance as the PBM for the Avera Health Plans’ fully insured members starting Jan. 1, 2016. This agreement aligns with Avera Health Plans’ commitment to offer innovative and cost-effective coverage for members with RxAdvance’s comprehensive PBM services that deliver overall pharmacy and avoidable drug-impacted medical savings, while streamlining the specialty spend. Collaborative PBM Cloud™, the game changing platform behind RxAdvance’s services deliver 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 PBM services agreement leverages RxAdvance’s fully integrated Collaborative PBM Cloud™ platform to provide a holistic medical and pharmacy care solutions that deliver better outcomes and cost savings for Avera Health Plan members. Pass-through pricing, low admin fee, complete transparency, granular benefit design, intelligent clinical rule configuration for optimal drug utilization, unlimited formulary tier design and superior member experience through mobile cloud are a few of the many services delivered through this agreement.

“Compared to our past PBM challenges while we were using few large PBMs, our experience to-date with RxAdvance has been very collaborative. Avera Health Plans is excited to partner with RxAdvance to deliver the most cost effective and innovative pharmacy solutions to our members through their holistic approach. The Collaborative PBM Cloud™ platform’s ability to integrate all pharmacy, medical and lab information to maximize the health outcomes for our members was a key criteria for selecting RxAdvance. RxAdvance provides Avera Health Plans with dynamic and fully user configurable solutions enabling our clinical and pharmacy staff to better engage members throughout our care delivery continuum,” said Avera Health Plans’ Director of Medical Management Christine Lounsbery.

“Our commitment to redefine the PBM value proposition to plan sponsors has been fully embraced by Avera Health Plans. I believe together, we will pave the path to create an industry standard of PBM-plan sponsor collaborative partnership model that reduces overall pharmacy costs, avoidable drug-impacted medical costs and optimize specialty spend,” says Ravi Ika, Founder & CEO of RxAdvance.

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 provide the most cost-effective, innovative health plans for 80,000+ members in South Dakota and northwestern Iowa. 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.