Charting a New Path to Home Medication Adherence with the Support of Digital Pharmacy

Polypharmacy and medication adherence are common issues among the Medicare patient population, and this article discusses how Medicare Advantage plans can address these challenges and improve patient outcomes.

Medication nonadherence is a $500 billion problem for health plans, providers and consumers, resulting in approximately 40% of avoidable readmissions and around 150,000 preventable deaths every year. If you simply believe that medicine works, then the healthcare industry needs to focus on innovative solutions to improve poor outcomes, which account for 16% of the nation’s annual healthcare expenditure.

People with multiple prescriptions are most affected by these challenges, as they are responsible for coordinating prescribers, frequent trips to the pharmacy, and parsing complicated orders to take prescribed medications each day. Polypharmacy is most common among the medically complex Medicare population. Statistics show that up to 4 in 10 seniors take 5 or more prescriptions. Nearly 20% take 10 or more medicationswhich may lead to a higher risk of adverse effects and drug interactions.

Managing multiple medications can be challenging, especially for vulnerable patients who are housebound or live in rural areas. Fortunately, innovative digital technologies are helping to provide the necessary medication adherence support, providing everything high-risk members with multiple prescriptions may need to stay safe and adhere, all from the comfort of their own homes. .

Sobering Medication Adherence Statistics

Despite growing attention to the medication adherence journey, too many people continue to experience diminishing returns when they are sent home from the doctor’s office, emergency department, rehabilitation center or hospital.

The statistics tell the story. For 100 prescriptions written, only 50 to 70 are picked up at the pharmacy. Once a patient leaves the pharmacy, only 25% of medications are taken home as directed. And then just a fraction – 15% to 20% – is then filled. All of this leads to unnecessary use and higher medical costs.

Older adults find it the hardest to join because they are disproportionately affected by chronic conditions, such as diabetes, arthritis and heart disease, and as a result more likely to have multiple prescriptions. Almost 50% of people with a prescription for a chronic disease, such as cardiovascular disease, stop taking it within the first year. As star ratings continue to focus on medication adherence, Medicare Advantage (MA) plans will need to quickly adapt their strategies to meet the needs of this challenging population.

Remembering to take each medication correctly, sometimes 3 or more times a day, can be taxing for anyone, let alone the growing number of older people now struggling with dementia and Alzheimer’s disease. Additionally, statistics show that the typical Medicare beneficiary saw a median of 7 doctors per year, highlighting the need for more coordinated and multi-faceted strategies. Going to the pharmacy to pick up a multitude of drugs that probably have different refill dates throughout the month is an ordeal.

Then there are the adverse drug reactions, the anxieties of what to do after missing a dose or deliberately not taking a controller medication if they feel well – and don’t understand that feeling good health is probably due to medication compliance.

Because of these challenges, achieving medication adherence is daunting. While nearly 70% of Americans have at least 1 prescription medication, 50% of Americans simply don’t take them as prescribed.

Addressing Patient-Provider Disconnect

Providers play a key role in helping patients understand their treatment regimens and overcome barriers that can impact adherence. Unfortunately, it is extremely difficult for providers to gain visibility into what is happening with their patients’ medication management outside of the clinic walls.

Although 68% of doctors are interested by receiving notifications if patients become non-adherents, few actually have access to data about whether a patient has filled their prescription or is an adherent. The traditional health care system places all of these burdens on the shoulders of the individual, with little or no support when things go wrong.

As the country’s population ages and more care shifts to the home, healthcare providers need to take a different approach. We need to create a holistic framework of support for these patients, especially the growing Medicare population. With the right tools in place, each individual can be fully equipped to become and remain a member.

Bringing health care from hospital to home

This proactive and comprehensive care will become even more important as services continue to move from hospital to home.

Home care should be multiplied by almost 4 by 2025, according to McKinsey & Co, including up to $265 billion in care services, representing a quarter of the total cost of care for Medicare fee-for-service and MA members. Care delivered at home—rather than in an acute care facility or skilled nursing facilities—provides lower Medicare costs, a better patient experience, and critical relief for many underserved hospital and residential care sites. funded.

However, home care can also exponentially increase existing medication adherence issues. Without a clinician providing the right medications to patients exactly when they need them, members and their caregivers will have to take on even more responsibility in medication management.

To realize the value home care is meant to bring to the system, we need to provide proactive support with multiple points of contact and intuitive technologies that ensure members stay on track with their prescriptions.

Developing new strategies to improve medication adherence: the role of technology

A combination of advanced predictive analytics tools, patient-centric strategies, and innovative home technologies can help us solve the country’s massive medication adherence challenges.

First, health plans should leverage advanced predictive analytics to identify their high-risk members, including those with 7 or more prescriptions, known socioeconomic challenges, and recent hospitalizations or emergency room visits. These individuals are likely to have more difficulty adhering to their medication and could benefit from modern digital pharmacy support, such as medication synchronization and comprehensive medication reviews.

For example, anchoring all patient prescription fills on the same day every month with medication synchronization can avoid having to go to the pharmacy multiple times. Digital pharmacies equipped with advanced analytics can also mitigate the risk of dangerous drug interactions by automatically connecting payer data with the most recent diagnosis to determine appropriate medications without a clinician visit.

Next, health plans must help patients maintain adherence at home. Using technology to organize pills, create a routine, and enable provider awareness when something starts to go wrong is essential for long-term success. This is where smart pill dispensers come in. Once medications are timed to be filled on the same day each month, these devices can further simplify complex medication regimens for high-risk patients with chronic conditions by sorting and by automatically dispensing medications based on the individual’s recommended care plan. Smart dispensers that include a connected app that automatically tracks dosage compliance in real time, sending alerts to providers, care teams and caregivers when a patient misses their dose would help improve outcomes.

The ability to remotely monitor medication adherence in real time, capturing patient data and automatically relaying it to clinicians and family members, will ultimately improve adherence and significantly reduce overall healthcare costs. .

A promising path to the hospital-at-home era

As home health becomes more popular and viable for more members, integrating a technology-driven digital pharmacy that integrates with an advanced home care platform is a critical piece of the puzzle.

Medication adherence is an important part of MA Star Ratings and it is so deeply tied to general member habits and barriers to engagement with the healthcare system. If you can help these high-risk members, with triple-weighted adherence metrics and quadruple-weighted patient experience metrics for consumer evaluation of healthcare providers and systems, the results will increase the global health plan star rating.

With the right combination of analytics, engagement, and smart home dispensers, plans can boost adherence rates, improve medication safety, and help members stay on track for better outcomes. Implementing a proactive, data-driven approach to medication adherence can bring more value and better experiences to members while resulting in lower costs for health plans by reducing the need for acute care and expensive long term.

Author Information

Jason Z. Rose, MHSA, is CEO of Adhere to health.

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