Medicare Part D Solutions

MedImpact actively focuses on enhancing your Medicare Part D program through expert guidance, oversight and clinical thought leadership. We have proven strategies to improve your Star Ratings and Quality Bonus Payments, while helping you retain and grow your Medicare membership.

2016 Medicare Part D Contract Average Star Ratings by PBM

We partner with you to implement clinical solutions that engage members, pharmacy providers and prescribers to target Centers for Medicare & Medicaid Services (CMS) patient-safety measures. Our clients benefit from Prescription Drug Plan (PDP) and Medicare Advantage Prescription Drug (MAPD) Star Ratings that are higher than the national average.

Enhancing CMS Compliance

Our combination of clinical and operational Medicare Part D expertise boosts compliance with CMS requirements. We provide oversight tools that make it easy for you to monitor our processes and perform quality checks:

  • Integrated Review Approach – We determine the potential impact of benefit changes specific to your Part D program aligned with federal and state legislative reviews.
  • Positive Regulatory Relationships – We work closely with you to help you heighten compliance with CMS regulations and guidance.
  • Forward-looking Processes – Our Part D analysts stay up-to-date with CMS changes and provide proactive consultative services to assist you in managing your program so you remain compliant.
  • Rigorous Prescription Drug Event (PDE) Management – Our expertise in PDE management results in positive financial outcomes for your organization.
  • Audit Support – We expertly support CMS audits and the various operational and compliance focus areas.

 

Quality Measurement and Monitoring

Our clinical analysis tools are effective at supporting Continuous Quality Improvement, National Committee for Quality Assurance (NCQA) and other accreditation initiatives. We can collaborate with you to provide a diagnosis and analysis of treatment and drug therapy gaps with our Quality Performance Monitoring Program. Sophisticated reporting packages also provide physician profiling and patient-level drug trend analysis.

Plan Sponsor Education

Our clinical professionals provide peer-reviewed drug, disease and therapeutic class monographs. Quarterly drug information publications include the Generic Drug Pipeline Report and the Clinical Pipeline® Report. Market opportunities and business trends are addressed in our MedImpact Connect® education series for Medicare Part D Plan Sponsors.