Visibility into what is happening with your members is limited. Too often care is fragmented. Chances are, you may not be certain how your clinical and engagement services are working together – or of their bottom line value. All the while, increased investment isn’t necessarily driving increased value, chronic conditions are on the rise and
healthcare costs are becoming unsustainable.
You are looking for more effective clinical care management for your members. To do this, you need a personalized engagement approach that supports each individual with the help they most need. The future of healthcare is looking at the whole person and providing the right care at the individual level. What if healthcare was truly flexible – and all your member’s health services could deliver personalized healthcare without duplicated efforts and cost?
In 2020, Express Scripts will change what you should expect of a Pharmacy Benefit Manager, by providing a new option not previously available in our industry and guaranteeing clinical outcomes. Health Connect 360SM is a fully guaranteed, outcomes-based clinical approach that offers an unprecedented in-depth view of your healthcare environment at the member level. Refreshed continuously with insights from patients, prescribers, pharmacists and payers, while utilizing machine learning processes, this new clinical model fully integrates all parts of the
healthcare continuum.
As Champions For BetterSM, we will help you maximize clinical outcomes, deliver better member experiences and improve financial results, all while achieving the clinical goals you set for your population.
Health Connect 360 is forging new levels of connection across the healthcare continuum.
Why is Health Connect 360 the best choice for lowering your total cost of care?
This transformative new approach:
You get truly personalized healthcare for your members – clinical support is
needs-based and specific to the individual’s preferences and health challenges, optimizing member experience and driving behavior change to achieve your goals
You get new levels of connection across the healthcare continuum – multi-source data integration generates a more accurate, 360-degree view of each patient – and therefore, a better understanding of opportunities across your population, allowing you to choose what matters most to you to match your plan’s needs. Additionally, this information is also available for other healthcare entities
You get an outcomes-based approach – achieve your customized
clinical targets…guaranteed
We bridge pharmacy, medical, lab and patient engagement data, daily, with unrivaled precision and analysis. This means we identify and act on more relevant, actionable gaps-in-care or health opportunities 14 times faster with medical data (30 times faster with biometric data) – getting those insights and alerts back to your pharmacies, physicians, nurses, medical carriers and healthcare vendor partners.
Your assigned Population Health Manager will provide additional support by reviewing suggested clinical engagements and targeting outreach based on individual patients’ needs. These clinicians study your data every day, looking for opportunities to address areas that need clinical attention. They will also keep you informed about the best available engagement options, making operations across different healthcare services easier and helping you achieve optimal outcomes.
Your patients receive only the clinical care support they need, preventing overlapping communications and outreaches across systems, tools and care providers. Personalized engagement means each member gets the most effective interactions and outreaches for their specific condition, needs, health risk and optimal engagement method including timing and communication channel. They will get only get what they need, when they need it, and nothing they don’t.
Pharmacies get increased visibility of actionable clinical support opportunities as well as member and population health insights.
Your medical carrier’s care and case managers are empowered with our data pulled into their system, allowing them to take action based on our recommendations, with fresh insights delivered daily. This provides a 360° view of each patient to keep patients from falling through the cracks without duplicative engagements or wasteful efforts. The data and insights are available on-demand to help them deliver informed, effective individual counseling for your members.
Physicians are enabled to make better clinical and cost-effective decisions at the point of prescribing for their patients with access to bi-directional clinical alerts, remote monitoring data and health insights from interactions with other clinicians. Physicians also see patient-specific out-of-pocket cost for medications, alternative therapeutic options and coverage alerts.
Every patient is unique. By proactively using patient-level risk and engagement scores, we will identify actionable health and safety issues and opportunities, enabling true personalization that drives better outcomes at the patient level – and bigger impact at the population level.
A 45-year-old man with diabetes struggling to remember to take his medications and keep his blood sugar levels in check. Due to a recent hospital scare, plus a track record of poor medication adherence, Jason started a remote monitoring program to track his blood glucose levels via a Bluetooth device connected to his phone.
Unfortunately, his physician doesn’t know Jason’s levels are being monitored, his retail pharmacist doesn’t notice he’s nonadherent and the medical carrier’s care coordination team isn’t aware of conversations he is having with his specialist pharmacist.
See the 180° change – a personalized, responsive approach leading to optimal care coordination and guaranteed results
Healthcare happens in real time. By leveraging unique member insights and utilizing our comprehensive understanding of Jason’s health, we are able to provide more efficient and effective engagements.
Just like a mobile navigation app, if your members go off course, we help reroute their paths to achieve optimal clinical care.
Start Over
A 45-year-old man with diabetes struggling to remember to take his medications and keep his blood sugar levels in check. Due to a recent hospital scare, plus a track record of poor medication adherence, Jason started a remote monitoring program to track his blood glucose levels via a Bluetooth device
connected to his phone.
Unfortunately, his physician doesn’t know Jason’s levels are being monitored, his retail pharmacist doesn’t notice he’s nonadherent and the medical carrier’s care coordination team isn’t aware of conversations he is having with his specialist pharmacist.
See the 180° change – a personalized, responsive approach leading to optimal care coordination and guaranteed results
Healthcare happens in real time. By leveraging unique member insights and utilizing our comprehensive understanding of Jason’s health, we are able to provide more efficient and effective engagements.
Just like a mobile navigation app, if your members go off course, we help reroute their paths to achieve optimal clinical care.
No more guessing about which clinical care support tactic will work best with your existing clinical programs. With Health Connect 360, we provide holistic benefit management to meet your plan’s customized clinical targets, guaranteed.
Health Connect 360 also allows for fast-track access to future clinical solutions that Express Scripts brings to market. Our scale and commitment to clinical innovation means we will deploy new clinical options faster than any single company can on their own, giving your population access to a wider and more effective range of clinical engagements without the risk of overlapping or duplicative efforts.
For a future that is connected, collaborative and customized for you, contact your Express Scripts account representative today to learn more about Health Connect 360. Customized modeling is available to help you discover how this revolutionary new model will work specifically for you by improving care coordination and member experience while lowering the total cost of care for your plan.