Resident Care Management Market Drivers
The resident care market often faces the challenge of balancing conflicting goals — containing healthcare costs, while maintaining and even improving the health of nursing home residents.
This is especially significant in the new millennium, when the aging of the baby boomers will dramatically increase the demand for a broad array of resident care services. The dynamics of the nursing home facility/pharmacy/resident relationship, in addition to the regulatory restrictions governing the health, safety and well-being of residents, drive this market’s need for efficient pharmacy management.
Resident care facilities — including assisted living and skilled nursing facilities — are seeking integrated systems that offer efficient claims processing and adjudication services, cost-saving clinical opportunities, census management, and business analysis capabilities. One SXC resident care client was searching for a solution to manage administration for its Medicare Part D residents across multiple processing platforms. The client needed a solution to help manage the complexities involved in changing from one payer (Medicaid) to multiple payers (Medicare Part A/Medicare Part D). SXC seamlessly integrated payment methodologies across their IT environment, enabling the customer to better manage its revenue stream and cash flow while improving the quality of care provided to its nursing home residents.
We deliver advanced, practical pharmacy management solutions
SXC has been involved with comprehensive resident care claims processing since 2003 and understands the needs and challenges of this market. In 2008, we processed more than 105 million transactions for our resident care customers.
SXC’s products and services for resident care include:
- RxCLAIM® for Pre- and Post-adjudication
- RxTRACK® for all reporting and tracking capabilities
- RxInterACT™ for therapeutic intervention
- RxEXCHANGE™ for support of e-Prescribing
- RxVIEW™ for real-time access to billing information
- Web Services for Pre-Admission screening and census management.
The application of these solutions allows our resident care clients to monitor and properly bill claims, manage formularies and other contractual obligations, and validate reimbursement with the introduction of true managed care through Medicare Part D. The exceptional flexibility and adaptability of SXC’s solutions make them ideal for the needs of resident care facilities, their pharmacy providers, and their auditors.