Overcoming operational bottlenecks to master OptumRx delivery If you’re managing pharmacy operations (like OptumRx delivery, MTM, prescription management, etc.) right now, you know the pain of watching massive backlogs pile up because of prior authorizations. You are fighting crippling drug shortages and endless admin work just to keep your head above water. Fixing this isn’t...
Overcoming disruptions and regulations in advanced medical supply Think about how crazy the pharma world has gotten lately when it comes to advanced medical supply. You are hit from two sides: supply chains (that are an absolute mess), and regulations (constantly shifting). If you cannot keep drugs consistently available and hit those strict compliance standards,...
MTM for Pharmacies: If you work in healthcare right now, you already know the storm that is coming. The Medicare Part D changes are pushing patient eligibility through the roof. We are talking about a jump from roughly nine percent of the covered population to twenty-three percent. Imagine running a restaurant where your daily reservations...
You know how frustrating it is when a revolutionary drug hits the market, but patients just don’t take it consistently. It is a huge leak in both patient outcomes and revenue. We have all seen people get overwhelmed by complex daily regimens. But integrating specialized distribution setups like DME Medical actually fixes a lot of...
In a landscape where financial pressures, workforce shortages, and operational demands are intensifying for healthcare providers, outsourcing business processes (BPO) has emerged as a vital strategic tool. Recent research indicates that over 90% of U.S. hospitals outsource at least one function, with the global healthcare outsourcing market projected to surpass $300 billion by the decade’s...
So, let’s talk about the prescription mess. You know exactly what I’m talking about. It’s that feeling when prescriptions seem to be vanishing into thin air refills get missed, approvals are stuck in limbo, and the phones just will not stop ringing. Your best people are pulled away from patients, all to chase down a...
Why 2025 feels like a fiduciary minefield for benefit managers Let’s be honest, it feels like our jobs have a target on them right now. If you work in pharma operations, you know exactly what I’m talking about. The spending on GLP-1s is exploding, the PBM contracts feel more confusing than ever, and now we’re...
What Are The Pharmacy Benefit Management Companies and How Do They Operate? Pharmacy Benefit Management (PBM) companies don’t make the drugs, and they don’t dispense them, but they sit right in the middle of the transaction. Health plans, big employers, and even government programs hire them to manage their prescription drug benefits. PBMs are the...
Why 2025 will break underprepared MTM pharmacy operations Medication Therapy Management pharmacy in 2025 is about to get intense. It is a perfect storm: the number of eligible patients is set to more than double, CMS is expecting more, and your staffing budget isn’t doubling to match. The CMS 2025 Final Rule is dropping the...
Negli ultimi anni, il settore sanitario ha vissuto un cambiamento radicale. L’aumento della domanda di servizi medici, la digitalizzazione dei processi e le aspettative sempre più alte dei pazienti hanno spinto cliniche, poliambulatori e strutture private a cercare soluzioni più efficienti per gestire sia le attività cliniche sia quelle amministrative. In questo nuovo scenario, l’outsourcing...
