A Unique Pharmacotherapy Review Process Yields Maximum Results

ANS Solutions’ Pharmacotherapy Review Program surpasses drug utilization review as a far more advanced and comprehensive pharmaceutical cost containment strategy.  As the only one of its kind, Pharmacotherapy Review  employs a three-staged approach to ensure economically balanced and appropriate treatment options for injured workers. The end result is a cost effective treatment regimen that simultaneously enhances the quality of care for injured workers.

Pharmacotherapy Review Program

PharmReview

As the first stage of ANS Solutions’ Pharmacotherapy Review Program, PharmReview applies an evidenced-based risk-profiling methodology for large loss cases in order to determine which alternative therapies should be recommended. Utilizing this pharmacy-driven clinical engine managed by our best-in-class team of Doctors of Pharmacy, ANS is able to present actionable treatment modification recommendations in a written proposal to treating physicians. Key items of interest during PharmReview include:

  • Consolidation and coordination of drug therapies between multiple prescribers
  • Consideration of alternate therapies
  • Specification of weaning programs for over-prescribed narcotics
  • Use of generics where applicable

PharmReview not only ensures optimal outcomes for the injured worker but lays the groundwork for achieving hard-dollar cost savings over the claimant’s life expectancy.

PharmIntervention

The second-stage of the ANS Pharmacotherapy Review Program (PharmIntervention) results in a signed agreement executed by the treating physician. Unlike the peer-to-peer telephonic approach of prescription drug utilization review companies, ANS deploys an exceptionally credentialed network of Nurse Experts to deliver the recommendations of the PharmReview Report in collegial, face-to-face meetings with treating physicians. The objective of this unique industry approach is to achieve consensus on a modified medication regime and to obtain commitment on a future course of treatment.

PharmCompliance

Physician and patient adherence to the Pharmacotherapy Review Program is crucial to ensuring hard dollar cost-savings and positive therapeutic outcomes. During stage three, PharmCompliance, we refer the successfully executed PharmIntervention Agreement to an ANS Clinical Liaison Officer (CLO) whose sole function is to ensure compliance with the new prescription treatment plan. At pre-designated dates, your ANS CLO will pro-actively manage your case to maximize Total Hard Cost Savings.

Drug Utilization Review

Benefits of ANS Solutions Pharmaceutical Cost Containment Program

  • An advanced and comprehensive alternative to drug utilization review
  • Enhance the quality of care for the injured worker
  • Enhance the quality of life of the injured worker
  • Improve your loss ratio by lowering Pharmaceutical costs by 25% or more on complex, large loss cases referred to ANS
  • Prepare case for settlement and mitigate Medicare Part D exposure

In addition to our Pharmacotherapy Review ANS provides a suite of services that allow payers to align cost containment strategies with the improved quality of care that Pharmacotherapy provides.

These services include:

  1. Legal Nurse Consulting Services
  2. Medical Cost Projection
  3. Reducing Medicare Set Aside & Part D Exposure
  4. Medical Record Review
  5. Home Health Care Evaluation

To learn more about how ANS can help you navigate complex Workers’ Compensation Medical Cost Containment, contact ANS today.