The pandemic accelerated digital health care. We have been investing heavily in digital connections with members for several years. Members benefitted from this during the pandemic because we were able to stay connected and engaged with them.
We are also tightly connected with prescribers. Our connectivity enables us to check the member’s diagnosis information in their electronic health records (EHRs), and therapy selections are based on rigorous clinical criteria. This means members start therapy with certainty and treatment decisions are unlikely to be overturned on appeal, delivering lasting savings for clients.
Connectivity also enables us to reduce waste throughout treatment. Using data-driven precision to prevent just one unnecessary prescription in a year, for a member who is compliant with their medication regimen, can translate into savings. For a large employer client with a subset of members for which this could happen, it’s significant.
* PA requests submitted using data from EHR and aligned to Specialty utilization management criteria
** Targeted patients make up less than 2 percent of all specialty patients