COLUMBUS, Ohio, March 20, 2019 /PRNewswire-HISPANIC PR WIRE/ — According to the newly-released ePA National Adoption Scorecard and the Real-Time Benefit Check National Adoption Scorecard, most EHRs, health systems, payers and pharmacies have committed to electronic prior authorization (ePA) and real-time benefit check solutions; however, attaining patient-benefit from these platforms relies on broader provider utilization.

While CoverMyMeds captures an average of 90 percent of ePA volume across the industry¹ and its RxBenefit Clarity™ solution has achieved the highest provider utilization rate of real-time benefit check, the reports illustrate that widespread provider adoption will deliver even more value to patients awaiting treatment. 

The new reports reveal that when ePA and real-time benefit check solutions are implemented well and adopted by providers, they can achieve the following:

• Faster turnaround times: 62 percent of prior authorization (PA) requests submitted electronically receive a determination in less than two hours, compared to 0 percent of PA requests completed via the traditional phone and fax method.²
• Improved dispense rate: Electronic prior authorization solutions can lead to an 80 percent higher dispense rate and three percent greater likelihood that patients pick up their medications due to the faster turnaround times on PA determinations, compared to PA requests completed via the traditional phone and fax method.²
• Increased adherence: Real-time benefit check solutions that deliver at least 97 percent accuracy for prescription cost information at the point of prescribing can lead to a nearly 20 percent increase in medication adherence.³

The reports also reveal areas for improvement:

• Complete provider adoption: Despite widespread availability of ePA solutions, provider adoption lags behind, with 47.5 percent of PA requests occurring through ePA.² Of those that submit PA requests electronically, the majority use CoverMyMeds.¹
• Provider trust in data: Among a survey of 1,300 providers, the average trust factor in the accuracy of real-time benefit check solutions that rely solely on existing formulary and benefit information is only 5.7 out of 10.⁴
• Implementation of provider-centric functionality: Only recently have real-time benefit check solutions emerged that deliver patient pay details at the point of prescribing. While EHR availability is currently at 73 percent and payer availability is at 81 percent, in order for provider adoption of real-time benefit check to increase, solutions must deliver the elements providers say are most important: cash price, patient assistance programs, PA requirements and medication alternatives.⁴

“As both of these industry reports highlight, having accurate visibility into prescription cost and prior authorization requirements within workflow helps combat common medication access barriers and helps patients get on therapy faster,” said Melissa Paige, Patient Access Principal Coordinator at University of Virginia Health System. “This is especially important for some of the most vulnerable patients who lack reliable transportation and cannot make multiple trips to the pharmacy if their medication is denied or too expensive to afford during their initial visit. If we miss our window on the patient’s first trip to the pharmacy, they may not come back to fill their prescription.”

The reports are published by CoverMyMeds, part of McKesson Prescription Technology Solutions, with an advisory board of leaders from The American Medical Association, athenahealth, BestRx, Blue Cross Blue Shield of North Carolina, Cardinal Health, Cerner, eMDs, Express Scripts, Horizon Government Affairs, Humana, National Alliance of State Pharmacy Associations, National Council of Prescription Drug Programs, OptumRx, RelayHealth Pharmacy Solutions, United States Public Health Service and University of Virginia Health System. 

Click here to download the 2019 ePA National Adoption Scorecard. Click here to download the 2018 Real-Time Benefit Check National Adoption Scorecard.

1. CoverMyMeds Data on File, 2018
2. 2019 ePA National Adoption Scorecard
3. CoverMyMeds Case Study: Improving Prescription Decision Support with RxBenefit Clarity™, 2019
4. 2018 Real-Time Benefit Check National Adoption Scorecard

About CoverMyMeds
CoverMyMeds, part of McKesson Prescription Technology Solutions, is one of the fastest growing health care technology companies in the U.S. and consistently recognized as one of the best places to work in the country. CoverMyMeds’ solutions help patients get the medications they need to be healthy by seamlessly connecting the health care network to improve medication access; thereby increasing speed to therapy and reducing prescription abandonment. CoverMyMeds’ network includes more than 500 electronic health record systems (EHRs), 60,000 pharmacies, 700,000 providers and most health plans and PBMs. By facilitating appropriate access to medications, the company can help its customers avoid billions of dollars each year in administrative waste and avoidable medical spending caused by prescription abandonment. Visit www.covermymeds.com for more information. 

SOURCE CoverMyMeds

LOS ANGELES, March 19, 2019 /PRNewswire-HISPANIC PR WIRE/ — Blue Shield of California Promise Health Plan is improving healthcare outcomes for Medi-Cal members with ConsejoSano’s language appropriate and culturally relevant text-messaging service that helps patients engage with their physicians and care providers.

ConsejoSano offers its services in 22 different languages. It has successfully held several health engagement campaigns for Blue Shield of California Promise Health Plan members, achieving meaningful results. The campaigns have included childhood and adolescent immunizations, well child visits, maternal health, diabetes and cervical cancer screenings.

Reaching plan members in their preferred language with timely prompts has resulted in more members receiving the care they need. So far, the campaigns have generated more than 127,000 texts in 22 languages, reaching nearly 18,000 members.

“Care gaps develop when patients miss important medical services such as childhood immunizations, cancer screenings and well child visits. This is why it is so critical for us to figure out new ways to help our members engage with their providers and receive the care that they need and deserve,” said Tanya Dansky, M.D., Chief Medical Officer, Blue Shield of California Promise Health Plan. “ConsejoSano helps us to do that in a way that’s culturally and linguistically relevant to each person in our health plan.”

One in three Californians is a Medi-Cal beneficiary. Those individuals come from diverse cultural and linguistic backgrounds, and they can feel disconnected from the healthcare system when they are not reached in a way that shows respect for their culture and language.

“As a result, patients can become disengaged, and may not seek the care they need,” Dr. Dansky said. “To address this issue, Blue Shield of California Promise Health Plan is taking a patient-centered approach to engage with its Medi-Cal members.”

“This is an important step in communicating with a diverse population and helping them understand the complex world of healthcare via their preferred method, which is text messaging,” said Abner Mason, CEO of ConsejoSano. “Blue Shield of California Promise Health Plan has shown tremendous foresight in meeting Medi-Cal patients where they are, understanding them, and communicating with them in their preferred way.”

Blue Shield of California Promise Health Plan and ConsejoSano have developed multiple unique engagement campaigns to help improve clinical quality outcomes for multicultural populations of Medi-Cal members in Antelope Valley and San Diego. They include:

• Well Child Visit Campaign that educates parents about the importance of well child visits. The effort has resulted in nearly 1,400 well child visits, closing an estimated 40 percent of care gaps. The two-way messaging feature allows members to notify the health plan when the child has been seen by their provider. This helps the health plan better understand any disparities in preventive care or barriers such as access to transportation which can impact a family’s ability to attend appointments.
• Cervical Cancer Screening Campaign that helps notify Medi-Cal members who are due for cervical cancer screenings such as Pap tests, which can be a difficult topic to address in some cultures. Through a campaign designed with these cultural sensitivities in mind, nearly 2,500 additional women have received these important screenings which may have an impact in the future on morbidity and mortality for a leading cause of cancer death in women.
• Type 2 Diabetes Care Campaign that provides outreach to Medi-Cal members who have type 2 diabetes and utilize the Blue Shield of California Promise Health Plan clinics located in Los Angeles County’s Antelope Valley. Patients’ response was so outstanding that the health plan redesigned the campaign to help the clinics with the high demand for appointments by motivated and engaged members.  

For more information, please visit www.blueshieldca.com/promise to learn more about Medi-Cal health plan options in your area.

About Blue Shield of California
Blue Shield of California strives to create a health care system worthy of our family and friends that is sustainably affordable. We are a not for profit, independent member of the Blue Cross Blue Shield Association with care for four million members, 6,800 employees and more than $20 billion in annual revenue. Founded in 1939 and headquartered in San Francisco, Blue Shield of California and its affiliates provide health, dental, vision, Medicaid and Medicare health care service plans in California. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have an impact on California communities. For more news about Blue Shield of California, please visit www.news.blueshieldca.com.

About ConsejoSano
ConsejoSano is a patient engagement platform that helps connect payers, providers and health systems with their multicultural Medicaid and Medicare patient populations. The company utilizes multi-channel engagement tools to reach patients in a culturally relevant way that increases engagement, lowers costs, and improves health outcomes. For more information, visit www.consejosano.com

Media Contact: Vikram Bakhru, [email protected].

SOURCE ConsejoSano