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The Problem

For an MAPD plan with 380,000 lives, quality managers realized that in order to hit their performance goals, they needed to apply an innovative approach to increase medication adherence among plan members. As clients already leveraging the RxEffect® workflow tool, they were familiar with the benefits that this platform could provide in terms of targeting, prioritizing, and reporting on MAPD members’ medication adherence. This led to the development of a unique engagement network featuring an RxEffect bonus program that leveraged the plans’ physician networks across multiple markets.

Our Solution

In order to encourage widespread adoption of RxEffect among care providers, the process of developing a provider incentive program first required the health plan to account for several factors: how would the MAPD plan communicate this tool? Who were the quality leaders in the markets they should be speaking to? Who would use the tool at the provider practices?

In answering these questions and to assist in more rapid implementation of RxEffect across provider offices, the RxEffect platform was updated to enable the health plan to identify the adherence rates of patients at provider practices in their network. Liaisons from the health plan were then appointed to be involved in group management. These “provider-facing associates” were already conducting quality audits at provider sites, where they then began leveraging the updated RxEffect platform as a means to identify specific practices that require assistance in patient engagement to improve adherence. Over time, the plan began developing closer relationships with its provider markets and was fully able to champion the provider-facing strategy through its vice president of Quality.

Since first implementing this program in 2014, adoption has continued to increase and sponsorship of the bonus program has spread across markets. The plan began a bonus program in 2016 to encourage further adoption among providers. As members’ care providers are often the most effective in being able to drive medication adherence, the health plan has witnessed a meaningful increase in medication adherence among practices leveraging RxEffect. And the longer provider offices use the tool, the more improvements they’ve experienced in adherence rates.

The Results

Implementing the bonus program and other continued collaborative efforts with RxAnte have driven consistent improvements in the health plan’s adherence rates.

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improvement in adherence for diabetes medication, versus an industry average of 1.5%

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improvement in adherence to RASA medications, versus an industry average of 1.5%

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improvement in adherence to statins, versus an industry average of 1.7%

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