Integrated Prescription Solutions (IPS) is a Pharmacy Benefit Management (PBM) and Ancillary Services partner to W/C and Auto (PIP) Insurance carriers, Self Insured Employers, and Third Party Administrators who specialize in Workers Compensation benefits management.
IPS has a comprehensive suite of PBM services structured to provide the highest quality prescription health services at cost containment prices while streamlining and simplifying the claims management process for adjusters. IPS also provides ancillary healthcare services to injured workers and policyholders in need of durable medical equipment and supplies, home healthcare, home therapy including physical, occupational, and speech, and transportation and language services through a single touch point.
Overview of the Workers’ Compensation Market
Workers’ compensation is a form of insurance that provides compensation medical care for employees who are injured in the course of employment, in exchange for mandatory relinquishment of the employee's right to sue his or her employer for the tort of negligence.
Over the past decade, workers’ compensation medical costs have steadily increased and now represent over half of total insurance carrier losses. Although claims volume has decreased, severity has increased, resulting in the need to balance quality of care for injured workers with cost containment benefits to stakeholders. The chart and accompanying figures below show total medical spending for workers’ compensation claims by category in 2008.
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Hospitals & Physicians: $18.4 billion
Physical Medicine: $8.8 billion
Pharmacy: $6.0 billion
Diagnostic Services: $3.2 billion
DME/Home Healthcare: $3.2 billion
Cost Containment (UR): $1.8 billion |
Integrated Prescription Solutions, Inc. provides innovative solutions that reduce the cost of prescription drugs and ancillary healthcare products and services to our clients through a seamless, fully integrated workers’ compensation medical management system.
Overview of the Auto Market
Personal Injury Protection (“PIP”) is also known as “Medical Payment Insurance” or “Med Pay.” PIP compensates policy holders for accidental bodily injury by providing payment for related medical and hospital expenses, pharmacy and ancillary healthcare products, child care expenses, loss of services and funeral expenses.
We believe Integrated Prescription Solutions, Inc. is leading the way in bringing successful PBM services to the PIP automobile insurance marketplace. The Company currently does business with Mercury Insurance, One Beacon Auto, Nationwide Auto, and GMAC Auto. We believe that the Company’s unique abilities to reverse third-party bills and to improve overall prescription capture rates above 90 percent provide the Company with significant advantages in this market space, since virtually all bills are third-party bills.
The PIP automobile insurance market is not viable in every state, since some states mandate policy limits as low as $2,000. However, Michigan, Florida, and other states permit generous policy limits that cover pharmacy-related costs. Therefore, we expect the Company’s cost containment PBM services and third-party bill management solutions to drive real bottom-line savings for the Company’s clients in this market. In summary:
- We capture third-party bills and direct pharmacy bills in the discount program over 90 percent of the time.
- We eliminate out-of-pocket expenses for policyholders, resulting in higher program utilization and optimized outcomes.
- We provide an easy-to-use pharmacy program for adjusters, eliminating multiple touch-points and improving access to clinical specialists.
All services are available nationwide.
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