Payors
Today, with the debate in Washington over national healthcare reform taking center stage, more than one half of all Americans live with at least one chronic condition. This percentage is expected to rise considerably in coming years as our population ages and health risks such as obesity continue to rise. It has never been more critical for employers, insurers, government agencies and managed care organizations to eliminate wasteful spending without reducing the quality of care.
Cost of Non-Adherence
Poor medication adherence is increasingly recognized as a significant source of waste in the U.S. healthcare system. It is estimated that the overall cost of poor adherence, measured in otherwise avoidable medical spending, is as much as $290 billion per year or 13% of total healthcare expenditures. To put this into context: for a typical midsized employer with $10 million in claims, poor adherence may generate avoidable healthcare spending of over $1 million.
Pharmacy Care Increases Adherence
New initiatives to promote medication adherence have increased as chronic disease management has become a national priority. Improved adherence is a goal of the 2003 Medicare Modernization Act that created the Medicare Part D drug benefit. Medication Therapy Management (MTM) services, in which pharmacists identify, solve, and prevent drug related problems, are becoming more widely recognized and practiced. There is overwhelming evidence of the value that pharmacists bring to patient care. Hundreds of published studies demonstrate that pharmacists significantly improve outcomes and reduce overall healthcare costs when they provide clinical guidance to patients. The Asheville Project and the Ten-City Challenge of the American Pharmacists Association Foundation (diabetes) as well as the Federal Study of Adherence to Medications in the Elderly (heart disease) are well known initiatives utilizing the pharmacist as the essential element in improving adherence and overall health outcomes.
HealthStat Rx's pharmacist-managed medication program is proven to increase patient adherence and improve overall health outcomes. Our comprehensive pharmacy care program addresses the underlying causes of poor adherence, provides clinical pharmacist education, includes intensive personal support and promotes convenience through reminder packaging. HealthStat Rx's nationally recognized medication management program has resulted in the reduction of healthcare costs and the prevention of chronic disease progression.
HealthStat Rx Improves Payor Outcomes
Our cutting edge disease management programs can be tailored to meet the unique needs of any sized payor. Scalable and flexible, HealthStat Rx's chronic care models can be implemented as a standalone disease management program or easily integrated to compliment an existing disease management initiative. The foundation of our program's success is a result of:
- Accurate measurement of a patient's level of engagement
- Complete evaluation of a patient's ability to adhere
- Thorough assessment of a patient's understanding
- Educational foundation provided by a clinical pharmacist
- Easy-to-follow patient plan of care
- Intensive personal support to address all of the patients needs
- Motivational interviewing techniques used to foster self management
- Written educational materials provided to reinforce disease knowledge
- Refill reminder tools to promote sustained adherence
Utilizing the most advanced database technology available, we provide the payor with a complete examination into their chronic disease population. HealthStat Rx's pharmacy care program provides adherence assessment and counseling at every patient encounter. We document each patient communication as well as any corrective action that may have occurred. Timely detailed reporting is available from the individual prescription level up to population trends and summaries (sample patient outcomes report).
For additional information about the benefits of HealthStat's Medication Management Program for your members and the cost savings potential for the payor, please contact us.
HealthStat Rx's Medication Management Program has yielded impressive results. An in-depth study of this exceptional Pharmacy Care program was presented at the 2009 International Conference on HIV Medication Adherence and the 2009 U.S. Conference on AIDS. For complete study details, see study.