The 3 As of value-based pharmacy: access, affordability, and adherence

The reasons healthcare executive teams underutilize their pharmacy programs vary. Some leaders are just used to traditional, hierarchical strategies for managing the workplace. Others, under pressure to deliver increasingly efficient, more personalized care with ever fewer resources, know something needs to change – they just don’t know how to change it. 

To put it another way: the United States healthcare system is in crisis. 

Dramatically rising costs paired with increasing rates of chronic illness prove we can’t just spend our way out of it. But what if we’re able to diminish the rehospitalization rate by reducing the reasons patients are hospitalized in the first place?

That sounds like a good start. And it’s exactly the work clinical pharmacists excel at.

Here’s how a comprehensive, value-based pharmacy program supercharges medication management – and three key focus areas to help reduce hospitalizations and lower costs across healthcare.

Area #1: Access 

Keeping patients out of the hospital means making sure they have easy access to care no matter where they are. Telehealth services are one way to improve access to care. As is empowering pharmacists to treat patients and answer their medication-related questions.

What’s more: patients want to be in their homes. This is true whether they’re asking questions over telehealth about their daily statin dose, arranging home infusions, or will soon transition to hospice. And when clinical pharmacists are embedded into care teams, it’s easier to deliver the standard of care patients expect – and the quality care they deserve. 

But beyond offering what patients prefer, access to comprehensive pharmacy services drives better outcomes. Consider how…

  • Patients in rural areas often lack access to primary care providers.
    • The problem: fewer rural patients receive the preventative care that can improve long term health outcomes.
    • How RxLive can help: telehealth services make it easy to receive expert, location-neutral care.
  • Pharmacies receive the lowest rate of reimbursement for filling Medicaid prescriptions.
    • The problem: pharmacies close, creating pharmacy deserts characterized by greater poverty, higher crime rates, and less access to health care overall.
    • How RxLive can help: in combination with partnerships like the one we recently announced with Outcomes, our value-based pharmacy technology helps ensure patients receive the medications they need before adverse events occur.
  • Nearly two-thirds of providers are experiencing burnout.
    • The problem: providers are quitting the medical profession – a fact complicated by the increasing number of physicians reaching retirement age.
    • How RxLive can help: by powering preventative care, promoting population health, and leveraging their medication expertise through prescriptive authority, our fractional network of pharmacists are helping fill the growing provider gap.

The more people want to stay at home, the less likely they are to seek out care outside of their homes. When providers are able to meet people where they’re at to deliver care, patients stay healthier – and out of the hospital.

Area #2: Affordability 

More than half of adults in the US say they have difficulty affording healthcare. Even still, according to a new white paper, Millennials in the US with chronic health conditions are seeking healthcare at higher rates than previous generations.

The numbers are eye watering. Millennial patients managing obesity are 29% more likely to be hospitalized than their Gen X counterparts, while those numbers increase to 55% for patients with hypertension and 106% for diabetes patients.

As medication experts, clinical pharmacists offer unmatched capabilities to help control patient costs and keep them out of the hospital

Say, for example, the costs of a patient’s medication regimen could be decreased by prescribing biosimilars. Their physician would obviously want to lower prescription costs if they knew how to do so. But physicians are often too overworked to keep up on developments beyond their specialty.

Medication management is a pharmacist’s specialty. That means pharmacists are uniquely qualified to drive down the costs of medications for all patients. For example, pharmacists can identify available and upcoming biosimilar drugs – like NovoLog, a rapid-acting insulin – and then educate patients about their safety and efficacy.

And if patients have already been hospitalized? With the average cost of a rehospitalization over $15,000, preventing a return to the hospital has more financial impact than ever.

Area #3: Adherence

It’s no secret: poor medication adherence directly correlates with increased readmission and higher mortality. With roughly 50 percent of patients not taking their medications correctly, that’s a problem. But it’s a fixable one. Studies show, for example, that pharmacist intervention for patients with heart failure significantly improves patient health outcomes.

Beyond helping control costs, pharmacists interventions increase the impactability of value-based programming through laser-focused disease state management. The prescriptive authority of collaborative practice agreements in particular allows pharmacists to fully manage patient medication regimens. The result? Patients prescribed medications by pharmacists are likely to

  • get the most affordable option possible.
  • receive expert answers about their medications when they’re prescribed. 
  • avoid drug-drug interactions.

That’s huge. The more patients understand their medication regimens – and the more they can afford them – the more likely they are to take their medications. And the more likely they are to take their medications, the more likely they are to remain healthy and out of the hospital.

Pharmacy Programs Improve Quadruple-Rated Quality Measures

It’s simple: improving patients’ access to affordable medications increases their adherence to prescribed care plans. Healthier patients are more satisfied patients.With patient experience scores now a quadruple-rated quality measure, keeping your entire empanelled population healthy is more important than ever before. Interested in how a comprehensive, value-based pharmacy solution can help improve your patients’ health and boost your bottom line? Reach out.

Kristen Engelen, PharmD
Kristen Engelen, PharmD, is the chief pharmacy officer of RxLive and a certified consultant pharmacist; she has over a decade of experience in retail pharmacy settings. Kristen became an RxLive co-founder because of her passion for geriatric pharmacy, with a focus on the intersection of pharmacy and aging.