Aetna, WorkingRx Share Information To Help Employers Reduce Workers’ Comp Pharmacy Costs
Pharmacy benefit manager and third-party biller provide industry-leading data integration, formulary management of unidentified prescriptions, and cost savings for employers and payers
HARTFORD, Conn., March 8, 2007 — Aetna Workers’ Comp Access® (AWCA) and WorkingRx™ have signed an agreement that gives AWCA pharmacy customers unique cost-saving advantages. Under the agreement AWCA and WorkingRx will share information so that prescriptions for eligible injured workers, especially those who may not yet be enrolled in AWCA’s pharmacy benefit management (PBM) program, can be matched to the program and their corresponding formulary significantly faster — often once the first prescription is processed.
Faster identification of prescriptions results in cost-savings earlier in the system by increasing enrollment and utilization of the PBM program, improving formulary compliance, reducing paper billing, applying AWCA’s contracted pharmacy rates, and eliminating other unnecessary fees.
"This is one of the most ambitious efforts to date to leverage the capabilities of a workers’ compensation PBM and third-party biller to better meet the needs and interests of employers, payers and injured workers," says Pat Scullion, AWCA president. "Often an injured worker may have several prescriptions filled before he or she is enrolled with a PBM. Without a formulary match, the worker is at greater health risk for dangerous drug interactions, and employers and other payers face higher overall medical costs. With this program we can accelerate information sharing among all parties, which can reduce unidentified prescriptions as well as extra expense and hassle from the lack of efficiency in present systems."
The agreement between AWCA and WorkingRx creates an integrated formulary that provides real-time edits — even on most unidentified prescriptions — to help improve compliance. Formulary compliance benefits employers, injured workers and doctors because the worker receives the appropriate prescription for the injury, the pharmacist is alerted to dangerous drug interactions and the worker can avoid out-of-pocket costs if the claim is disputed as not being for the injury. Prescription data can be collected earlier in the process as well, which helps AWCA identify opportunities to improve formulary compliance among physicians.
"This program creates greater collaboration and opportunities for all of our clients — pharmacies, cost-containment companies, PBMs, employers and carriers combined," says Lori Daugherty, president and CEO of WorkingRx, which provides essential financial services to over 22,000 independent and chain pharmacies nationwide.
About Aetna
Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 35.9 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, workers’ compensation networks and medical management capabilities. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans and government-sponsored plans. www.aetna.com
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