Nonadherence costs the US health care system between $100 and 300 million annually, according to multiple studies. Medication adherence is key to boosting pharmacies’ performance, lowering their DIR fees, and making them attractive partners for health plan providers.
In 2008, the Center for Medicare & Medicaid Services (CMS) created the Five-Star Rating system to evaluate health plans for service quality, patient care, and adherence. Some types of adherence that health plans are evaluated for include:
- Adherence for (non-insulin) diabetes medications
- Adherence for hypertension patients
- Adherence for cholesterol medications
While this system is not used to rate pharmacies directly, their performance in these clinical categories affects plan providers’ star ratings. By prioritizing adherence, pharmacies are more likely to be added to health plan networks and increase their patient base.
High-performing pharmacies with adherent patients also have a better chance of earning discounted DIR fees, a valuable perk during COVID-19 and the 2020 recession. A recent NCPA survey found that keeping up with DIR fees is the biggest current business challenge for over 52% of pharmacies. While some pharmacy associations have recently petitioned Congress for DIR fee reform, adherence remains the best way to advance your pharmacy’s interests.
Here are 6 ways to improve your performance and keep DIR fees to a minimum:
- Digital refills. Offering refills online turns a trip to the pharmacy or time waiting on the phone into a simple process that takes just a few minutes. For maximum convenience, give patients multiple options for prescription fulfillment or retrieval. Adding a refill request option to your website can also help automate your business and attract new patients.
- Prescription refill reminders. Promote medication adherence with refill reminders and notifications. This can be done in a variety of ways, from email or messaging to an automated IVR call or voicemail. Remember to tailor your reminders to each patient based on their needs and preferred communication platform.
- Secure 2-way messaging. Digital Pharmacist’s 2-way messaging offers a secure point of contact between you and your patients. You can increase adherence by simplifying communication, making it easy to share protected information like insurance cards and Rx numbers. Our clients have found that patients appreciate connecting with their pharmacists on a user-friendly platform
- Home delivery. During the coronavirus pandemic, many pharmacies are choosing to expand their prescription fulfillment options. Adding low-cost or free home delivery helps you cater to immunocompromised, elderly, and at-risk patients more effectively as well as your local community.
- Specialty services. Consider adding Medication Therapy Management (MTM) to your list of offerings. Meeting regularly with patients increases accountability and the chances that they’ll take their medication as prescribed. Medication Synchronization and pill packaging can also help reduce serious side effects while encouraging adherence.
- Educational materials. Patient education can make a big impact on adherence as well. Patients need to understand the significance of their conditions and medication they’ve been prescribed. Make information on diabetes, hypertension, and high cholesterol readily available and consider offering wellness classes for further education.