Milligram Health

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All outcomes
Operational Decision SystemMargin & Reimbursement Recovery

Community Pharmacy Operations

A daily decision system for margin, 340B, and workflow

Executive Summary

Community pharmacy operators had the data — dispensing, claims, purchasing, 340B — but the decisions still lived in reports and experienced people's heads. We built the system that connects that data and converts it into a prioritized daily queue of actions with expected economic impact, assigned ownership, and outcome tracking. It became Phios, the first Milligram decision system delivered as a repeatable product.

Timeline
Live and ongoing
Scope
Community pharmacy operations — retail reimbursement, 340B, purchasing, and workflow
Decision Type
Operational
Technology
Phios operating queuePHRET pharmacy data platformPMS, wholesaler & claims integrations
The Problem

What problem existed

Pharmacy operations were losing margin they couldn't see — across retail reimbursement, 340B capture, and purchasing — because the data to find it sat in systems nobody had time to connect, and the knowledge of what to do about it lived with a few experienced people.

The Context

Why it was difficult

The pharmacies had software and reports in abundance. What they lacked was prioritization — of everything the data could surface, what deserves action today, who should act, and how would anyone know it worked? Every location handled the same situations differently, and high-value opportunities expired quietly while staff worked whatever was in front of them.

The Decision

What had to be decided

Which reimbursement, purchasing, 340B, and workflow opportunities deserve action each day — and who should act on each one? The system had to answer that question continuously, not in a monthly report.

The Approach

What we made possible

We connected the fragmented data — dispensing, claims, purchasing, 340B — and converted it into a prioritized operating queue with clear opportunity logic, expected economic impact, assigned ownership, and action tracking through to the measured result. The queue lives where the team already works; nothing new to interpret.

The Architecture

What we built

Built as Phios on the PHRET pharmacy data platform, with models tuned to pharmacy economics. Each opportunity carries its reasoning and dollar impact; actions are routed, tracked to completion, and measured — so the system learns which interventions actually pay.

The Outcome

The business result

In live deployments, the system surfaces and recovers material margin monthly: $2,000+ in recovered reimbursement margin per month for a ~3,000-patient pharmacy, $10,000+ in missed 340B profit identified monthly, and roughly 40 staff hours returned each month. Representative results — outcomes vary by pharmacy profile, payer mix, staffing, and available data.

What Continued

What remained after the engagement

The system runs daily and keeps improving — every opportunity worked teaches it which actions pay. It became Phios, the repeatable product now available to community and multi-site pharmacy operators.

From the Partner

"The tool is easy to navigate and gives me the information I need to quickly realize profit."

— Pharmacy owner & operator

Results Delivered

What we achieved

$2k+ recovered reimbursement margin per month (~3,000-patient pharmacy)
$10k+ missed 340B profit identified monthly
~40 staff hours returned per month
Opportunities routed, tracked, and measured through to the result
Became Phios — the repeatable product for pharmacy operators
Lessons Learned

The gap in pharmacy operations was never information — it was prioritization, ownership, and follow-through. A decision embedded in the daily workflow, with a name attached and a result measured, behaves completely differently from the same decision sitting in a report.

Results shown are representative of live deployments and vary by pharmacy profile, payer mix, staffing, and available data. Client identities are confidential.

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