Proactive Intelligence

Intelligence

Phase 4/4 · BenchmarkingSample data

Surfaced before anyone asked

· 13 anomalies across the network

University of Michigan Healthcritical

PA turnaround SLA

30 hrs vs <24-hr expectation · 1h ago

Deploy the AI PA pre-fill tool; close the 2-FTE queue gap.

Onvidacritical

Projected GP below baseline

Projected $1.09M GP < $1.133M baseline → fee $0 · 30m ago

Accelerate capture/qualification to clear the baseline before month-end.

Memorial Hermannwarning

Per-drug 340B mix — channel drift

Keytruda 340B share −12 pts MoM (→ GPO/WAC) · 2h ago

Audit purchasing routes — confirm 340B pricing is loaded before margin erodes (>10-pt drift trigger).

Memorial Hermannwarning

Consolidated projection vs budget

Projection $662.9K = 57% of budget pace · 1h ago

Gap is largely pending lines at $0 — confirm go-lives to close it (reviewed at WBR).

Ascensionwarning

Per-drug margin — unloaded pricing

High-volume LDD line at 22% margin (<25%) · 3h ago

Confirm the HRSA 340B ceiling price is loaded in the catalog for this NDC.

University of Michigan Healthwarning

Invoice-lines-reviewed outlier rate

6.2% of lines flagged (>5% trigger) · 5h ago

Prioritize credit attribution on flagged lines — found-by-LRx-only.

Onvidawarning

Bulk-qualification gap

Qualified-by-date vs dispense-date spike +24% · 2h ago

Confirm old dispenses were bulk-qualified this month — adjust the cadence model.

Onvidawarning

Capture rate

48.2% of all-eRx TAM — largest upside · 1d ago

Target the top 6 oncologists; every captured eligible script recovers 340B margin.

Memorial Hermanninfo

MTM billable line

Data pipeline pending activation · 1d ago

Stand up the MTM data feed to unlock the planned MTM revenue line.

Ascensioninfo

340B optimization capture

+6% eligible volume captured vs trailing 3-mo · 1d ago

Sustain capture — every eligible script is realized 340B savings.

University of Michigan Healthinfo

Price-parity credits

$48K recoverable identified this cycle · 1d ago

Rebill on Michigan’s behalf — 19.5% of recovered credit accrues.

Providenceinfo

Revlimid / Lenalidomide packages

Same-month signal tracking to projection · 8h ago

Packages are the tightest predictor — projection on track, no action.

Providenceinfo

Per-drug margin

Brand Revlimid GP/pkg ≈ $20.5K, stable · 1d ago

No action — monitor channel mix for 340B→GPO/WAC drift.

Client:

Revenue Forecast — 3-Month Projection

Actual Projection Confidence band

Predictive Risk Scores

Patient discontinuation

72%

Driver: PA delays + staffing gap

Capture-rate freefall

78%

Driver: Prescriber leakage, top 6 oncologists

Adherence collapse

64%

Driver: No refill-reminder program

Prediction Funnel — leading indicators

TAM: All eRx (not drug-limited) · Lag to billed: 3–6 mo, decaying (~50% mo 1, ~20% mo 2)

eRx (TAM)

12.4K

$9.2M

48%

Captured

6.0K

$4.4M

70%

Qualified (340B)

4.2K

$3.6M

78%

Packages

3.2K

$3.1M

92%

Invoiced

3.0K

$2.9M

Tightness ladder: capture → qualified → packages → invoiced. Packages are the tightest predictor of billed revenue.

Per-Drug Economics — signature cut

Ranked by gross profit. COGS uses the corrected basis (wholesaler price, channel-matched) — not the TPA invoice price. Flagged rows breach a §13 trigger.

Drug	Rx	Revenue	COGS	Gross profit	Margin %	% 340B	Drift
Keytruda (pembrolizumab)	140	$1.7M	$560K	$1.2M	67.4%	58%	-8pp
Trikafta (elexacaftor/tezacaftor/ivacaftor)	60	$1.6M	$540K	$1.1M	66.0%	76%	-2pp
Venclexta (venetoclax)	110	$1.3M	$470K	$870K	64.9%	70%	-5pp
Enbrel (etanercept)	95	$720K	$560K	$160K	22.2%	38%	-11pp

Enbrel (etanercept): 22% margin · 38% 340B · -11pp drift — 340B pricing likely not loaded or the channel has drifted to GPO/WAC. Re-route purchasing and confirm the 340B ceiling price is loaded.