Vender Management

           Quarterly Utilization & Cost Review
           Plan Design Change &
           Savings Analysis

             Clinical Services
             Medicare Specific Services

Quarterly Utilization & Cost Review

IPC/ Evergreen Rx runs YTD reports that are broken down quarterly to reflect the financial performance and utilization of a client’s plan. These reports are compared to the same reporting period of the previous year. Quarterly Utilization Reports provide:
• Financial information
• Contractual information
• Top drug information
• Top therapeutic class information
• Top pharmacy information
• Top doctor information
• Top consumer information
• Positive and negative trends in the data for recommended action

IPC/ Evergreen Rx runs a quarterly Top Therapeutic Class cost comparison for a client that reflects the top therapeutic classes and the competitive drugs in each of those classes. Cost Review Reports provide:
• Actual costs of the utilized drugs
• Member’s physicians
• Awareness to cost saving alternatives

Plan Design Change & Savings Analysis

IPC/EvergreenRx uses the most recent full year of claims data available. The current formulary and benefit design is applied to the claims for benchmark purposes. IPC/EvergreenRx identifies areas for improvement and suggests benefit design changes for the plan. The benefit options are applied to the claim dataset and compared to the benchmark statistics. IPC/EvergreenRx detects the change in cost for members and for the plan, providing a balanced analysis. For Medicare Part D plans, all reinsurance and subsidy amounts are also considered and the plan is presented with the Per Member Per Month cost compared to the benchmark data.


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