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Patient Risk Scores: Finding Patients That Payers Want You to Work With


Caitlin Sattler - April 13, 2016 - 0 comments

Shreveport, LA – PioneerRx has partnered with Community Care of North Carolina (CCNC) to bring its customers a groundbreaking benefit for independent pharmacies. Today, pharmacists can access Patient Risk Scores, a new feature based on CCNC’s careTRIAGE™.

At the core of its population management services strategy, CCNC’s careTRIAGE™ system is centered on targeted interventions that have consistently resulted in reduced costs and hospitalizations and better patient outcomes across multiple systems of care. PioneerRx has licensed a similar algorithm to apply the same methods for patient ratings within the pharmacy system.

PioneerRx pharmacies can identify and score patients’ risk of hospitalization over a 30-day/12-month history, including the likelihood of drug therapy problems. The Patient Risk Scores feature is prominent throughout PioneerRx’s comprehensive workflow. MTM alerts are automatically generated for high risk patients and direct pharmacists to conduct interventions that may lead to improved patient outcomes. Patients do not need to worry about exposing identifiable information or potential HIPAA violations; only an encrypted patient ID and a list of medications are sent to the algorithm to calculate the risk score.

Troy Trygstad, Vice President of Pharmacy Programs at Community Care of North Carolina, expresses his anticipation of this new module.  “CCNC has a nearly two decades’ history of integrating analytics and care processes between locally-based providers of all types,” he says. “PioneerRx represents our first real-time analytics integration with Community Pharmacies. I’m excited to see that more than 2,000 pharmacies are now able participate fully in the same population management strategies that have been have been the hallmark of our own success.”

PioneerRx’s Managing Director, Jeff Key, sees this as the beginning of changing the face of healthcare in favor of independent pharmacists. He adds, “The Patient Risk Score will allow pharmacies to prove their value to payers by providing additional care to the patients most at risk of serious health consequences.”

Don’t miss out on this exciting opportunity to change the future of healthcare. Contact your account manager for more information on how to use Patient Risk Scores to benefit your patients and your pharmacy.

About PioneerRx

Developed with the experience of over 35 years of pharmacy software development and support, PioneerRx was built from scratch to provide the pharmacy community with a solution that can grow as the industry changes for the next 35 years.  PioneerRx delivers weekly improvements and cutting edge features that are designed to provide speed, simplicity, consistency and flexibility, however, their ultimate goal of development is to help pharmacies make more money. Leading the industry in first to market functionality in one seamlessly integrated package, PioneerRx Pharmacy Software has become one of the most successful and frequently talked about pharmacy systems in the United States.

About Community Care of North Carolina

CCNC’s family of companies includes parent company CCNC, Inc. and its wholly owned subsidiary, North Carolina Community Care Networks, Inc., which is a community-based, public-private partnership that creates “medical homes” in all 100 counties for North Carolina Medicaid recipients. The CCNC family of companies is dedicated to innovative approaches to population management that improve health and reduce costs, particularly for vulnerable populations. To learn how CCNC improves quality and saves millions of dollars every year, visit www.communitycarenc.org.