MedImpact | Specialty Management

Specialty management

MedImpact’s unique model allows us to leverage multiple fulfillment partners to identify the lowest cost and best service for each class of medication.

HOW WE HELP

Although only 1% of pharmacy claims for commercial plans are for specialty drugs, they often account for greater than 50% of all prescription benefits spending. It will take bold new thinking to manage this trend.

Pharmacy and medical benefit management

50%–60% of specialty spend is under the medical benefit. Through MedIntegrate®, we look at specialty drug utilization across both medical and pharmacy to increase savings.

Monitoring and care management program

MedImpact offers condition management to help ensure members are on the most appropriate therapy.

Personalized support

Specialty medicine usually needs unique care and close follow up. The specialty pharmacy clinicians we work with give members personal support including scheduling therapy, help with how to take the medicine, answering questions about managing side effects, and help with understanding benefits.

Convenient dispensing and delivery

If the member’s doctor administers the medicine in the office, the medicine will be shipped to them. If the member administers the medicine themselves, it will be shipped to the address provided, in private packaging that doesn’t indicate what is in the box.

Our specialty program offers members:

Help with treatment plans

Copay assistance

Nurse and pharmacy helpline

After-hours service

Educational information about their medicine

Personalized refill program

Free standard shipping

Translation services

Innovative specialty solutions

We partner with Ray Savings Solutions to offer a new and innovative approach to reducing the cost of specialty medications for plans and members. Leveraging Ray’s deep industry expertise, they advocate on behalf of plans and members to identify ways to cut the cost of specialty medications, in some cases down to a $0 cost share.

ON A MISSION

Connected care

Every year, we invest hundreds of millions of dollars in technology, people, and solutions to make healthcare benefits more connected, personal, and affordable.