公开(公告)号：US10657480B1

公开(公告)日：2020-05-19

申请号：US15669741

申请日：2017-08-04

Applicant: Express Scripts Strategic Development, Inc.

Inventor： Dhanur S. Balagere ,  David A. Tomala ,  Robert F. Nease ,  Reethi N. Iyengar

IPC: G06Q10/06 ,  G06Q50/22 ,  G06F19/00 ,  G16H40/20

Abstract: Methods and systems for pharmacy modeling are described. The risk adjusted pharmacy predictive model is created from member data, claims data, and population data. This model can be used to compare the actual pharmacy performance to an expected actual pharmacy performance value, which can be used to identify pharmacies at risk or not performing to an acceptable level. The model can be used for adherence and generic drug utilization ratings of pharmacies. The pharmacy can be judged on a therapy class by therapy class basis with factors that reflect the demographic, socio-economic, location, benefits attributes, etc. that actually affect the performance of the pharmacy and may assist in determining the quality of care by a pharmacy.