Although useful, it takes more than PBM phone interventions to create and maintain successful medication adherence programs that help health plans meet performance goals. Among other things, health plans need workflow platforms that adapt and grow with ever-advancing healthcare technology. They also need networks of providers who understand and make full use of those platforms.

This is the problem we faced when we were approached by a longtime MAPD plan client who had been using our workflow solution, RxEffect®. Although the client had come to rely on RxEffect’s usefulness in targeting, prioritizing, and reporting, they were struggling to gain full adoption across their physician network. Their quality managers recognized the need for a new method to make the most out of the platform and see medication adherence numbers improve.

The Importance of Communicating with Providers

We’ve certainly said it before, but we’ll say it again – there’s nothing that can replace the value of collaborating to establish a strategic approach with physicians in your networks. This was the tactic we focused on as we worked with our MAPD plan to garner support for RxEffect. We worked closely with the health plan to communicate consistently with their provider network, and the plan took additional steps to identify “provider-facing associates” who would interact directly with providers. We helped the plan use RxEffect to pinpoint practices that needed support with patient engagement, and they connected their associates with those providers. With time, the relationship between providers and plan associates began to evolve.

With these tools and this program, health plans can get consistent, sustainable improvement in adherence rates that are as much as 1.1% above industry averages.

Ongoing Improvements in Medication Adherence, and Beyond

In fact, the plan-provider relationship took on a life of its own, culminating in a strategy championed by the vice president of quality. Adoption of the RxEffect platform increased. Two years in, the plan established a bonus program to generate even better use of the platform. Something incredible happened: medication adherence improvement was a byproduct of stronger plan-provider relationships and consistent use of the workflow platform. Ultimately, it solved the original problem we set out to solve, but it accomplished so much more. Check out the full results in our case study.

Empowering providers is just one piece of the puzzle. Engaging providers is another.