Overview
MedMetrics Health Partners Products & Services
MedMetrics is a full-service pharmacy benefits manager providing all of the services that traditional PBMs provide – and more.
Services:
Clinical Programs — Our extensive line of clinical programs truly distinguishes MedMetrics as a company focused on excellence. We continually develop evidence-based clinical programs that help members obtain and use the right medication in the right dosage, while avoiding unnecessary costs. See Clinical Programs for a complete description of the programs we now offer.
Client Account Management — Attentive and consultative account management is central to our success and yours. Account managers meet regularly with clients, in person or by conference call, to ensure that we meet your requirements and address your concerns in a timely and professional manner.
Reporting and Analytics — MedMetrics provides every client with customized reports to meet unique needs for program monitoring and evaluation. MedMetrics also offers a full line of cost and utilization reports about each clinical program we provide. See Reporting and Analytics
Benefits Administration — Our benefits design and administration team ensures our claims processing system is programmed to reflect your unique benefits structure. We can easily make exceptions and benefit changes as needed to meet your changing needs.
Retail Pharmacy Services — For maximum convenience, MedMetrics members can obtain retail services from a robust and extensive nationwide pharmacy network consisting of national chains and many independent pharmacies. MedMetrics is also able to offer 90-day-at-retail options for clients, and applies an objective Maximum Allowable Cost (MAC) program that reduces client costs for generic medications. See MAC Programs for description of MedMetrics MAC program.
Rebate and Pharmaceutical Relations Services — MedMetrics negotiates drug rebate or discount contracts with pharmaceutical manufacturers that are based upon development of an evidence-based formulary, sound pharmacy benefit management controls, and current drug utilization patterns. MedMetrics fully embraces the philosophy that financial transparency and alignment are the foundations for sound, data-driven decision making. This philosophy drives MedMetrics’ affinity to provide open access to accurate information, including full disclosure of manufacturer drug discount contracts and terms, supporting documentation explaining discount revenue sources and calculation methodologies, and 100 percent pass-through of all discounts.
MedMetrics utilizes a state-of-the-art web-based drug discount management system that provides fast and accurate discount calculation, electronic manufacturer invoice submissions, on-line discount and net-cost reporting and a unique prospective modeling software tool to determine the net-cost impact from changes in price, drug discounts, formulary status or drug utilization patterns.
Mail Service and Specialty Programs — MedMetrics also provides clients with a fully integrated mail and specialty pharmacy program option. Mail services programs offer a 90-day supply of medication and apply MedMetrics aggressive maximum allowable cost (MAC) to the pricing of generic medications. MedMetrics Specialty Program provides payors with significant savings on those products that are extraordinarily costly or require unique preparation, handling, or administration.
Member Services — Member service calls are answered by experienced technicians and routed to pharmacists if needed, ensuring that our members have immediate access to knowledgeable staff right from the start.
Products:
Full-Service PBM Programs — MedMetrics provides one-stop shopping for pharmacy benefits management. As a full service PBM, we can provide comprehensive packages of PBM services that are either standard or customized to meet your unique needs.
Clinical Carve-Out and Support Services — MedMetrics can provide you with comprehensive clinical support services to either augment your own internal pharmacy management capabilities or enhance the performance of your existing PBM. See Carve Out Programs
Medicare Part D — MedMetrics offers a continuum of Medicare Part D support services including RDS (subsidy support), wrap programs and services, or backroom MA-PD or PDP functionality.
