NPAX for Health Plans
Identify medication-driven risk before it becomes medical cost.
Connect pharmacy and medical intelligence to identify emerging member risk, prioritize actionable interventions, and help prevent avoidable utilization while supporting quality, affordability and member outcomes.
The Cost of Risk You Haven't Identified Yet
49.7%
The highest-spending 5% accounted for about half of total healthcare expenses in AHRQ's 2022 MEPS population.
Source: AHRQ, Medical Expenditure Panel Survey (MEPS), 2022
27.8%
Prescribed medicines represented 27.8% of total healthcare expenditures among the highest-spending 5% of the population.
Source: AHRQ, MEPS, 2022
1.5M+
Emergency department visits annually in the United States are associated with adverse drug events.
Source: Centers for Disease Control and Prevention
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The opportunity isn't simply managing high-cost members. It's identifying clinically actionable risk early enough to change what happens next.
Health Plans Don't Lack Data. They Lack an Early, Actionable Signal.
Pharmacy and medical claims contain valuable indicators of emerging medication-related risks. Unfortunately, those signals are often fragmented across systems, disconnected from clinical context, or identified only after an expensive event has occurred.
NPAX connects these signals to help health plans identify clinically meaningful risk earlier, prioritize members who may benefit from intervention, and support care teams in preventing avoidable utilization.
From retrospective cost analysis to proactive clinical intelligence.
NPAX helps identify opportunities involving:
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Potential adverse drug events and medication interactions
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Drug-condition conflicts and inappropriate therapies
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Therapeutic alternatives and optimization opportunities
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High-risk medication combinations and vulnerable populations
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Emerging medication-driven risks that warrant clinical attention
Rather than generating more alerts, NPAX focuses attention on actionable opportunities that can make a meaningful clinical and financial difference.
From Member Risk Intelligence to Measurable Intervention
NPAX transforms existing healthcare data into prioritized clinical intelligence, helping health plans move from identifying risk to taking action and evaluating results.
IDENTIFY
Detect emerging medication-related risks across pharmacy, medical, and other available clinical data before they contribute to potentially avoidable utilization.
INTERVENE
Equip pharmacists, care managers, and clinical teams with actionable intelligence to support targeted outreach, medication optimization, and appropriate therapeutic interventions.
MEASURE
Evaluate intervention activity, clinical outcomes, utilization patterns, and financial performance to understand the value of prevention.
PRIORITIZE
Apply AI-driven intelligence, clinical rules, and vetted protocols to distinguish meaningful intervention opportunities from analytical noise.
INTEGRATE
Complement existing PBMs, pharmacy teams, care-management platforms, and provider networks through flexible integration and workflow options.
Aligned Economics. Shared Success.
Prevention should create measurable value, not another technology expense.
NPAX offers shared-savings arrangements designed to align financial incentives with verified outcomes.
Rather than requiring a large upfront technology investment, eligible arrangements allow health plans to pursue medication-risk prevention opportunities with economics tied to measurable results.
No large upfront platform investment.
Shared-savings opportunities.
Clinical and financial outcomes measured together.
Commercial terms, implementation requirements, and savings verification methodology are established by agreement.
NPAX Is Here To Help
See What NPAX Could Identify in Your Population
Your existing data may already contain signals of medication-driven risk that traditional claims analysis has not yet transformed into actionable intelligence.
Discover how NPAX can help identify those opportunities, prioritize clinical interventions, and evaluate their potential impact on medical costs, utilization, and member outcomes.