Abstract: A system and method of distributing pharmaceutical prescriptions within a network of pharmacies based on the review of prescription claim data and patient medical state to enable stratification of patients, wherein each pharmacy within the network has been established to handle one or more particular patient medical states.

Abstract: A system and method of distributing pharmaceutical prescriptions within a network of pharmacies based on the review of prescription claim data and patient medical state to enable stratification of patients, wherein each pharmacy within the network has been established to handle one or more particular patient medical states.

Abstract: A computer system architecture and process transforms the organizing principles of business data management seen in traditional or common place settings across disparate data stores into an object-semantic model. The transformation is implemented in a transitory, managed risk implementation approach for data access migration. This approach will enable data agility and will move data storage closer to information storage, while supporting the rapid development of business capabilities. This approach will bridge the gaps between relational database/file based storage (less expressive) and object-semantic representation (more expressive). This process/method will connect information residing in legacy data structures such as relational database/file based storage on disk drives to instances populating an expressive object-semantic model in persistent grid based memory.

Abstract: A system and method of distributing pharmaceutical prescriptions within a network of pharmacies based on the review of prescription claim data and patient medical state to enable stratification of patients, wherein each pharmacy within the network has been established to handle one or more particular patient medical states.

Abstract: Systems and methods for analyzing spend and/or trend for a prescription drug plan may be provided. In response to receiving a request to analyze spend and/or trend, a prescription drug spend and/or trend application may retrieve data related to the prescription drug plan from a database. The data may include drug claims data related to the prescription drug plan. The results of the analysis may be provided to a user computing device for display. In connection with the spend and/or trend analysis, a profile may be created for a prescription drug plan using data from at least one data source. The creation of a profile for a prescription drug plan may include the selection of a performance metric for a parameter of the prescription drug plan. If the performance metric deviates from plan data, a performance alert may be provided to the user computing device indicating this deviation.

Abstract: Systems and methods for determining options for reducing spend and/or trend for a prescription drug plan are provided. Based on an analysis of spend and/or trend for the prescription drug plan, a prescription drug spend and/or trend application may determine that an option is available to reduce spend and/or trend. For example, an option may be provided that addresses a primary component of spend and/or trend as determined by the spend and trend application. In another example, an option may be provided that addresses a deviation by the prescription drug plan from a selected performance metric. In yet another example, an option may be provided that addresses a status change for a drug in a marketplace. The spend and/or trend application may optionally project an impact of an option on the prescription drug plan (e.g., financial impact, member impact) using a related model.

Abstract: A system and method of distributing pharmaceutical prescriptions within a network of pharmacies based on the review of prescription claim data and patient medical state to enable stratification of patients, wherein each pharmacy within the network has been established to handle one or more particular patient medical states.

Abstract: Systems and methods for simulating a change to a prescription drug plan may be provided. In response to receiving a request to simulate the change to the prescription drug plan, a prescription drug spend and/or trend application may retrieve data related to the prescription drug plan from a database. A model that includes a plurality of calculations to simulate the change may be applied to the retrieved data A user computing device may be provided with an indication of an impact on the prescription drug plan responsive to the at least one change based at least in part on the application of the model to the retrieved data. The modeling of the change may be related, for example, to an option to reduce spend and/or trend as determined by the spend and/or trend application.

Abstract: Systems and methods for simulating a change to a prescription drug plan may be provided. In response to receiving a request to simulate the change to the prescription drug plan, a prescription drug spend and/or trend application may retrieve data related to the prescription drug plan from a database. A model that includes a plurality of calculations to simulate the change may be applied to the retrieved data A user computing device may be provided with an indication of an impact on the prescription drug plan responsive to the at least one change based at least in part on the application of the model to the retrieved data. The modeling of the change may be related, for example, to an option to reduce spend and/or trend as determined by the spend and/or trend application.

Abstract: A computer system architecture and process transforms the organizing principles of business data management seen in traditional or common place settings across disparate data stores into an object-semantic model. The transformation is implemented in a transitory, managed risk implementation approach for data access migration. This approach will enable data agility and will move data storage closer to information storage, while supporting the rapid development of business capabilities. This approach will bridge the gaps between relational database/file based storage (less expressive) and object-semantic representation (more expressive). This process/method will connect information residing in legacy data structures such as relational database/file based storage on disk drives to instances populating an expressive object-semantic model in persistent grid based memory.

Abstract: Systems and methods for determining options for reducing spend and/or trend for a prescription drug plan are provided. Based on an analysis of spend and/or trend for the prescription drug plan, a prescription drug spend and/or trend application may determine that an option is available to reduce spend and/or trend. For example, an option may be provided that addresses a primary component of spend and/or trend as determined by the spend and trend application. In another example, an option may be provided that addresses a deviation by the prescription drug plan from a selected performance metric. In yet another example, an option may be provided that addresses a status change for a drug in a marketplace. The spend and/or trend application may optionally project an impact of an option on the prescription drug plan (e.g., financial impact, member impact) using a related model.

Abstract: Systems and methods for determining an impact on spend and/or trend for a prescription drug plan are provided. In response to receiving the request to analyze spend and/or trend, a prescription drug spend and/or trend application may retrieve data related to the prescription drug plan from a database. The analysis of spend and/or trend includes a determination of components of spend and/or trend having a significant impact on spend and/or trend. In one example, the spend and/or trend application may determine whether an option is available to improve at least one of the components having the significant impact on spend and/or trend. If an option is available, the impact (e.g., financial impact, member impact) of the implementation of the option on the prescription drug plan may be modeled by the spend and/or trend application.

Abstract: A system and method of distributing pharmaceutical prescriptions within a network of pharmacies based on the review of prescription claim data and patient medical state to enable stratification of patients, wherein each pharmacy within the network has been established to handle one or more particular patient medical states.

Abstract: A system and method of distributing pharmaceutical prescriptions within a network of pharmacies based on the review of prescription claim data and patient medical state to enable stratification of patients, wherein each pharmacy within the network has been established to handle one or more particular patient medical states.

Abstract: A system and method of distributing pharmaceutical prescriptions within a network of pharmacies based review of prescription claim data and patient medical state to enable stratification of patients, wherein each pharmacy within the network has been established to handle one or more particular patient medical states.

Abstract: A method, apparatus, and article of manufacture for performing data mining applications in a relational database management system. At least one analytic algorithm (110) is performed by a computer directly against a relational database (116), wherein the analytic algorithm includes SQL statements performed by the relational database management system (114) and optional programmatic iteration, and the analytic algorithm creates at least one analytic model within an analytic logical data model from data residing in the relational database.

Abstract: A method, apparatus, and article of manufacture for performing data mining applications in a relational database management system. An analytic algorithm for association is performed by the relational database management system to measure one or more associations between a plurality of items in a stream of transaction data stored in the relational database, wherein the analytic algorithm for association creates at least one analytic model within an analytic logical data model from data residing in the relational database.