Pharmaceutical Managed Care Rebate Project

Centric automates a complex rebate process.

The Business Need

The Diabetes Care unit of this pharmaceutical firm manages roughly 60 managed care provider contracts that pay the providers rebates when certain contract criteria are met. The process currently requires several employees to manually import and scrub data submitted by providers. Next the submitted file is passed to a third party vendor for additional data validation. Once the data is approved by the vendor the file is entered into a contract-specific Access database. Finally the data is  exported to Excel where the rebate is calculated. This process is time consuming, expensive due to the third party service fees, and does not allow reporting across contracts because the final output resides in individual Excel files.

Centric’s High-Impact Approach

The client partnered with Centric to create a Managed Care Rebate (MCR) project to implement a Contract Management and Rebate Payment system. The implementation relied on a mix of technologies including Microsoft VB.NET and IIS for the Web Portal, SQL Server for the database and Microsoft Reporting Services for Data Analysis and Reporting. When completed the System will Consolidate 60 Access databases from as many data sources and provide business analysis and reporting across contracts.

Key objectives associated with this engagement included:

  • Provide a system that could process multiple input file standard, including the NCPDP file format
  • Provide a set of tools to provide data scrubbing based on contract rules
  • Build a single Data Warehouse for reporting and auditing capability
  • Key activities performed over the course of this engagement included: project management, project requirements and design, database design and implementation, and .NET design, implementation, and testing

Results

The Diabetes Care Unit accomplished several goals with this project:

  • They simplified the rebate process and freed up Contract Consultants and Business Analysts to perform higher value work.
  • By bringing the File processing and Data Scrubbing in-house they were able to save $250,000 on an annual basis paid to Data Niche Associates (DNA) for their data processing services.
  • By switching to SQL Server, the Diabetes Care unit consolidated 60 separate Access Databases and Excel files into a data source that can be Backed Up, Archived, Audited by Governmental Agencies and Reported on across all customers.
  • They developed an important Sales and Contract development tool. By allowing true business and contract analysis, data can now be used by Salespersons in presentations to clients and Contract Consultants can analyze the financial impact of contract options when making contract amendments.