Outcomes

Below are just a few examples of client successes with the US-Rx Care pharmacy risk management program.

Health Plan A

An at risk medical group serving 10,000 patients in Medicare HMOs, 10,000 in commercial HMOs, and 10,200 in Medicaid was consistently over budget on their pharmacy capitation PMPM. The individual doctor offices have been able to decrease their pharmacy cost significantly using the US-Rx Care program. Combined aggregate savings to date are just under $3.0mm per year.

Health Plan B

A Medicare HMO with 30,000 lives and a zero copay benefit design reached out to US-Rx Care to trim their high per member per month cost for prescription medications. The plan licensed US-Rx Care’s Right Rx risk management program, which they implement with a small team. In the first 15 months of program implementation, the plan saved over $1.3 million of a total savings target of $4-$5 million annually.

Independent Practice Association

The IPA saved over $20 pmpm in drug costs within the first six months of program implementation (greater than 30% cost reduction).

Self-Insured Union Health & Welfare Fund

Members have enjoyed significant reduction in out-of-pocket costs and greater access to needed medications. In addition, the trust fund’s annual expenditures per member per month have remained unchanged since 2006.