Pharmacy Data Processing

Increasing Cost Of Health Care

HealthChoices Pharmacy Data Processing

Pharmacy data provides a valuable source of information that often goes untapped in HealthChoices behavioral health programs. Provided by physical health managed care organizations (PH-MCOs), pharmacy data files provide behavioral health programs with vital information regarding utilization patterns of prescription drugs and the physical health problems for which they are prescribed. However, the meaningful use of this information presents a variety of challenges, including:

  • Data Quality Problems
  • Drug Identification and Categorization
  • Provider Identification

ACA has developed data processing mechanisms for addressing these challenges and incorporating this information into a variety of monitoring reports and into its standard OLAP HealthChoices reporting tools. Among other things, these tools can provide means of identifying specific at-risk populations as well as the capacity to identify and address problematic patterns of drug dispensation.