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Rx Data Driven Compliance Monitoring: Opioid Prescribing, Dispensing, and Utilization
Fran Grabowski, Digital Risk Solutions Healthcare Director, PwC. Benjamin Wright, Risk Assurance Healthcare Compliance Director, PwC. Sandhi Ton, Manager, Risk Management Analytics, SCAN Health Plan.
January 27, 2020
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Regulators are increasing focus on how plans are responding to the opioid crisis and compliance has a growing role in developing the strategy and controls related to provider prescribing practices, pharmacy dispensing, and member drug utilization
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Incorporating insights gained through the fact-based analysis of trends and outliers is a solid base from which to launch an aggressive attack on the crisis
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Advanced analytics, such as network analysis, can further help plans understand overlap between providers, pharmacies, and members, allowing the identification of unexpected connections and potential bad actors
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