Targeted Intervention

As the second level of care in the MedAssess™ program, Targeted Intervention works to assess and address high-risk, high-cost care issues through prescriber alert and intervention services. The program applies risk-profiling methodology to uncover high-risk and elevated cost situations that might go unnoticed at the individual prescriber or pharmacy level.

Targeted Intervention typically benefits injured workers moving from the acute to chronic phase of injury as well as long-term chronically injured workers. In addition to hard-dollar pharmacy savings from each individual service, these interventions can decrease overall medical cost by significantly reducing the risk of adverse drug events known to increase the need for office visits, emergency room visits and hospitalizations.

High-Risk Profiling Service

Once identified through proprietary analytic tools honed through three decades of experience, our highly trained and credentialed clinical pharmacists review the high-risk pharmacy records for inappropriate medication use that may lead to increased medical and pharmacy costs. As part of our High-Risk Profiling service (also known as the Arkos Risk Management™ system), our pharmacists reach out to the treating physicians to alert them of their patients with high-risk medication concerns.

Multiple Prescriber

This important intervention reduces the risk of significant adverse drug events for injured workers with chronic pain by reducing the number of narcotic prescribers. It also deters behavior typical of drug abuse or diversion.

Generic Conversion

By reaching out to prescribers and injured workers regarding the safety and effectiveness of generic medications, our Generic Conversion service facilitates conversion of brand-name medications to their generic equivalents. PMSI maximizes the opportunity to increase your generic efficiency rate by going beyond generic mandatory regulations to drive the use of generic medications in your injured worker population.

Value to Our Clients

Typical results for the Targeted Intervention program include:

• High-Risk Profiling service results in a 28% reduction in total drug spend for high-risk injured workers when converted to more appropriate therapy
• Generic Conversion service can achieve 20% to 60% savings, depending on the drug, when changes are made from brand to generic formulations
• Multiple Prescriber service successfully converts 90% of injured workers using multiple physicians for narcotic prescriptions to a single prescriber