With PlexxusAI, FutureRx® Debuts a Groundbreaking Generative AI-Enabled Approach to Help Health Plans Improve Star Ratings, MTM Program Outcomes and Medication Adherence

Posted in Press Releases on Monday, October 23, 2023.

With PlexxusAI, FutureRx® Debuts a Groundbreaking Generative AI-Enabled Approach to Help Health Plans Improve Star Ratings, MTM Program Outcomes and Medication Adherence

The unique solution leverages Generative Artificial Intelligence (AI) and the mobile-based gig economy to help health plans overcome resource shortages, close medication intervention gaps and reduce administrative costs.

TAMPA, Fla. – October 23, 2023 – FutureRx® (FRx) today announced the launch of PlexxusAI, a ground-breaking Generative AI-enabled system that helps elevate medication adherence and ensure comprehensive pharmacy care management – addressing critical compliance pain points that are driving down Star ratings among Medicare Advantage Part D (MAPD) and Medicare Prescription Drug Plans. (PDP) PlexxusAI does this by leveraging the power of Generative AI, speech recognition, and mobile technology along with the scalability of the gig economy and on-demand access to thousands of credentialed providers to close gaps and lower costs without additional resource demands and often without the need for human intervention.

According to the Centers for Medicare and Medicaid Services (CMS), MAPD and PDP plans saw declines in nearly every Part D measure for 2024, including member retention, medication adherence, and MTM program completion for comprehensive medication review (CMR) – critical factors contributing to the drop in the overall Star ratings.

“PlexxusAI brings together the technology tools and human resources capable of reversing those trends, driving up Star ratings and increasing the effectiveness of MTM programs overall. Industry studies show that effective MTM programs realize savings in excess of $3,700 per beneficiary and $250 per member per month,” said Anil Kottoor, CEO, FutureRx. “As the first and only healthcare technology to use the power of Generative AI to close care gaps without human intervention, PlexxusAI protects and improves Star ratings and dramatically increases a health plan’s capacity to reach members while eliminating thousands of wasted resource hours and dollars.”

PlexxusAI leverages Generative AI to intelligently organize information on care and medication adherence gaps, MTM services, and health assessments in an integrated 360-degree view by priority and stakeholder, allowing for targeted engagement. Its human-like interface then initiates thousands of simultaneous calls to members, verifying their identity, conducting the appropriate assessments, and automatically routing the call to the proper workflow queue based on verbal responses and keywords. When human intervention is appropriate, PlexxusAI initiates a warm handoff by intelligently routing the call to the health plan’s internal team or the system may leverage the power of FutureRx’s mobile app to escalate outreach to one of thousands of qualified pharmacists, pharmacy technicians, doctors, nurses, and CSRs to complete the interaction. Once calls are complete, the system properly documents interactions, ensuring full compliance with CMS requirements.

Along with a high-touch, member-centered assessment/intervention experience, PlexxusAI offers an innovative new business model under which FutureRx providers are only paid if they are required to successfully close care gaps with members.

More information on PlexxusAI can be found at https://futurerx.com/frxplexxusai or by contacting FutureRx at  This e-mail address is being protected from spambots. You need JavaScript enabled to view it or online at https://futurerx.com/contactus.

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About FutureRx

FutureRx (FRx) offers a first-of-its-kind healthcare platform for health plans and pharmacy benefits managers (PBMs) that combines technology and access to pre-vetted fully integrated service providers on a single platform. FRx is a cloud-based, modular, user-configurable technology solution that was built from the ground up to meet complex and continuously evolving compliance requirements in today’s Medicare and Medicaid environment. FRx modules, which can be purchased together or individually as needed, currently include Drug Management (DMP), Formulary Management, Rx Prior Authorization, Grievance and Appeals (RD), Complaint Tracking (CTM), Customer Service, Medication Therapy Management (MTM), and PDE Insights. FRx’s PlexxusAI leverages Generative AI, speech recognition, mobile technology, the scalability of the gig economy, and a bench of thousands of credentialed providers to close medication adherence and MTM gaps without additional resource demands. For more information, visit https://futurerx.com/.

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