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Reducing DIR Fees and Maximizing Reimbursement with AI Technology

Direct and indirect remuneration (DIR) fees are a hot topic in the pharmacy industry, and efforts to regulate DIR fees consistently hit the headlines. Recently, the Centers for Medicare and Medicaid Services (CMS) proposed substantial changes to DIR regulations to help… Read

3 Ways to Improve the Affordability of Specialty Drugs

Specialty drugs are essential for treating complex, chronic conditions. However, they’re also relatively expensive, and prices are continually rising. According to an AARP report, the average specialty drug price is rising  more than three times faster than other goods and… Read

How Effective is Your Patient Support Program?

Pharmaceutical companies spend more than $5 billion on patient support programs each year, but only 3 percent of patients actually use them. So what gives? What does an effective patient support program look like, and why do so many fall… Read

How Can Predictive Analytics Prevent Non-Adherence?

In the digital age, we have access to more data than ever before. Companies of all shapes and sizes use data to make smarter business decisions, manage budgets, improve efficiency, meet customer expectations, and more. As technology advances, people are… Read

Adherence Interventions and AI: An Overview

Medication adherence remains one of healthcare's biggest challenges. It accounts for up to 50% of treatment failures, 25% of hospitalizations, and 125,000 deaths annually. Adherence interventions can change this, but only when you target the right patients in the right… Read

The Impact of COVID-19 on Quality Measures: The New Reality

The COVID-19 pandemic derailed much of what was once standard in healthcare, and quality measures are no exception. On March 26, 2020, the Centers for Medicare and Medicaid Services (CMS) published their response document, outlining regulatory revisions that would change… Read

Patient Intervention: Effective Tactics for Pharmacies, Payers, and Pharma

Medication adherence rates for most chronic disease medications hover around 50-60 percent. This results in sky-high healthcare costs and preventable morbidity or mortality. Patient intervention programs can promote adherence, but choosing the right tactics is critical. All tactics may be… Read

Leveraging AI to Improve the Patient Journey

The patient journey is paramount in healthcare today. Newly emerging technologies, shifting industry dynamics, and evolving consumer preferences are reshaping what the modern patient experience should look like. That’s why more and more healthcare organizations look to deliver personalized, patient-centric… Read

Optimize Performance-Based Pharmacy Reimbursements

Over the last several years, PBMs and other payers have instituted performance-based contracts that leverage direct and indirect remuneration (DIR) fees to alter prescription-level reimbursement. Although each contract can be complex, the burden placed on pharmacy organizations is magnified due… Read

The Halo Effect of Adherence to Antidepressants

In the popular imagination, depression is chronic sadness. In reality, it is a devastating illness with widespread mental and physical health effects. One of the most common challenges of depression is a motivation deficit. People with depression can struggle to… Read

How a Medication Adherence Program Can Increase Pharmacy Revenue

Pharmacies today face significant challenges, from ever-increasing competition with retailers to  quality performance measures to high costs of care and beyond. Like any business, pharmacies must maintain a healthy revenue stream to remain competitive and grow over time. However, doing… Read

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