Clinical Programs

Health plans and payers function as a hub of a member’s healthcare journey, and are uniquely positioned to drive value-based care for their members. Success will involve making practical sense of the vast amounts of data that are available on topics such as out-of-pocket spending, adherence, hospitalizations, laboratory results, and more. SS&C Health clinical programs help integrate data and summarize information from key stakeholders – patients, providers, and medical and pharmacy teams so that you can make better, faster decisions that have real impact on drug and medical spend and support more personalized, accessible care for healthier members. We offer an array of clinical programs that support value-based care.

  • Real-Time Benefit – Deliver thorough point-of-care price transparency for members to promote medication adherence, reduced drug spend, and, ultimately, better outcomes. Even better, our solution allows you to validate actual RTB-influenced savings on pharmacy claims so you can make decisions based on substantiated results instead of relying on projections.
  • CMR Supplement – Improve your Star Ratings and reduce drug spend with an effective, easy-to-implement, cost efficient CMR solution that offers one of the highest member engagement rates in the industry.
  • Opioid Management ProgramImprove patient safety by monitoring appropriate use, reducing overuse, and supporting abuse/addiction prevention. Our solution helps prescribers and pharmacy team members make better opioid-related decisions along the total healthcare spectrum through the use of clinical edits and DUR protocols, interventions, and analytics & reporting.
  • RxAdherence – Reduce therapy drop-off for members with eight chronic conditions for which improved adherence to drug treatment is most likely to reduce total cost of care and improve ROI. We do this by helping you determine prescription nonadherence prevalence and intervention opportunities through easy-to-interpret member and disease-level analytics.
  • Utilization Management Programs – Deliver access to effective, appropriate prescription medications at the appropriate price. SS&C Health offers a full suite of utilization management strategies that enhance value for you and your patients, balancing drug spend with appropriate member access to clinically proven medications.

Return to Key Offerings.