10 Nov ProTPL Return on Investment Case Study
In the previous post, I discussed how ProTPL uses Rx claims to “trigger” cost avoidance, not only for pharmacy claims, but for medical claims as well. In the case study that started in 2012, we see how this is put into practice.
There are two key insights that this case study brings to light. The first insight is that while OHI might be discovered in a given year (in this case, 2012), cost avoidance savings can be realized as far as three years beyond the initial discovery of OHI. The second insight that is worth mentioning is the significant medical claims cost avoidance savings that can be garnered when the OHI discovery process is triggered by an individual Rx claim.