Since MyMatrixx by Evernorth owns our pharmacy network, our clients benefit from cost savings, network control and clinical insight into claims. Undercutting this system is when a patient fills their prescription at an out-of-network pharmacy. In fact, many industry programs see upwards of 20% of pharmacy transactions fall out of network.
“In group health, if a patient doesn’t use a network pharmacy, they immediately feel the impact because they are paying a higher price for their medication. In workers’ comp., they aren’t paying the bill, so there’s no financial impact to the patient,” states Viviana Brantley, MyMatrixx by Evernorth® (MyMatrixx) Chief Operating Officer. Unless the patient is in a Direction of Care state that allows employers to direct employees to use specific pharmacies, the patient is only concerned with receiving their medication, not where it is filled.
But it’s not just about the money. When a script is filled out of network, we also lose the opportunity to drive real-time patient safety.
In the recent WorkCompWire Partner Post, Brantley and Danielle Hayman, MyMatrixx by Evernorth Operations Director, discuss the ways MyMatrixx works to make sure prescriptions start in network or how we convert them to in network to decrease medications costs and increase a patient’s medication safety.
You’ll learn how we:
- Target patient behavior and make it easy to adhere to the network
- Take action to convert and keep all future scripts in network
- Work to control and eliminate physician dispensing
See how the MyMatrixx Out-of-Network Management solution is comprehensive and different. Our process puts the needs and best interests of our clients and injured workers in the forefront, so they get the most from their pharmacy benefit management.