PROVIDER INTERVENTION INCREASES MEDICATION ADHERENCE

Mayank Shah, MD - Chief Medical Officer of Home-based Care Delivery Services

CareAllies pharmacy professionals work with providers to identify opportunities that will improve health outcomes and affordability for their patients. This includes helping providers improve medication adherence by identify patients who have not filled or refilled their prescriptions. 

This is an important focus area for two reasons:

1. We know that taking the right medication helps patients stay well, which improves health and lowers health care costs. Currently 17% of our gross domestic product is spent on health care.  Up to 30% of these dollars are identified as being wasteful. Approximately 10% of hospitalizations in older adults may be caused by medication nonadherence.¹ 
2. Medication adherence impacts a provider group’s quality measures and Medicare Part D Star ratings, which demonstrates a provider’s commitment to quality and improved outcomes in value-based contracts.

There are two ways a medication adherence is usually measured: Medication Possession Ratio(MPR) and Proportion of Days Covered(PDC).  MPR is a ratio of total days of medication supplied and the number of days between first and last refill.  PDC is the ratio of the total number of days supplied and the days in refill interval.  Multiple studies have shown that adherence can be improved with some simple interventions and such interventions do indeed lead to cost savings and improved quality.¹

Providers often recognize that medication adherence is an area of opportunity in their practice, but they need help with identifying effective processes and resources to improve this metric. Fortunately, our pharmacy teams are able to help identify and implement solutions. 

Medication Adherence Tracker Initiative

When an independent physician association (IPA) in Texas adopted a value-based care goal of significantly improving their medication adherence, they looked to CareAllies to help them find a way to overcome this challenge. 

Their solution was the Medication Adherence Tracker initiative, which combines efforts of both the CareAllies pharmacy team and embedded care coordinator (ECC) nurses to give providers and their office staff more timely, actionable information to effectively engage with patients who are not filling or refilling their prescribed medications.

Results show that providers are key to success:

• When providers successfully connected with patients, they were 20 times more likely to refill their medications 
• Patients were also three times more likely to be adherent by year-end
• Collectively, the providers’ commitment to this initiative led to improved quality outcomes and Medicare Advantage Part D star ratings

Dr. William Torkildsen, a primary care physician with the participating provider group, shared this reflection in a recent CareAllies Valuable Insights podcast:

“I think that our patients need leadership, that's why they chose us to be their PCPs (primary care providers). And I think it's appropriate that we should be expected to take a leadership, and an ownership, position in a patient's medication adherence… As our patients start to realize that this is important, and it is important to us, then it will matter to them.”

CareAllies pharmacy team members were recognized with the 2018 Academy of Managed Care Pharmacy (AMCP) platinum award for their research abstract about the initiative titled: “Evaluating the Impact of Primary Care Provider Intervention on Paid Pharmacy Claims Using a Medication Adherence Tracker in a Medicare Advantage Plan”.  A second abstract showcasing additional research findings on the tracker was presented at the 2018 AMCP Nexus Conference.

We’re excited to be launching this initiative with additional providers for 2019 and working together to improve health outcomes and affordability for their patients.

Hear more on the CareAllies medication adherence tracker initiative from Dr. William Torkildsen, a primary care physician with the participating provider group, and Rickie Cruz, LVN, an embedded care coordinator for CareAllies, in a recent CareAllies Valuable Insights podcast. 

^1. Iuga, Aurel O and Maura J McGuire. “Adherence and health care costs” Risk management and healthcare policy vol. 7 35-44. 20 Feb. 2014, doi:10.2147/RMHP.S19801