By: Thomas Lehner, MD, FAAFP, CMD, Medical Director, Long-Term Care, Buckeye Health Plan
Reprinted from the winter 2018 issue of The Ohio Family Physician.
Prescription non-adherence is widespread and is significantly impacting the health and pocketbooks of a growing number of Americans. The Centers for Disease Control and Prevention (CDC) reports that half of Americans stop taking their medications within one year of being prescribed. Non-adherence leads to approximately 125,000 deaths and costs the U.S. healthcare system between $100 billion – $289 billion annually. For those with chronic illnesses, hospital admission rates increase by up to 69% for non-adherent patients.
“Non-adherence is a huge challenge for the U.S. healthcare system, especially for chronically ill patients who may take more than eight medications at one time,” says Meera Patel-Zook, senior director of pharmacy at Buckeye Health Plan (Buckeye), a managed healthcare plan for Ohioans on Medicaid, Medicare, and the Health Insurance Exchange. “While many simply forget to take their medication, we also know there can be a knowledge gap for some patients in understanding how to take their medication properly. At Buckeye, we saw an opportunity to expand upon traditional adherence programs by looking at this issue through our members’ eyes.”
Buckeye does this through its prescription management program, BuckeyeRxPlus, an innovative and customized approach to improving medication adherence, decreasing costs, and creating better patient outcomes. Piloted in 2017, the program targets members who take 10+ medications daily and/or have a high-cost chronic disease.
“There is so much we can gain from sitting across the table with our members and seeing the medication first-hand and listening to them talk about it in their own words. The in-home assessment is an added layer of intervention and insight compared with traditional programs. It deepens our understanding in a way a paper form or even a phone call can’t accomplish,” says Patel-Zook. “Gathering an accurate picture of each patient’s medication usage and challenges is key to the program’s success.”
BuckeyeRxPlus Works
The program has resulted in adherence rates close to 100% for BuckeyeRxPlus patients. Additionally, Buckeye has decreased inpatient stays and emergency department visits along with cost savings of approximately $500 per member per month for members participating in the program.
“We are thrilled with the program’s success and are looking at ways to expand it in the future,” says Patel-Zook. “We’ll pilot a program expansion in 2019 for members discharging from inpatient care. We see a lot of hospital re-admittance due to medication management, and we believe our program can make a substantial impact here.”
See additional graphics and information tables in the full article.