Picture of Dr. Emily Peak

Dr. Emily Peak

SVP, Client Strategies

“Our nurses and adjusters love the Cadence portal for its speed, clarity, and ease of use. The ability to quickly see prescription history, authorization status, and clinical notes has streamlined their workflow. On the analytics side, the combination of curated data and ThoughtSpot’s search-driven analytics has been a game-changer. We now have instant visibility into drug trends, prescriber patterns, and outliers at the patient, physician, and dispensing entity level — enabling targeted interventions that we simply couldn’t execute before.”

National Carrier & Trusted Partner, Cadence Rx Client Testimonial
In workers’ compensation, every prescription is more than a transaction; it’s a clinical decision that impacts recovery, claim cost, and return-to-work outcomes. At Cadence Rx, we believe the pill you swallow matters, and we’ve built an entirely new PBM model around that belief, one that puts the injured worker at the center, empowers claims professionals with real-time intelligence, and delivers unprecedented transparency into the data driving outcomes.
For decades, pharmacy benefit management has been a delicate balancing act: controlling costs while supporting recovery. But that balance is harder than ever. Nearly 50% of medications now require prior authorization, claim complexity is rising, and outdated PBM systems still rely on retrospective reporting that is too slow to influence real-time decisions.

Cadence Rx changes that. By embedding predictive analytics, pharmacist-guided insights, and transparent data access directly into the PBM workflow, we transform pharmacy from a reactive process into a proactive, outcome-driven strategy.

From Reactive to Predictive: Changing the PBM Equation

Traditional PBMs look backward, reporting on what already happened. Cadence Rx looks forward.

Our SMART Insights engine continuously analyzes real-time claim data, including drug history, comorbidities, prescriber patterns, and regulatory nuances, to calculate risk scores and identify cases most likely to escalate. This predictive intelligence allows payers and clinical teams to intervene early, well before a case becomes costly or complicated.

That could mean flagging potential opioid misuse, coordinating a taper plan with a prescriber, or alerting claims staff when a prescribing pattern doesn’t align with best practices. It’s actionable insight delivered when and where it’s needed, not months after the fact.

Beyond Cost Containment: Precision Interventions That Improve Outcomes

Cost savings are essential, but predictive analytics unlocks a more powerful value proposition: better clinical outcomes.

By guiding evidence-based interventions, from optimizing drug utilization to preventing polypharmacy, Cadence Rx ensures that every injured worker receives the right medication at the right time with the right oversight. The result is fewer complications, faster functional recovery, and accelerated return-to-work timelines.

And the impact goes beyond individual claims. By proactively managing prescribing behavior and treatment patterns across an entire book of business, our clients consistently see 30–40% program savings beyond the cost of the pill itself, all while improving patient satisfaction and outcomes.

Radical Data Transparency: Empowering Clients with Immediate Access

Predictive analytics only drives value when it’s accessible and actionable. That’s why Cadence Rx delivers something legacy PBMs cannot: complete visibility into every data point that drives program performance.

Our analytics platform offers real-time, self-service access to curated insights, enabling clients to search naturally, filter by key metrics, and drill into trends across medications, utilization, clinical programs, network performance, and more. There’s no waiting on analysts or static monthly reports. Data is live, intuitive, and always within reach.

This level of transparency gives payers and clinical teams the power to:

  1. Spot outliers and emerging risks before they escalate.
  2. Measure program performance in real time.
  3. Tie every decision back to measurable outcomes and ROI.
  4. It’s more than a dashboard — it’s a command center for pharmacy strategy.

The Future of PBM Is Now

In the past, being data-driven was a differentiator. Today, it’s the baseline. The future belongs to PBMs that predict, personalize, and perform, and that’s where Cadence Rx leads.

Our approach combines predictive analytics, pharmacist-guided decision support, patient-centric program design, and unmatched data transparency, creating a PBM model that doesn’t just control costs but reshapes how pharmacy impacts recovery.

Because in workers’ compensation, every pill matters. And with Cadence Rx, every decision does too.