IAIABC Member Spotlight

Each month, the IAIABC highlights one of its member organizations, asking about what the organization does; what challenges it sees workers' compensation facing; and why they're involved with the IAIABC. Find past member spotlights here. 

IAIABC: Please provide an organizational overview (number of employees, years in business, vision)

Scott Brener, SVP/General Council, Cadence RX:  With headquarters in Tampa, FL, and 62 employees across the US, Cadence Rx has been providing pharmacy benefit management services nationally since 2019.

Our vision is to transforming workers' compensation pharmacy benefits management (PBM) with innovative technology and advanced medication management solutions. Cadence Rx is not just another PBM…Cadence Rx is the solution that elevates and expands the scope of pharmacy benefit management services available in today’s workers’ compensation market.

IAIABC: How does your organization serve the workers’ compensation industry? 

SB: As an industry-leading peer-to-peer prescription platform, Cadence Rx was created to elevate our clients’ experience within the workers’ compensation market. Our patient-centric technology applies complex clinical and business rules, ensuring optimal medication management. Ultimately, this approach focuses on improving patient experiences and providing better outcomes overall.

IAIABC: What do you see as some of the major challenges the industry is facing, and how can we as a community address them? 

SB: One of the most significant challenges our industry faces relates to disparate and uneven regulatory laws.  The PBM business model is distinctive and varies greatly from a traditional carrier, TPA or other historical entity within the insurance space.  Generally speaking, a PBM neither assumes risk nor collects premium.  Our primary function focuses on providing pharmaceuticals to claimants in an efficient and economical manner while providing clinical analysis ensuring claimant safety from the risks of unsafe drug interaction or any other harmful exposure.  As such, jurisdictions need to better consider the differences associated with a PBM versus that of carriers, TPAs and any other like entity.  Unfortunately, many jurisdictions define a PBM as a carrier or a TPA which is much like forcing a square peg into a round whole—it just doesn’t fit resulting in awkward compliance results.  The IAIABC can assist in this regard as it serves as a neutral forum for broad based regulatory discussion and resolution.  We are not debating the need for regulation-we just want the regulations to better align with the role and structure of the PBM industry. 

IAIABC: Are there any projects/programs/initiatives going on at your organization that you are particularly excited or enthusiastic about?

SB: We have several program innovations here at Cadence Rx that we are excited about. Specifically designed for the workers' compensation pharmacy space, these meaningful programs focus on leveraging technology with a patient-centric approach:

Patient-Centric Platform Design: With a patient-centric design, Cadence Rx's platform places the needs and experience of patients at the forefront. By considering the patient's perspective, our platform improves medication outcomes and overall satisfaction.

Streamlined Authorization User Interface: Cadence Rx has developed a simple authorization user interface to address the challenges encountered by claims staff. Built with Pharmacists' knowledge and insights, this interface ensures that the information displayed facilitates quick and accurate decision-making, while also enhancing navigational efficiency by reducing the need for multiple clicks across different buttons and tabs.

SMART Medication Risk Scoring and Routing: The Cadence Rx risk scoring methodology, SMART (Secure Managed Authorization Routing Technology), enables us to evaluate medications before dispensing. By identifying potential risks and routing medications accordingly, we effectively optimize patient safety and improve outcomes overall.

Improved Analytics and Reporting: Cadence Rx has made significant improvements in analytics and reporting, addressing the issues of inconsistency and timeliness. By enhancing the platform's analytics and reporting capabilities, we provide comprehensive and up-to-date information that support decision-making processes. This enhancement enables better monitoring, analysis, and assessment of medication outcomes.

Management of Out-of-Network Bills: In addition to medication management, Cadence Rx's platform also solves the problem of mismanaged out-of-network bills. Using a single platform to manage medication authorizations and handle out-of-network bills, we ensure compliance with appropriate medication, business, and state regulations. This unified platform streamlines the management of out-of-network bills, reducing errors and inefficiencies.

Our program innovations aim to improve medication outcomes, promote transparency, and optimize the workers' compensation pharmacy experience.

IAIABC: What's an interesting fact about your organization that most people don't know?

SB: Cadence Rx is a certified Woman-owned Business Founded by Industry veteran Artemis Emslie. 

IAIABC: Why is your organization a member of the IAIABC? What would you tell others about the benefits of membership?

SB: With a shared goal of improving outcomes in workers' compensation, aligning with a like-minded organization such as the IAIABC provides a valuable resource to Cadence Rx. Together Cadence Rx’s commitment to improve patient outcomes through proactive management of medications and the IAIABC’s mission to reduce harm and aid recovery from work injuries and illnesses brings reassurance to injured workers during an uncertain time and provides knowledge and insights for informed decisions.

Previous Member Spotlights

2024 Member Spotlights

PERMA -  October 2024
Workplace Safety and Insurance Board (WSIB) - September 2024
American Medical Association (AMA) - August 2024
Association of Workers' Compensation Boards of Canada (AWCBC) - July 2024
American Association of Payers, Administrators, and Networks (AAPAN) - June 2024
The Beacon Mutual - May 2024
Ohio Bureau of Workers' Compensation - April 2024
Arbicare - March 2024
Acuity Insurance - February 2024
Alaska Division of Workers' Compensation - January 2024