Results. Savings. Quality.
SPECIALTY SWAT – SPEND, WASTE AND TREND ANALYSIS
Uncover hidden spend and strategies to manage it
Powered by Specialty IQ™, Archimedes’ SWAT Analysis™ analyzes specialty spend across both the pharmacy and medical benefits to identify waste, typically exceeding 20% of spend, and develop an action plan for a sustainable specialty benefit. Areas commonly addressed include:
- Clinical appropriateness
- Site of care optimization
- Duplicate billing
SPECIALTY PBM CARVE OUT
Take back control of your benefit
Archimedes is helping plan sponsors address the rising cost of specialty medications through our unique specialty drug carve out solution.
- Moves management of specialty drug benefit away from the traditional PBM.
- Leverages Archimedes’ clinical expertise and technology to implement a robust prior authorization program and case management for high cost specialty patients.
- Utilizes Archimedes’ formulary to optimize appropriate use and net cost before rebates.
SPECIALTY DRUG MEDICAL MANAGEMENT
Manage the most challenging part of the specialty drug spend
Archimedes’ Medical Management program helps plan sponsors manage the cost of specialty medications coming through the medical benefit, identifying opportunities for savings and optimization of care on prospective or retrospective basis.
- Rigorous clinical management including prior authorization, drug reviews and ongoing monitoring of response to therapy.
- Interventions to promote cost-effective sites of care for infusions.
- Medical claims editing and monitoring for billing errors.
- Combining medical management with Archimedes’ specialty drug carve out solution gives plan sponsors, consultants and health plans visibility to the entire specialty drug spend across the pharmacy and medical benefits, maximizing the ability to identify and remove waste.