ROI
Using your data, Sanovia can project potential drug spend savings by drug or drug class in addition to calculating your projected gross savings for new drugs under management. Sanovia also will model how you can handle increased PA volumes without increasing staff. Contact us today to find out how to receive this free analysis including a calculator to model your own savings potential.
Controlling the pharmacy component of medical loss is becoming a focus of payers due to the double digit growth in pharmacy spend. The main driver of this growth is increased utilization of high-cost specialty pharmacy medications. In addition, payers are faced with higher administrative costs to implement the necessary utilization management processes to control costs for the growing number of pharmaceuticals that require management. Sanovia has helped our clients achieve up to 50% administrative cost savings, and between 5-10% savings for drugs under management through the automation of pharmacy utilization management.
Sanovia has developed Return on Investment (ROI) tools to assist prospective customers with the quantification of savings that result from automating pharmacy prior authorization. These ROI tools are used to project administrative and pharmacy savings through the implementation of Sanovia’s PA-Logic™ solution, which automates the pharmaceutical prior authorization process, while simultaneously improving the quality and consistency of decisions. The ROI tools are used to project the following:
Administrative staff reductions or reallocations achieved through automation
Increased capacity of prior authorizations that can be achieved by improving the efficiency of existing staff
Pharmacy savings driven by improving the quality and consistency of decisions for pharmaceuticals that are subject to PA
Pharmacy savings driven by increasing the number of drugs under management
Many prospective customers want to understand the link between automation and drug savings. While Sanovia’s solution streamlines the administrative aspects of prior authorization, it also includes:
Clinical best practice criteria which are developed to drive quality decisions based on medical appropriateness as well as Sanovia’s customers’ real-world experience using Sanovia’s PA-Logic product
Intelligent branching logic to drive consistent application of clinical decisions regardless of the user’s knowledge of the criteria, policies, and formulary rules, etc.
Sanovia’s clinical best practice criteria are embedded in the automated workflow, which means that non-clinical users can apply clinical rigor to an automated process with minimal training. The use of branching logic ensures that the complexity of the decision making is hidden from the user, guiding them through simple questions that lead to a determination. Sanovia’s clinical criteria can be used “out-of-the-box” or customers can choose to configure the criteria to match their unique business needs. Sanovia has found that while customers will often configure their solution, they will use Sanovia criteria as a starting point, and then easily adapt them to their needs.
In summary, there is a direct link to pharmacy savings that can be achieved by combining the value of automating complex decisions while inserting consistent best practice clinical criteria, and intelligent branching logic that would otherwise be unachievable in a manual processes
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