New Measures Expand Beyond Adherence to Include Prescribing Recommendations

When it comes to medication use—which carries costly consequences for noncompliance in the range of $100 to $289 billion a year—the ability to provide health plans with effective resources for monitoring and intervention is key.

Further, with CMS introducing two new prescription recommendation measures for 2020 Star Ratings—Statin Therapy for Patients with Cardiovascular Disease (SPC) and Statin Use in Persons with Diabetes (SUPD)—it is equally necessary for health plans to have appropriate methods to address these measures to boost their Star Ratings.

This is why RxAnte’s latest rounds of updates are so critical. RxAnte’s enhancements to our comprehensive Stars solution now encompass new prescription recommendation measures, on top of the existing triple-weighted adherence measures for 2020 Star Ratings. Read on for more information regarding RxAnte’s newly-released enhancement.

Monitor and Address New SPC and SUPD Prescription Recommendation Measures

RxAnte now supports several prescription recommendation measures, with the most recent addition being SPC. The SPC measure is a medication gap measure; the measure recommends that patients who have a cardiovascular disease diagnosis take a moderate- to high-intensity statin to reduce their atherosclerotic risk, as recommended by the American College of Cardiology. The SPC measure joins the existing SUPD prescription recommendation measure, both monitored and viewable via our RxEffect tool, prescriber files, and patient recommendation lists.

While the majority of RxAnte-informed outreach remains focused on attempting to modify patient behavior to drive medication adherence, we continually strive to provide additional ways to improve medication-related patient outcomes. The addition of these new measures leverages a new intervention approach that taps into prescribing behavior. When discussing prescribing opportunities with the patient’s provider, users can reference information they may not be able to access or see, including previous adherence information, pharmacy claims, and prior interventions and documentation. These statin recommendations can also be discussed with the patient directly to help promote a meaningful patient provider interaction. RxAnte is committed to providing the best care coordination and medication-related intervention tools to our clients, and we are excited to add these new measures to our clients’ toolkits.

Maintain a Fuller Picture of Your Members’ Prescribing Opportunities in RxEffect

With RxEffect, RxAnte identifies the patients in most need of outreach and continually prioritizes them to ensure you spend precious resources on members that can most benefit from outreach. With our “Priority” outreach list, a patient will have a “Statin Rx” alert when they meet the criteria for this measure and based on clinical guidelines should be taking an appropriate strength statin medication. Once the recommendation has been discussed with the patient and/or provider, feedback on next steps can be documented in our system to update our future recommendations. In the event a recommended patient does begin taking a statin medication, RxEffect will continue to track and document the patient’s adherence to keep you informed of his or her progress.

At RxAnte, we continually look for ways to help our clients get more from medicines. We take in medical and pharmacy claims data to determine patient eligibility for items like SPC and SUPD and process this information—so you don’t have to.

If you’re looking to leverage a medication adherence solution to reach your members, contact us.