Powerful Wellness Management to Reduce Healthcare Costs for Commercial Health Plans
Built to improve outcomes for both simple and complex disease states, CSS Health’s MTM Commercial solution provides powerful, intuitive healthcare cost management for payer organizations seeking to reduce costs and improve HEDIS ratings by identifying wellness issues sooner.
Rapidly Identify At-Risk Populations to Improve Medication Adherence
MTM Commercial’s advanced analytics works across multiple coverage areas to improve quality and deliver a rapid return on investment. Typical program areas include:
- Diabetes management
- Behavioral health, including both treated and untreated
- At-risk opioid management
- Special populations, including MS, rheumatoid arthritis, hepatitis C, HIV, and oncology
Drive Cost Savings
MTM Commercial automatically identifies members taking name-brand medications that can safely switch to lower-cost generics. By highlighting duplicate or unnecessary therapies, payers and physicians gain the ability to optimize medication regimens proactively, as well as avoid expensive hospitalizations and ER visits.
Improve HEDIS measures
MTM Commercial helps drive revenue for commercial health insurers by automating the management of more than 90% of key drug-related HEDIS measures. By making this scalable outreach available to both provider and member, MTM Commercial’s adherence monitoring quickly identifies at-risk members for intervention.
Support Employee Outreach with Medication Consultation
One of the most complicated issues facing commercial payer organizations occurs when members receive multiple forms of medication and treatment for multiple conditions, delivered from multiple organizations. MTM Commercial helps identify and simplify these treatment regimens, lowering the risk of dangerous interactions. MTM Commercial also identifies opportunities for alternative or generic medications, saving money for both payers and members.
Simplify Complicated Multi-Dose Medication Regimens
CSS Health’s compliance packaging, offered through Medicine-On-Time, enables members to adhere to complex medication regimens through color-coded, by day blister-packs. Our robust national pharmacy network also plays an integral role in helping members manage their medications in a simple, timely, and affordable fashion.
Improve Adherence through Person-to-Person Contact
CSS Health supplements MTM Commercial with powerful telehealth programs that improve outcomes by coaching patients to improve adherence and removing social issues limiting care. This service enables organizations to identify potential treatment issues sooner, with adherence improvements that range from 54% – 80% for major chronic diseases.
Flexible Configurations for Organizations of All Sizes
CSS Health knows that there’s no such thing as a one-size-fits-all commercial payer situation. Some organizations prefer outsourced wellness operations. MTM Commercial serves as a fully functional virtual extension for these environments. Other groups prefer to augment existing operations with targeted medication therapy management (MTM) offerings. No matter the need, CSS Health’s MTM Commercial provides the solution that saves money and increases wellness.