Rewarding high-potential plans
NPS rewards high-potential plans with the business intelligence to continuously improve performance and, when opportune, the technical and operational bedrock to sustainably expand membership. A partnership with NPS goes beyond transactions — NPS provides a wealth of knowledge and resources to help you maneuver in the highly-sensitive Medicare environment.
- Private Prescription Plans (PDPs) that offer drug-only coverage
- Medicare Advantage Prescription Drug (MAPD) plans that offer both prescription drug and health coverage
- Special Needs Plans (SNPs)
- Private Fee-For-Service Plans (PFFS)
- Program of All Inclusive Care for the Elderly (PACE)
- Employer Group Waiver Plans (EGWPs)
- Retiree Drug Subsidy (RDS)
An unparalleled ally for federally funded pharmacy benefit programs
By aligning the plan design with robust clinical protocols and reporting strategies, NPS will establish compliance and goodwill with the CMS.
Having long maintained a positive audit record, NPS offers comprehensive support for audit protocols and can serve any role necessary to plan or execute processes. NPS can act as a designated entity, perform routing reporting, and providing access to data feeds necessary to support audit-readiness programs. This includes support for CMS audits of MAPD transactions or processes. NPS also supports periodic risk assessment and mitigation processes.
Numerous NPS clients maintain a five-star rating. NPS has developed a star rating maximization program to assist clients in navigating this five-star quality rating system to benchmark the beneficiary experience within health plans. Partnership with NPS provides stability for a future in which more members will fill more prescriptions than ever.
Flexible plan design, ongoing optimization
NPS clients have the final decision regarding plan design recommendations — the only requirement is that plan designs meet CMS guidelines. After plan implementation, dedicated account management, benefit design, and clinical staff continuously assess plan performance. For instance, the NPS system compares the plan’s pricing to Medicare.gov pricing, and then simulates CMS calculations and provides predictive modeling each month to estimate how the plan would score. Plan teams monitor these measurements and recommend adjustments as needed to ensure optimal downstream results.
As a partner, NPS endeavors to strengthen the pharmaceutical supply chain. From the manufacturer all the way to the member, NPS clients have the visibility to make decisions that consider the entire healthcare continuum rather than a myopic view that can jeopardize longer term outcomes.
Complete Medicare Part D Services
- Star Rating System (SRS) support and the rating maximization program
- Medication Therapy Management (MTM) and personal 1-on-1 outreach
- 24/7/365 beneficiary support operating from NPS headquarters in Omaha, NE
- Reporting and filing information to fulfill CMS guidelines
- Custom formulary development services and compliance assurance
- Network management to support specific communities or regions at a competitive cost-share
Connect with an expert, request a price analysis, or submit an RFP.
National Pharmaceutical Services
PO Box 407
Boys Town, NE 68010
Toll free: (800) 546-5677