Recognizing the challenges of affecting change within the Medicaid population, a health plan client partnered with RxAnte to pioneer a predictive analytics approach to medication adherence and identifying adherence barriers. A dynamic Clinical Pharmacy Program (CPP) was created to address members with asthma, a condition with a strong correlation between adherence and unplanned care episodes, symptom severity, and costs.

A Predictive Model for Identifying Non-Adherent Patients

In 2017, almost 20,000 of the health plan’s members received controller medications, and RxAnte was able to identify 2,265 who were at risk for non-adherence. These members were selected to be called by a clinical pharmacist and their data was used to create a baseline for overall adherence. When called, the pharmacist explained implications of non-adherence to patients, educated them on proper medication usage, and assessed the patient’s health in the process.

Program Impact on Adherence – and More

Results were more than promising – the CPP significantly improved adherence and reliably identified candidates in the Medicaid population for successful clinical intervention. At the end of the CPP, 44% of members had been reached, with an estimated 8.6% adherence improvement rate among those reached members and a significant population-level adherence lift of 6.8%.

Additionally, the CPP uncovered the most commonly reported medication adherence barriers included forgetfulness (28%) and a lack of understanding of how to use controller medications (26%).

Interestingly, a trend in the data also suggests a reduction in unplanned care is correlated with improved adherence. As we continue to learn what this means for other clinical measures, we have the unique opportunity to continue to monitor patients and data to understand the greater implications of the program. But the overall results give us a new level of understanding of the sheer power interventions can have on improving medication use and efficacy.

44% of members had been reached with an estimated 8.6% adherence lift at the end of the program

A Game-Changing Adherence Program

Honing the ability to use predictive analytics to estimate adherence and performance measure eligibility among key populations, Medicaid or otherwise, is a game-changer. Healthcare organizations and patients will both benefit from improved outcomes from data-based, targeted, and better-informed interventions. And CPPs combined with RxAnte’s rich data legacy are blazing the trail for new, better healthcare and strategies for improved medication use.

To learn more about this program, read the full case study here.