Engaging pharmacies to increase adherence for Medicare members

BACKGROUND
Maintaining member adherence requires careful coordination between health plans, providers, and PBMs. Too often, however, pharmacies are left without the resources they need to make a meaningful impact. As COVID-19 brings new challenges to adherence, engaging pharmacies in member health is more important than ever.

OBJECTIVE
Increase member adherence for a large Medicare plan by engaging community pharmacists in a comprehensive pharmacy incentive program and improving medication access.

METHODS

  1. In 2019, Abarca reintroduced the RxTarget pharmacy incentive program and made it available to its entire pharmacy network. As part of the program, pharmacies have access to:
    • A technology platform that allows them to access advanced analytics and reporting, prioritize members who may require intervention, and track their progress throughout the year.
    • A continuing pharmacy education program focused on improving patient adherence.
    • Daily training sessions that provide support and resources.
  2. Abarca provides the Medicare client with weekly updates of its pharmacy network’s progress in the RxTarget program–ensuring ongoing communication on the results and allowing timely recommendations and decisions.
  3. In March of 2020, Abarca launched Puerto Rico’s first home delivery pharmacy program to ensure members across the island had safe, reliable, and convenient access to medications while social distancing amidst the global pandemic.

RESULTS
In the first two years of the program, the Medicare plan saw significant year-over-year increases in adherence across three chronic conditions—even amid the COVID-19 pandemic:

    • In 2020, participating pharmacies achieved a cumulative six percentage point (6pp) increase in adherence metrics in comparison to 2019 and an incremental 10 percentage point (10 pp) increase compared to 2018.
    • Pharmacies that participated in the daily training sessions achieved a 20 percentage point (20pp) increase in adherence in 2020, while those who did not participate achieved a four percentage point (4pp) increase versus the previous year.
    • 73% of prescriptions ordered through the home delivery program are for 90-day supplies—a strong indicator of ongoing adherence.
    • 7 out of 10 active pharmacies are satisfied with the RxTarget pharmacy program. (Margin of error: 6.01% | Confidence Level: 95%)

CONCLUSIONS
Engaging pharmacies and empowering them with advanced technology can significantly increase member adherence—and allow interventions to be made before a member’s health has been compromised. This can also contribute to health plan CMS Star Ratings.

Additionally, the availability of the home delivery pharmacy program eliminates barriers to medication access, which can also facilitate higher adherence and help members maintain their health amid unforeseen events.

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