What’s Next for Medication Reconciliation?

Nov 18, 2018

According to NCQA, 82% of all adults in the United States take at least one medication. Nearly one-third of that population takes five or more. Whether these medications are prescription, over the counter, or supplements, they need to be properly managed–and the first step is making sure they are each accounted for.

To gather a complete and accurate list of a patient’s medications, healthcare providers utilize a process called medication reconciliation. Once compiled, they use the list to:

  • Identify discrepancies in drug regimens or levels of care
  • Inform prescribing decisions
  • Determine medication adherence
  • Prevent medication errors

Most importantly, medication reconciliation is crucial to ensuring safety after a patient has been discharged from an inpatient facility. Not only does this need to happen accurately, but HEDIS–a tool used by more than 90% of health plans to measure performance–mandates that medication reconciliation must be completed within 30 days of the patient’s discharge.

Unfortunately, a number of barriers exist that prevent this critical component of care from running smoothly. The root of these issues lies in proper access to patient information. For example, a health plan may not give the date that their member was discharged, let alone what medications were changed. The good news? This process is on the verge of a shakeup.

The onus for medical reconciliation currently falls to health plans, but PBMs are beginning to play a more significant role. There is also increasing exploration into how EHRs and medical claims will be factored in going forward. At Abarca, we say bring it on.

Because of Abarca’s “better way” approach to member engagement, we already have some necessary pieces in place to accelerate our transition into medication reconciliation. For example, as part of the pharmacy benefit services we offer, like medication therapy management (MTM), and coverage determination we are in constant communication with our members. These communication channels can be leveraged to gather any additional medication data, and keep patient information up to date.

Speaking of data, Darwin, our smarter PBM platform, was built to ensure that our partners can access the information they need in real time–and we are continually developing new modules and evolving our analytics capabilities. Our members also have unrestricted access to the platform, allowing them to update their own information including test results, claims data, and more.

There is a better way for manage medication reconciliation–and Abarca is looking forward to delivering it.

This blog was written by Francina Bonnelly, PharmD, Manager of Darwin Clinical Products at Abarca, based on sessions she attended at AMCP NEXUS


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