A self-insured group health plan, also known as a self-funded plan, is one in which the employer assumes financial risk for providing health care benefits to its employees. In practical terms, self-insured employers pay for out-of-pocket claims as they are incurred instead of paying a fixed premium to an insurance carrier.
Managing pharmacy benefits can be costly for self-funded employers. Empirian Health’s industry specialists maintain focus on the clinical and financial aspects while utilizing state-of-the-art systems to process claims and manage pharmacy programs. Our team excels in finding the right balance for self-funded employers.
Mental health providers face increased regulation and policy concerns. Empirian Health partnerships help alleviate pharmacy obligations, allowing providers to keep patient outcomes centric.
Dedicated to serving the needs of those in the behavioral health and addiction treatment communities, and others who have complex, chronic health conditions, we are the largest provider of pharmacy adjudication, utilization review, and rebate management services.
Reining in pharmaceutical costs should be a top priority. Our solutions help clients gain control of spending so they can focus on what matters most: patient care. Empirian Health creates tailored workflows to address business and clinical needs. We enhance pharmacy programs through effective solutions, targeted clinical oversight, and actionable reporting tools.
Significant, functional reports are delivered directly to staff, providing daily insight into dispensing issues at the facility level, as well as companywide financial analytics. These tools equip staff with accurate, timely information to control and analyze pharmacy spend.
National LTC Consultant
Profits for skilled nursing facilities (SNFs) are being diminished by increasing operating expenses which continue to outstrip the growth in Medicare reimbursement rates. Partnering with Empirian can help manage costs by mitigating the third largest—but fastest growing—of these expenses: prescription drugs. Brand drugs represent 12%-15% of the drugs used, compared to 8%-12% in other populations.
Our programs provide industry-leading solutions for managing the overall pharmacy process while driving cost efficiencies and positive patient outcomes. Empirian offers à la carte options that provide unique solutions to fit specific organizational needs.
Empirian Health assists providers with cost control by developing targeted pharmacy programs. We implement applicable drug formularies and supply accurate utilization reports to identify various key metrics, such as percentage of residents on medications and number of medications per resident. This knowledge allows the facility to target appropriate patterns of high-cost prescriptions and work closely with our clinical pharmacists to effectively reduce costs.
Put us to work for you. We’ll navigate the process, manage your program and make sure you get the maximum benefits. Get in touch with us today!