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.
Read: Ten ways to boost medication adherence
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.
Next: Real-world examples
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.
In the Scope of Virtual Health and the Future of “Website” Manner, Per Ateev Mehrotra
August 10th 2023Briana Contreras, an editor of Managed Healthcare Executive, had the pleasure of catching up with MHE Editorial Advisory Board Member, Ateev Mehrotra, MD, MPH, who is a professor of healthcare policy at Harvard Medical School and an Associate Professor of Medicine and Hospitalist at Beth Israel Deaconess Medical Center.
Listen
David Calabrese of OptumRx Talks New Role, Market Insulin Prices and Other Topics 'On His Mind'
April 13th 2023In this month’s episode of the "What's On Your Mind podcast," Peter Wehrwein, managing editor of MHE connects with the now Chief Clinical Officer of OptumRx Integrated Pharmacies, David Calabrese. In this conversation, David touches on his transition in January as OptumRx’s former chief pharmacy officer and market president of health plans and PBMs to his new role as Chief Clinical Officer where he now focuses more on things such as specialty pharmacy to home delivery — with an overall goal of creating whole-patient care. Throughout the conversation, Calabrese also touched on the market’s hot topic of insulin prices and behavioral health services within the OptumRx community, among other topics.
Listen