Success Story HEALTHCARE

RX Reimagines Pharmacy Services with Cloud

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This healthcare technology company provides a cloud-based, flexible and advanced analytics platform for pharmacy benefits administration and claims processing.

The platform serves pharmacy benefit managers and provides access to more affordable prescription medications to Americans. The company also delivers low prices directly to consumers on prescription drugs through its programs by directly contracting with large pharmacies such as CVS, Walmart, etc.

The company partners with its pharmacy clients to provide the highest quality prescription healthcare services at the lowest price. Having been in the healthcare and pharmaceutical technology industry for over 20 years, the founding team of this company had experienced first-hand the pain of being tied to antiquated, traditional PBM (Pharmaceutical Benefits Management) legacy systems. The result was long onboarding timelines for clients, complicated plan design changes that required extensive support from IT and development teams, and black-box pricing.

  • health and pharma tech innovation company

    World’s Most Innovative Companies – Fast Company

  • pbm cloud migration benefits

    $3B+ annual managed pharmacy spend program

  • FDA approved

    Delivering savings of up to 80% on nearly all FDA-approved prescription drugs

  • covering 95% of pharmacies in usa

    Covering approximately 95% of pharmacies where US consumers fill prescriptions

enterprise technology partner for the healthcare and pharmaceutical

Founded in 2015, the company wanted to shake up the industry and provide simplified access to lower-cost prescriptions for its pharmacy clients – all in a transparent environment. Doing this would require a secure, efficient, and scalable cloud-based modular enterprise platform based on a modern microservices architecture.

Apexon began its strategic partnership with this company in 2017. This relationship included application development, data engineering, and quality engineering service to help create a simple, efficient platform that has reduced customer onboarding time from 90 days to 30 days. Since then, Apexon has helped the company scale its business by 100% YoY to $3 billion in annual managed pharmacy program spend, without any disruption to its services.

The Customer Journey

2017

2018

2019

2020

2021

2017
  • Manual testing
  • API testing

2018
  • Development partner
  • Front-end development (admin and member portal)
  • Back-end development (member portal)
  • Data engineering partner

2019
  • Strategic tech partnership for development
  • Became sole quality engineering partner
  • Digital services into consulting and product engineering

2020
  • Moved from hybrid/extreme to agile
  • Continuous performance monitoring
  • Product and user experience enhancements

2021
  • Redesigned and rewrote the complete platform using Go, Kubernetes, gRCP, Kafka

the Results

Key Outcomes

Scalable Cloud Architecture

Scalable Cloud
Architecture

Scalable Cloud
Architecture

To support exponential growth

Higher Service Levels

Higher
Service Levels

Higher
Service Levels

Reduced customer onboarding time from 90 days to 30 days

Increased Flexibility & Ease of Use

Increased Flexibility
& Ease of Use

Increased Flexibility
& Ease of Use

Reduced new implementation time from 6 months on legacy systems to between 45-60 days and time-to-change drug formulary configuration from 4-6 weeks to 30 minutes on new platform

Higher Customer Satisfaction

Higher Customer
Satisfaction

Higher Customer
Satisfaction

New claim adjudication engine accelerated claim processing by integrating a solution that was easy to configure, manage and onboard

Faster Cycle Time, reduced costs

Faster Cycle Time,
reduced costs

Faster Cycle Time,
reduced costs

Increased automation, agility and scale; easy access to performance data, reduced regression time from 6 to 2 days, made it possible for client to achieve weekly releases, working to achieve on-demand releases

Our methodology

Apexon works with companies across the digital lifecycle:

Go Digital
Go Digital

Accelerating the delivery of new digital initiatives with confidence

Be digital
Be digital

Creating the infrastructure and foundation to scale digital initiatives

Evolve Digital
Evolve Digital

Leveraging data and analytics to continuously improve digital delivery processes

Launch & Experiment transform the patient experience

Automate & Accelerate transform the patient experience

Be Intelligent & Autonomous transform the patient experience

Launch & Experiment

Enable digital adoption in a quick, and agile mannertransform the patient experience

Apexon has been involved with several of company’s technology initiatives from concept through go-to-market

Apexon blitzscaled to deliver on company’s urgent requirements

Apexon recommended a scalable, cloud-based data warehouse and analytics solution built on AWS and Snowflake including architecture design

Apexon’s Quality Engineering Maturity Model helped company measure up against industry best practices and set up robust QA processes

Automate & Accelerate

Build digital infrastructure and foundation for enterprises to scaledigitization on patient Experience

Apexon developed SingleCare, a native App for Direct-to-Consumer pharmacy savings and is currently developing Admin and Member portals for their PMB platform

Apexon developed and automated company’s data management infrastructure

Apexon automated invoicing and margin calculation using a UI-based portal to manage rules, and implementation

Be Intelligent & Autonomous

Leverage data engineering to make strategic decisions and get digital right every time

Apexon designed an implementation wizard with intuitive UI to streamline pharmacy benefit program set up

Apexon enabled data analytics including reporting within the admin tool providing clients easy access to information related to members, benefits and plan performance

The effort included a web portal providing actionable data, reporting and business analytics for this company’s customers

Intelligent QA services optimized test cases and reduced the number of errors and exceptions

The challenge

to fundamentally change its business model

The company wanted to fundamentally change its business model. This required a new cloud-based enterprise platform solution that could make the company a one-stop, enterprise technology partner for the healthcare and pharmaceutical technology industry.

In other words, a solution that would simplify pharmacy benefit design, management and execution in an infinitely scalable environment.

To achieve this, the company needed a product engineering partner to collaborate with that could deliver on its vision. Specific goals included:

healthcare digital transformation partner

Digital Transformation Building a modern digital platform while easing the transition from its existing legacy-based systems

migration from legacy enterprise environment to cloud

IT Infrastructure Upgrade Supporting new market demands across a range of customers (B2B and consumer)

optimize the financial performance for pbm

Value Generation Enabling customers to optimize the financial performance of their pharmacy benefit plans and help better manage costs

built cloud-based enterprise platform solution

Ease of Implementation & Use Building a flexible, self-service platform for its customer adding transparency for both clients and their employees

it infrastructure upgrade

Higher Service Levels Addressing new and increasing customer requirements

higher service level

Streamlined Operations Making the company more agile and efficient

The Solution

continuously innovate & transform the healthcare technology platform

As company’s dedicated product engineering partner, Apexon provides a variety of services including digital product strategy for blueprinting and MVP, front-end and backend development for enterprise platform, mobile application development, data and cloud engineering services for core infrastructure setup and test automation for quality engineering.

The Apexon team has been working with the company since 2017 to eliminate challenges associated with legacy PBM systems and antiquated business models.

Apexon has worked closely with company’s product and engineering teams to build, scale-up, and continuously innovate and transform the healthcare technology platform and applications. This included the design and development of an implementation “wizard” to further reduce onboarding times from days to hours (this was recommended but not implemented).

One proposed solution was to build a modular architecture that allows the company’s end customers in its network to pick and choose the components they need. This enabled faster client onboarding and simplified configurations for business operations staff. Additionally, the Apexon team helped the company automate many of its manual legacy business processes.

Apexon has also recommended the company integrate to deal with growing data management needs, Apexon has recommended the company integrate a cloud-based data warehouse and data analytics solution built on AWS and Snowflake.

Digital Strategy & Digital Engineering Services

Digital Strategy & Digital Engineering

Apexon has been involved in developing a secure, cloud-based HIPAA compliant platform for the company. The engagement spanned blueprinting through implementation and included agile design and delivery to minimize risk. Apexon also worked with the company to quickly launch new initiatives and validate them through a Minimum Viable Product (MVP) approach in advance of production implementation.

Cloud Migration Services

Cloud Migration

Apexon proposed the migration of the company’s SQL database to AWS Aurora PostgreSQL using AWS migration tools and Cloud Factory methodology for automation. Responsibilities related to this recommendation included project definition, tool selection, execution, mitigation strategy, execution, testing and verification. This project would have enabled the company to lower infrastructure management costs while increasing database performance and resilience.

Data Engineering Services

Data Engineering

Apexon re-imagined the underlying data architecture of the company platform. This included a scalable, cloud-based data warehouse and data analytics solution built on AWS and Snowflake. Apexon also designed and developed PoCs on revised workflows to assess the efficacy of the solution before expanding it across the overall back-end systems. In addition, Apexon helped in the automation of invoicing and margin calculation using a minimalistic UI-based portal to manage rules implementing Matillion Jobs, thus eliminating expensive manual efforts and errors.

Digital Quality Assurance

Digital Quality Assurance

Apexon’s Digital Quality Assurance scope included a Quality Engineering Maturity Model assessment to help the company compare its organization against industry best practices. This enabled it to set up a robust QA process for testing platform APIs, front-end, adjudication, load UI, and performance.