Senior Living Facilities Test The Limits Of Pharmacy Benefits Management

Managing the medical complexities of seniors is not for tyros, as novices are typically challenged to address the challenges of rising costs of medications to treat residents with chronic diseases or high-cost conditions. 

 

This environment requires heavy lifting to balance outcomes with efficiency, proficiency, and expertise in the way medications are accessed, approved, and reimbursed. In these high-needs care settings, organizations face surges in pharmacy claims that have prompted many to rethink their models. Many are shedding outdated processes in favor of technology-driven approaches that deliver real-time visibility, faster processing, and stronger support for both clinical and administrative teams. 

 

Lori Daugherty, CEO, RxLogic, captures the results of RxLogic initiatives to streamline operations, reduce delays, achieve better cost control, and implement more reliable medication access for these vulnerable populations.

 

In a recent edition of McKnight’s Senior Living, Daugherty explains, “RxLogic increasingly serves a fast-growing commercial market for PACE -- Programs of All-Inclusive Care for the Elderly, which are designed to support older adults with high-acuity, medication-heavy needs. In these environments, PBMs, health systems, and other organizations turn to our technology platform and solutions to process claims, responding to the need for timely medication access, transparent pricing and integrated systems to effectively manage the pharmacy benefits needs of these elderly populations.”

 

The article also includes an RxLogic case example focused on hospice and palliative care settings.

 

Nick Opalich, founder and CEO, HospiceChoice Rx, says, “HospiceChoice Rx believes we are legally obligated to act in the best interest of the hospice provider and its patients, managing their finances with care, skill and prudence. We operate with complete transparency, providing hospices with detailed financial reporting that includes the actual costs of drugs, rebates, and discounts. HospiceChoice Rx reports that through its transparent pricing and hospice-friendly pharmacy network, it assisted a medium-size hospice client in achieving a 46% reduction in cost per patient pay, or CPPD, over 2.5 years.”  

 

Building What Matters to Senior Living Operators and Their Residents

 

For senior living operators seeking a more resident-centered approach, RxLogic technology solutions provide real-time data, flexible plan designs, and direct integration with care workflows. Medications are authorized on the spot, reducing administrative burden, preventing unnecessary rework, and improving the resident experience at one of the most critical points of care.

 

Automation and transparency provide additional advantages:

• Prior authorizations can be handled through embedded workflows that reduce paperwork and eliminate back-and-forth delays.
• Transparency is achieved with a clear view into medication costs, contract performance, and rebate flows.
• The experience of caregivers and families is reflected when they can access accurate, easy-to-understand information, including digital tools that allow caregivers to review medication histories, check coverage, and compare costs in real time.

Launch a Strategic Asset

 

RxLogic technology solutions are turning pharmacy benefit management into a high-value asset for senior living leadership teams, providing a lever for improving care, reducing staff burden, and strengthening operational performance.

Read the full article here.