Formulary Management and New Value Opportunities with ICD-10

Two of the key problems facing the specialty drug industry today are: Utilization Management; applying new tools for increasing control over appropriate use, and Drug Selection, also known as Formulary Management; shifting utilization to therapeutic equivalent and more cost effective alternatives. Over 47% of specialty drug utilization is managed by payors under the medical benefit. Historically the medical benefit has not had the same tools and controls to support more effective utilization and formulary management. The imminent transition to ICD-10 opens new value opportunities that can be exploited by leveraging the portfolio of coding tools available from RJ Health Systems and ReimbursementCodes. The ICD-10, clinical coding data, drug-specific pricing and NDC crosswalk can be a strategic solution set for improving overall specialty drug management and mitigating drug trend. Join Randy Falkenrath on Thursday, September 10th at 2 pm (EST) to learn more about Formulary Management. Randy will go in depth on how ICD-10 can be a key component for reducing drug trend. Register for the webinar here.