The pharmaceutical industry operates in a complex environment, with payer analytics playing a pivotal role in shaping the landscape of healthcare. Navigating the world of payer analytics within the pharmaceutical industry comes with its own set of challenges, from intricate reimbursement models to the diverse nature of available data sources. However, the emergence of AI-powered analytics is revolutionizing this space, enabling insights that drive better-informed contracting and reimbursement decisions. Let's explore how payer analytics is transforming healthcare, and how AI-powered analytics is leading the way.
The Challenges of Payer Analytics in Pharma
Analyzing everything from drug utilization to claims, medical records, prescriptions, and patient demographics is a monumental task. The lack of data standardization, complex reimbursement models, and the sheer time-consuming nature of analysis and extracting meaningful insights make navigating payer analytics a formidable challenge. It requires sophisticated analytics tools, data integration capabilities, and expertise in data management techniques to unlock the potential within this vast sea of data.
AI-Powered Analytics for Payer & Rebate Teams
An advanced AI-powered analytics platform, is at the forefront of transforming the payer analytics landscape in the pharmaceutical industry. By connecting disparate data sources such as prescriber, patient, market, sales, finance, digital, and third-party data, Tellius empowers payer analytics and rebate teams to make better-informed contracting and reimbursement decisions.
Key Offerings from Tellius for Payer Analytics include:
A Google-like natural language search interface and AutoViz layer for ad hoc exploration
Intuitive point-and-click live dashboarding, reporting, and embedded analytics
Robust automated insights to isolate key drivers, root causes, and anomalies
Accessible advanced analytics, such as AutoML, for HCP targeting
These offerings enable payer analytics teams to self-serve ad hoc analysis, leading to better decision-making and truly data-driven operations, resulting in a substantial competitive advantage.
Driving Positive Patient Outcomes
Payer analytics in the pharmaceutical industry goes beyond cost considerations. It encompasses tracking rebate utilization rates and measuring the performance of reimbursement programs to improve patient access and medication adherence. AI-powered alerts provided by Tellius offer 24/7 visibility into shifts in rebate usage. Trend-based insights provide root causes of high variance, equipping healthcare professionals with the necessary data and insights to intelligently manage costs and negotiate rebates.
Formulary & Plan-Level Performance Management
Analyzing the formulary placement and plan-level performance of a brand compared to competitors provides critical insights for pharmaceutical companies. Tellius automates formulary monitoring and provides proactive alerts, freeing up time, reducing risk, and revealing opportunities. It facilitates the measurement of the impact of patient cost and payer utilization management controls on brand performance, providing invaluable insights for informed decision-making.
Forecasting and Reviews
Cash flow forecasting in the pharmaceutical industry is made intricate due to multiple rebates, TPAs/PBMs, and rebate thresholds adding layers of complexity. Tellius enables payer and rebate analytics teams to resolve larger-than-usual rebate submissions via automated trend-based insights. Moreover, the platform lends itself to no-code rebate and cash flow forecasting based on historical data and analytics. Additionally, it significantly improves detecting disputable rebate dollars for greater profitability compared to traditional manual rebate evaluation approaches.
Customer Success Story
A pharmaceutical company’s managed markets finance team utilized Tellius to automate invoice data processing, enrichment, and monitoring. Through this approach, the team cut down analysis time from three weeks to four days, uncovering $5 million/year in disputable rebate dollars from a single use case. This remarkable success story underscores the transformative potential of AI-powered payer analytics in the pharmaceutical industry.
Why Tellius for Payer Analytics
Its empowers organizations to receive intelligent alerts on shifts in rebate utilization and trend-based insights into areas with the highest variance, enabling the spotting of costly fraudulent cases. The platform enables the creation of interactive views and answers ad hoc questions related to any rebate or payer, driving profitability, improved forecasting, budgeting, and price negotiation. With its scheduled and automatable data blending capabilities, real-time anomaly detection, and forecasting, Tellius stands as a game-changer in the field of payer analytics.
Payer analytics in the pharmaceutical industry represents a new frontier in data-driven healthcare. The emergence of AI-powered analytics, particularly through platforms such as Tellius, is revolutionizing decision-making processes for better-informed contracting and reimbursement in the industry. The transformative potential of AI-powered analytics is not only driving operational and financial efficiencies but also positively impacting patient outcomes, ultimately leading to a smarter, more effective, and patient-centric healthcare ecosystem.
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