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medimpact

What tools are available to help us manage fraud, waste, and abuse?

We are integrating data analytics, clinical services, and case management to help identify and act on fraud, waste, and abuse earlier and more effectively.

THE PROBLEM

Fraud, waste, and abuse (FWA) is a national epidemic that costs our healthcare system at least $200 billion every year. These costs are borne by plans, employers, providers, members -- all of us.

  • $ 270 Billion

    Estimated cost of healthcare fraud, waste, and abuse

M
Identifying fraud, waste, and abuse early.

MedImpact uses artificial intelligence and machine learning to analyze data across pharmacies, prescribers, and members and identify suspicious claims before they are paid. We then work with our clients to take action in order to combat FWA.

Fraud, waste, and abuse.

MedImpact’s integrated bundle of analytic and clinical services help empower plan sponsors to identify and combat fraud, waste, and abuse.

Analytics.

MedImpact’s Quality Performance Management Program (QPMP) delivers information from the population to the member level about adherence, treatment gaps and safety issues to help improve outcomes, CMS Star Ratings, and drug and medical spend.

Clinical outcomes.

We provide clinical expertise, national strategy, local customization, and personalized engagement programs to help improve member health.
HERE FOR YOU

Proven results.

Every client has unique priorities and needs. That's why we are the PBM that offers highly customized benefit designs, formularies, clinical programs and analytics. No one-size-fits-all here. See what we mean:
How can we be sure our home delivery service is designed with our plan’s best interest in mind?
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What should we consider when choosing a PBM?
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Can we make it easier for members to understand their benefits?
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How can we manage the rising cost of specialty medications?
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Can we use genetics to achieve better health outcomes?
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How can I reduce the cost of prescription benefits?
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How can we help members save money and plans gain access to critical data?
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Can analytics empower us to make better decisions?
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What tools are available to help us manage fraud, waste, and abuse?
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How can we reduce costs and improve outcomes for people on government programs?
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Can we help doctors and members make better decisions at the point of care?
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Ready for clarity from your PBM?