Patient non-adherence and medication errors cause 125,000 deaths per year and place a considerable financial burden on the nation’s healthcare system. This burden is estimated to be $290B annually, according to the New England Healthcare Institute. RxAdvance believes it is the responsibility of PBMs to not only dispense appropriate medication but also enhance patients’ adherence. If PBMs proactively engage all care stakeholders, it will not only reduce the financial burden on plan sponsors but also generate better health outcomes for the patient.
Academic researchers and industry experts agree that medication adherence alone cannot reduce the drug-impacted medical costs for plan sponsors. RxAdvance clinicians concur that the true solution requires a comprehensive three-pronged approach.
AdvanceMAM™ is a fully automated, comprehensive medication adherence management solution that engages patients, prescribers, pharmacists, and caretakers at every touch point in the care continuum.
1. Identify and enroll: Prescriber-led and pharmacist-assisted CMR is used to eliminate ineffective medications
- At Point of Care, during a refill/new prescription, system alerts prescribers with adherence-related information that prompts a physician to conduct a comprehensive medication review (CMR). This system-generated medication review identifies and eliminates medications for which adverse drug events outweigh the benefits and are ineffective for the patient’s overall quality of life. After identifying the right prescription regimen, the patient is recommended to a health plan-sponsored adherence-monitoring program. At that point, the enrolled patient information is directly pushed into the RxAdvance patient advisory team workflow, which allows RxAdvance to monitor and facilitate patient intervention/outreach (through qualified advisors) using system-generated alerts
- At Point of Sale, if for some reason the patient is not identified at Point of Care, then the pharmacist will be alerted to engage the patient to conduct a CMR and can also recommend the patient to an adherence program
2. Aggregate, organize, and deliver: AdvanceMAM™ aggregates, organizes, and delivers medications through a disposable pill tray that is implemented in two stages
- Outreach and educate: During this stage, RxAdvance advisors proactively reach out to recommended/qualified patient, explain the program, and enroll/on-board the patient
- Install and dispense: During this stage, an electronic patent-pending PillStation™ is shipped to and installed at the patient’s residence. This device is fully integrated with and wirelessly connected to Collaborative PBM Cloud™. In real-time, it collects, consolidates, and transmits member’s adherence and vital-signs data to RxAdvance. After installation, RxAdvance aggregates and delivers all medications to the patient’s home on a weekly or bi-weekly basis from a centralized location using prefilled disposable pill trays. This unique differentiator of the AdvanceMAM™ program reduces ADEs, improves medication organization, and increases adherence and convenience
3. Monitor and Report: AdvanceMAM™ monitors and follows up efficiently with all care stakeholders
On an ongoing basis, Collaborative PBM Cloud™ monitors patient adherence and automatically generates alerts that are tracked by care advisors who reach out to non-adherent patients. Another distinct feature of AdvanceMAM™ is the ability of RxAdvance advisors to build a social connection with the patients and collect vital information about their well-being.
AdvanceMAM™ also automatically identifies member adherence gaps and alerts members and their caretakers through a mobile device. For a typical Medicare plan, RxAdvance recommends the following level of monitoring:
These recommendations and the member distribution can vary by line of business, patient demographics, and plan sponsor goals. AdvanceMAM™ collaborates with plan sponsors to conduct data analysis to recommend the appropriate adherence program.
Patient adherence activity, which is part of Patient-Rx360°™, is pushed real time into the workflow of clinical/pharmacy staff of plan sponsor using IntelligentDUR 360°Gateway™ and becomes part of a patient’s registry. This also helps clinical/pharmacy staff of the plan sponsor to take corrective action towards those patients who are enrolled but not adherent. In addition, vital information that was collected during the outreach by an advisor is aggregated and shared with the clinical/pharmacy staff of the plan sponsor, which can help plan sponsors identify precursors to major health events (emergency visits) as part of each patient’s case/care management.
“No doctor ever really knows if their patients are getting their medication filled except by patient self-reporting. Actionable information at the point of care for the provider is essential for the best patient care and for the important Medicare Advantage Star Medication Adherence outcome measures. Finally, someone in the PBM industry has realized the doctor must be given actionable information at the point of care to be able to prescribe intelligently. This should be the standard of care.”
George Rapier III, MD
Chairman and CEO
WellMed Medical Management Inc.,
120K Member Medicare Risk Organization