The EncompaaS contract cognition service

Rebate management is one of the most important and strategic business issues that pharmaceutical companies deal with on an everyday basis. It impacts market share, brand reputation and profitability. Rebate management is a business process that intersects every aspect of the pharmaceutical business, from manufacturer to provider to payer and, of course, consumers of pharmacology itself.

Based on 2020 prescription drug spending in the US of $348 billion, rebates touch around 25 percent of that total. In addition to revenue, rebate management also poses significant compliance challenges. Drug price and cost reporting requirements have changed, with new mandates and brand-impacting compliance actions. While rebates have safe harbor protection from the Federal Trade Commission, there are significant compliance and reporting challenges emanating from providing sufficient information on accounting policies, judgements, and estimates. The FTC has announced ramp up of enforcement against “illegal” rebate schemes and payoffs that block availability to lower cost prescription drugs.

The core business issue is, at scale, how does a pharmaceutical company sift through literally tens of thousands of contracts and identify clauses, conditions and requirements to maximize revenue, protect brand reputation and reduce potentially expensive compliance risk?

Whether you consider rebate management as a compliance issue, revenue management project or both, the common rebate management thread is the need for connecting the dots between contracted terms and conditions to actual performance and reporting. There are two key elements to rebate management served by automation: the business process used by the life science company or third-party outsourcing partner AND the analytics and reporting that need to be driven from contracts and supporting documents to assess internal performance with legal requirements. 

The EncompaaS Contract Cognition Service for Rebate Management provides manufacturers and their process outsourcing partners an advanced and sophisticated analytics/reporting platform to discover, manage and use data from the thousands of contracts used to define and govern business relationships between the manufacturer and the payer (private carriers or government agencies – Medicare and Medicaid). The end result is performance at scale in a timely manner with accuracy not achievable from manual human driven process.

The EncompaaS Contract Cognition Service connects the dots between contract language – terms, conditions, warranties, and addendum – and the actual performance of the business. Providing discovery, analytics and reporting capability, extracting, and relating terms and conditions of contracted pricing directly with communication, and other exhibits supporting the rebate management result. 

Using power AI-driven discovery and extraction engine, EncompaaS can identify terms and conditions that outline financial value and can calculate those values for comparison against rebate performance and tracking. It transforms contracts into highly visual infographics to easily understand performance status, as well as providing reports with complete drill-down functionality.

The EncompaaS Contract Cognition solution is SaaS-based, resides in your organization’s Azure cloud for security and data protection and can integrate to multiple repositories and locations where contract and related information is stored. In addition, EncompaaS can also capture other communications – emails, Teams conversations and business process management tools – to provide a contextual and federated management view for your organization and third parties contracted to support your program. 

The EncompaaS solution can identify, extract and report on every element of your rebate program, including, but not limited to: Live Rebates, Rebate Start Date, Rebate End Date, Fees, Incremental rebates, payment schedules, payment timing schedules, fraud and incorrect billing clauses, compliance and review clauses.

Advanced data extraction identifies any range of terms and concepts related to a rebate management program in contracts, other complex documents, Office Documents, PDFs, TIFFs and video and voice and contextually relate them to reporting, RPA and manual business processes for enhanced content intelligence, compliance reporting and re-use of the information for business planning and analytic purposes.

EncompaaS AI services provides visual dashboards to identify ‘core’ positions and the extent of deviations or departures from preferred clause positions. EncompaaS locates contracts, classifies, and operates AI extraction automatically, including:

• classifying contracts by type.
• analysing and comparing entire contracts, clauses, and fallback positions.
• operating across agreements on corporate templates (also called on brand/on template), as well as externally drafted agreements (also called off brand/off templates).
• suggesting fallback positions based on your playbook or fallback grid, as well as positions based on pre-existing arrangements with a party.
• extracting content through text and table cognition; and
• publishing data insights to other systems (i.e., Contract Management System).

The bottom line for Pharmaceutical Manufacturers is that revenue, brand reputation and compliance reporting derived from contracts is no longer a “manual activity.” The scale, time demands, and accuracy requirements command sophisticated AI-driven tools that connect the dots between agreement and business performance. The EncompaaS Contract Cognition Service for Rebate Management is a business imperative for lowering operational costs, enhancing revenue management, and lowering the risk of compliance reporting.