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Robert S. Oscar, R.Ph. CEO/president of RxEOB, has more than 25 years of experience in healthcare, having developed and implemented successful programs to effectively manage pharmacy benefit risk, including pioneering work in the Medicare HMO market. In 2
Medication non-adherence is a growing issue for patients, physicians and health plans. Here’s one effective solution.
Medication non-adherence is a growing issue for patients, physicians and health plans. A recent report by the United States Government Accountability Office indicated that in each fiscal year from 2009 through 2011, the most expensive 5% of Medicaid-only enrollees accounted for almost half of the expenditures for all Medicaid-only enrollees. In contrast, the least expensive 50% of Medicaid-only enrollees accounted for less than 8% of the expenditures for enrollees.
Patient nonadherence to prescribed medications is associated with poor therapeutic outcomes, progression of disease, and an estimated burden of billions per year in avoidable direct healthcare costs.
Beyond medication non-adherence for Medicaid enrollees, the total costs to the U.S. healthcare system for non-compliance include a direct cost estimated at $100 billion to $289 billion annually and costs of $2000 per patient in physician visits annually, according to the CDC.
It’s clear that medication adherence needs to be a key area of focus for plans and providers hoping to provide higher-value care. Here’s how offering messaging to patients through their preferred channels of communications can help.
For health plans and providers, understanding the what, when and how of personalized messaging delivery is critical to more compelling engagement with patients.
As indicated in a study noted by the American Heart Association, the potential of text messaging and other mobile-phone based methods (mobile health or mHealth) to engage patients has been met with great enthusiasm because of the relatively low cost, transportability, and widespread use of mobile technologies.
Creating a personalized healthcare messaging program for patients via text messaging, email, portals and other outreach programs should begin with determining and accommodating the patient’s preferred method of communication.
This can be determined through programs that request a response from patients regarding their preferences.
Health plans and providers should consider content for messaging that reflects the language preference of the member, healthcare savings topics that are determined using the patients’ current benefits, and health improvement tips that offer social network site support that are of value to the patient.
Creating a coupon offer for a free screening at a healthcare services location that is close to the patient suggests to the patient that the health plan or provider understands the patient’s interest in convenience, while delivering medication reminders via mobile messaging can be an impetus to adhere to medication guidelines to help raise adherence and lower costs associated with non-compliance.
A University of Chicago Medicine pilot program using text message reminders for diabetes patients has shown success for enhancing patient support and self-care for chronic conditions.
The program showed an average decrease of HbA1c levels from 7.9% to 7.2%, while individuals that had the most poorly controlled HbA1c levels dropped from 10.3% to 8.5% in only six months.
The total cost of care declined $812 per participant, reflecting a savings of $1,332 in inpatient, outpatient and emergency department visits, offset by a $520 increase in drug costs, according to program researchers.
The ability to use a variety of different messaging platforms, including text messaging, email and portals, to reach patients to raise adherence rates and lower non-compliance costs will be critical for health plans and providers.
As health plans continue to see their medical losses climbing higher for their covered patients, they will quickly see that deploying innovations within the areas of mHealth could offer them the best approach for improving patient access to care and quality of care.
Robert S. Oscar, RPh, CEO/President of RxEOB, has more than 25 years of experience in healthcare. RxEOB assists health plans, PBMs and their patients with software applications and services to reduce costs and improve care quality.