Design and manage clinical programs to support stronger Part D Star Ratings.
RxSentinel+ helps Health Plans, PBMs, and TPAs configure patient safety, medication adherence, and pharmacy quality improvement programs that support better patient outcomes and higher clinical and formulary compliance.
Manage the clinical needs of your patients with configurable pharmacy quality programs.
The managed care market is increasingly challenged by unnecessary medical spend caused by gaps in medication adherence. At the same time, growing patient care barriers create pressure to improve quality measures through innovation.
RxSentinel+ enables organizations to configure and manage patient safety and medication adherence programs designed to support higher clinical and formulary medication compliance.
Quality Measure Support
Support Star Rating measures for high-risk medications, dangerous drug interactions, antiretrovirals, and D15-D18 measures.
Flexible Configuration
Define clinical rules, adherence criteria, disease-state programs, and program-specific workflows.
Program Outreach
Use high-touch and low-touch communication modules to manage notifications and intervention campaigns.
From claims analysis to targeted outreach, RxSentinel+ supports the full quality improvement workflow.
Automate the work of identifying eligible members, applying clinical rules, tracking adherence, and coordinating the right intervention.
Configure and administer opioid overutilization and controlled substance programs.
Opioid overutilization remains an evolving public health crisis. Health Plans and PBMs with clinical programs to address opioid abuse while educating providers can play a meaningful role in improving patient outcomes.
- Identify eligible members for opioid case management
- Support controlled substance monitoring programs
- Configure rules for Diabetes, DTM, MTM, and other clinical programs
- Coordinate provider education and member outreach
Control and flexibility to define clinical quality rules.
CMS Guidelines
Use pre-configured CMS Star Rating guidelines and measures.
Disease-State Programs
Configure adherence definitions for managing any disease state.
Communication Modules
Manage integrated notifications to patients and providers.
Incentive Campaigns
Administer incentive campaigns for clinical and formulary adherence.
Combine RxSentinel+ with RxMTM+ for a holistic view of the patient profile.
Together, RxSentinel+ and RxMTM+ help clients manage medication-related problems, resolve gaps in care, and coordinate timely information to prescribers and pharmacies from a central location.
