The challenges you face in improving the health of your members may seem daunting. From ensuring quality care while managing cost, to keeping up with emerging therapies and technology, we’re here for you.
Our programs and services are as unique and varied as your members’ health needs. We answer those needs with personalized solutions that help you and your members realize better outcomes.
How do you improve the health of your members when you have a limited line of sight across the care continuum? It takes a 360° view of your patients and population to drive the 180° impact you want.
Health Connect 360SM is the most comprehensive clinical management model in the industry. It bridges pharmacy, medical, lab and patient engagement data on a daily basis, with unrivaled precision and analysis. Identifying more relevant, actionable gaps in care or health opportunities, we get those insights and alerts back to your pharmacies, physicians, nurses and case managers. Then, we leverage patient-specific risk and engagement scores to trigger the most effective, personalized intervention for each patient.
Health Connect 360 is a fully guaranteed, outcomes-based approach. It helps you maximize clinical outcomes, deliver better member experiences and improve financial results, all while achieving the clinical goals you set for your population.
SafeGuardRx® addresses the most complex and expensive health care issues: improving patient care while controlling costs.
Through a multi-program platform, SafeGuardRx combines our specialized clinical model and value-based contracting strategies, delivering better outcomes and increased value for patients living with critical diseases states.
SafeGuardRx helps patients realize better medication adherence, higher therapy completion rates and greater compliance with clinical guidelines, while helping lower costs for plan sponsors. In 2018, enrolled clients saved more than $2.4 billion.
The SafeGuardRx platform is continuously evolving, identifying new opportunities in critical disease states in addition to those currently covered: cholesterol, diabetes, hepatitis C, inflammatory conditions, migraine, oncology, pulmonary conditions, multiple sclerosis and rare conditions.
The opioid crisis doesn’t discriminate. Anyone is vulnerable and everyone is affected – your members included. Advanced Opioid Management (AOM) is a clinically-driven solution created to combat this nationally recognized crisis. AOM maximizes safety and minimizes early opioid exposure, then helps prevent progression to overuse and abuse.
Providing a dynamic and much-needed way to fight opioid abuse across the care continuum, AOM touches the pharmacist, the patient and the prescriber. In just 2 years, the program has prevented 1.4 million days’ supply of opioids from being dispensed, while directing patients to safer, short-acting alternatives.
Patient results include:
- A 55% reduction in average day supply per claim
- 93% of new patients starting with a 7-day supply or less
- 77% of patients redirected from long-acting opioid to safer, short-acting alternatives
We’re in an era of continuously developing health technology giving people greater control over their health and well-being. However, a constant flow of new digital health solutions is streaming into an already crowded market. The technology is still emerging and hasn’t gone through rigorous validation.
To make it simpler for members and plan sponsors to navigate the vast landscape of personal health technologies and interventions currently available, Express Scripts will introduce the industry’s first, stand-alone digital health formulary.
Our digital health formulary – a curated list of technology- and software-enabled applications and devices to help prevent, manage or treat a medical condition – allows plan sponsors to ensure the safety, usability and cost effectiveness of health technology tools available to their members.
People living with a chronic health condition deserve responsive, straightforward answers from experts who understand what they're going through – experts who have the training and experience needed to help.
We believe the best care for these patients comes from specialists, not generalists. Our Therapeutic Resource Centers® (TRCs) are dedicated to serving patients diagnosed with complex disease states. We're committed to connecting patients with the right care, specific to their individual need.
For example, patients with cancer are served by pharmacists, nurses and other health care experts in our Oncology TRC, which offers compassionate, comprehensive cancer-specific care.
We help patients achieve their best health outcomes by providing personalized care and resources they may not get anywhere else.
The price tag for lifesaving therapies has ballooned into a costly and serious problem that’s increasingly impacting the health and wellbeing of patients diagnosed with diabetes. From 2006 - 2016, out-of-pocket drug costs for these patients rose by 54%.1
Yet skipping a single insulin dose can increase expensive and serious risks for eye, kidney and nerve complications.2 Alarmingly, 1 in 4 people living with diabetes admit to insulin rationing due to cost.3
These patients deserve better. Addressing the need for affordability and access, our Patient Assurance ProgramSM ensures that those eligible in participating plans pay no more than $25 for a 30-day supply of preferred, participating insulin products.
RationalMed® improves patient health and safety – integrating medical, pharmacy and laboratory claims data to initiate changes and correct errors in care, lowering both medical and prescription drug costs.
Gaps in care lead to higher costs. Using predictive modeling, ScreenRx® closed 37% of medication adherence gaps, recording $188.6 million in total health savings for our clients.
In partnership with leading high-tech companies, we’re helping members monitor their health status in real-time. To improve outcomes, our solutions are always paired with clinical support through our Therapeutic Resource Center®pharmacists.
Explore related insights
2 Centers for Disease Control and Prevention
3 “Medication Adherence and Improved Outcomes Among Patients With Type 2 Diabetes,” The American Journal of Managed Care
4. Journal of the American Medical Association: Internal Medicine, January 2019, Vol. 179