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Health plans and PBMs that are reluctant to invest in mobile tools for their covered members will miss out.
As healthcare organizations and the consumers that they serve seek best practices for personalized communication programs to achieve better health, one challenging area is the difference between the number of medications prescribed by medical practitioners and the subsequent fulfillment rates for those prescriptions by their patients.
For patients, deciding not to pick up and pay for a prescription can often be attributed to potential cost concerns, concerns about drug side-effects, or even doubts about if the medication will actually work.
A study by the American College of Preventive Medicine noted that for every 100 prescriptions written, 50 to 70 are actually picked up and paid for at the pharmacy, 25 to 30 are taken properly, and only 15 to 20 are refilled as prescribed. The same study also noted that while overall satisfaction of care is not typically a factor in medication adherence, the level of adherence does drop when there are long lapses between appointments or communication with their healthcare professional.
An additional barrier for consumers related to prescription adherence can be restrictions placed on medications by healthcare plans. Surveys indicate that upwards of 40% of patients who receive a prior authorization request for the prescribed medication are likely to neglect treatment altogether, which often can lead to a decrease in the patients’ long term health prognosis and additional financial burdens.
Healthcare organizations that provide more streamlined medication prior authorization support, personalized mobile pharmacy benefit applications and patient portals, can improve their rates of overall prescription adherence.
Integrated messaging platforms that access a member’s preferred communication channel-be it texting, email, print or phone call reminders-are most likely to improve prescription adherence rates, which in turn lowers costs for the patient, the patient’s employer and the health plan and government payers (Medicare/Medicaid) who might ultimately be at risk for the total cost of patient care.
Benefits of mobile and messaging applications include:
As patients access their mobile applications and receive personalized messaging from their health plans or PBMs, they can be involved in managing their own healthcare, which is becoming more important as their health plan deductible are increasing.
Patients are consumers of myriad retail mobile applications that continually strive to enhance the consumer experience and demonstrate value to the consumer.
Health plans and PBMs that are reluctant to invest in technologies that are equally compelling for their covered members will most likely not achieve better patient satisfaction scores, improved care quality ratings, and reductions in their overall costs of care.
As patients, consumers, healthcare providers and payers work together to find solutions to reduce the increasing costs of medical and pharmacy costs, the use of personalized communication and mobile application platforms will most likely improve medication adherence and better pharmacy benefit utilization, thereby helping the healthcare delivery system in the United States to save billions of dollars each year.
Robert S. Oscar, RPh, 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.