Payer Solutions

Enhance member experience. Improve quality measures. Lower the cost of care.

With Outcomes®, you can leverage the expertise and personal relationships that pharmacists have in their communities, multi-channel capabilities, and technology to support your clinical and quality strategies.

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Future of Pharmacy

Engage the Largest Network of Pharmacists

Your members can access MTM services from a familiar, trusted healthcare provider at one of 68,000 contracted MTM Centers. Outcomes is part of workflow for pharmacies, clinics/health systems and long term care organizations across the U.S. and Puerto Rico.

In addition, our telephonic channel of clinical pharmacists expands service to more members. Payers with internal MTM providers can also leverage our OutcomesOne platform for consistent documentation and reporting across all delivery channels.

Pharmacy Network
Practice Sites
Daily Users

Who We Serve

Outcomes connects more than 48,000 community pharmacies through technology solutions and services. Our network of pharmacies touches more than 70 million patient lives each year, including the patients that your health plan is trying to reach.

  • Medicare
  • Medicaid
  • Marketplace
  • Commerical
  • Self Insured Employers
Self Insured Employers

Improve Plan Performance

of timely refill requests picked up by patients
lower rates of hospitalization and ER visits
of medication-related problems resolved
higher PDC levels and $1.25-$37.00 medical savings spent on medications
up to per patient per month in reduced avoidable health expenditures

Interactive, personal interventions empower members to manage their medications and achieve better health outcomes.

Adherence Interventions

Identify and overcome a member’s unique barriers to adherence with a range of services that address supply management, reduce barriers and increase medication knowledge.

Prescriber Consultations

Close gaps in care, correct suboptimal drug selections and address dosing concerns by engaging pharmacists to connect with the member and prescriber to optimize therapy.

Comprehensive Medication Reviews

Proactively address medication-related problems and increase a member’s understanding of their medications with a one-on-one review of their entire regimen, inclusive of prescriptions and OTC products.

Patient Education Consultations

Provide members with information and encouragement to schedule annual wellness exams, complete important screenings, obtain immunizations and effectively manage their chronic disease.

How We Help

Impact Star Ratings, address HEDIS measures, and reduce member abrasion through a customized solution that works for you. 

Quality Performance

  • CMR
  • Adherence
  • Transition of Care
  • Social Determinants of Health
  • Medication Gap Closure
  • Gaps in Care
  • Condition Management

Population Health

  • Value-Based Pharmacy Programs
  • Immunizations
  • Opioid Safety
  • Gaps in Care
  • Maternal Care
  • Patient Education
  • Condition Management
  • Trend Solutions
  • Specialty Drug Management

Partner with us to improve member health in collaboration with your organization’s goals

Engagement at any scale

Reach more members, serve different populations or tackle diverse goals while maintaining consistent service documentation and centralized reporting across programs.

Network management

Leverage our established relationships with pharmacy organizations and let us manage engagement strategies, contracting, payment processing, training and support of MTM providers.

OutcomesOne platform

Activate our Insight™ clinical engine and Clarity™ predictive modeling to deploy the right services and be confident that PHI is secure in our HITRUST-certified OutcomesOne platform.

Quality rating performance

Impact Medicare Star Ratings, deliver a mandated CMR program, address HEDIS measures and reduce healthcare costs by optimizing regimens, improving adherence and resolving medication therapy problems.

Positive member experience

Reduce abrasion from frequent communications and meet your members where they are by delivering critical healthcare messages and personalized interventions through their community pharmacist.

Industry expertise

Gain a reliable partner with deep industry knowledge and 20+ years experience in delivering successful MTM programs for Medicare, Medicaid and Commercial plans.

Want to discuss what the Outcomes network can do for you?

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