Mobile Technology Improves Pharmacy Utilization, Cuts Health Care Costs
Given the US consumer’s growing reliance on mobile technology, more people are turning to their smartphones to make better decisions about health care. For employers, this trend poses an enormous opportunity: with drug prices on the rise, and health care reform demanding an evidence-based approach, pharmacy benefit managers (PBMs), health plans and self-insured employers recognize the potential for mobile communications to influence patient behavior long after they have left the doctor’s office.
Employees can use the convenience of their smartphones to research prices, refill prescriptions, check order status, find the nearest pharmacy — all of which help to improve compliance and, ultimately, health and productivity. By engaging patients in their own health, employers, health plans, and PBMs are well positioned to build upon the mobile communications revolution and ensure that plan members gain the greatest possible benefit from the health care services available to them. The key is a thoughtful and engaging mobile-access and mobile-platform technology strategy.
Fast Access to Pharmacy Information
Smartphone technology and mobile website capabilities give plan members easy access to essential medical and pharmacy benefit–related information, including:
- In-network provider directories and directions to offices
- Pharmacy and medical benefit summaries and claims history
- Drug formularies and drug prior authorization status
- Deductible summaries and cost-sharing requirements
- Drug prices of nearby pharmacies and expected out-of-pocket costs with generic and therapeutic alternatives
- Self-diagnosis tools with symptom and disease lookup features
- Daily wellness tracking tools for achieving health-related goals
- Health-related symptom checkers
- Reminders and alerts for prescription drug compliance
- Options for in-home monitoring and in-home care
Health-related apps also support programmatic interventions and provide employees with a simple means for self-managing existing health-related conditions. Apps can also serve as decision-support tools for health care providers and PBMs, allowing them to quickly connect plan members to appropriate care sites, encourage healthy behaviors, deliver compliance alerts and suggest additional prescription drug purchasing channels, such as mail order and retail discount options.
Health apps can also help streamline the flow of information between health plans, physicians and patients — facilitating one-on-one exchanges that close gaps in care, shorten medical response times, and improve the overall health care system. For employers, this means a positive impact on the bottom line.
Choosing a Mobile Technology Platform Partner
Designing an effective mobile strategy begins by partnering with a service provider that can offer web-based platforms that automate labor-intensive processes, such as gathering, integrating and accessing drug claim histories and formulary data. These platforms should also have the capabilities of delivering:
- Personal notifications to members regarding drugs that require prior authorization
- Personalized messaging to increase the effectiveness of consumer engagement communications
- Web-based reporting applications that measure changes in pharmacy utilization and prescription drug adherence for chronically ill patient populations
Automated personal mobile application services — combined with reporting applications that measure the appropriate use and effectiveness of healthcare — will inevitably increase satisfaction for both employers and plan members alike. They can also:
- Save time and money across the health care delivery system
- Simplify pharmacy benefit design understanding and utilization
- Enhance the effectiveness of medication therapy management and value-based drug benefit designs
- Integrate financial data from the increasingly popular consumer-directed/high-deductible health plans (CDHPs)
A unified approach to mobile access through an integrated suite of applications gives employers and members the best approach to informed and personalized decision-making. The ideal member engagement for better use of pharmacy benefits tool relies on a pharmacy utilization and reporting application to support member care and enable clinical pharmacists and staff members to improve member pharmacy utilization by encouraging adherence to medications for chronic health conditions, such as diabetes and asthma. This kind of solution can cut costs by identifying preferred brands and generic drugs, and by enabling pharmacists to work collaboratively with members who are at risk for adverse drug events.
Once an effective mobile strategy is in place, plan members can take greater control of their own health and work more closely with their in-network healthcare providers. This is especially true for those who are incentivized by the possibility of saving money and reducing out-of-pocket healthcare expenses. Smartphone technology apps and systems are the ideal tool for self-insured employers, in particular, who are focused on developing new health benefit strategies and shaping their choices based upon the needs of their workforce.
Robert Oscar, R.Ph., has more than 25 years of experience in health care. Throughout much of his career, Oscar has developed and implemented successful programs to effectively manage pharmacy benefit risk including pioneering work in the Medicare HMO market. Before founding RxEOB more than a decade ago, Oscar worked in the medical information systems industry, designing, developing and implementing several different claims analysis tools. Licensed in Virginia and certified in pharmacy-based immunization, Oscar is a graduate of Ohio Northern University