Engaging Medicaid Patients With Pharmacists Improves Adherence, Outcomes

A recent presentation at the World Congress 10th Annual Medicaid Managed Care Summit addressed strategies for engaging members in face-to-face interactions with pharmacists in order to improve compliance, improve quality ratings, and reduce costs. 

The presentation, entitled “Facilitate Medicaid Member Engagement by Meeting Members Where They Are” was presented by Jan Reed, director of health plan solutions at RelayHealth. 

According to the presentation, adherence and care management are negatively impacted by a myriad of barriers, especially among Medicaid patients. Ms Reed explained that these barriers result in significant costs. She cited research showing that 75% of health care spending in the United States is related to treatment for chronic conditions, making up about $300 billion in annual costs. Additionally, every dollar of Medicaid spending is made up of 80 cents spent on chronic conditions. Among these chronic conditions, hypertension, hyperlipidemia, and diabetes make up the bulk of spending. 

Ms Reed stated that barriers to treatment for Medicaid patients with chronic conditions include communication issues and the lack of an interpersonal health care relationship with a provider. 

During her presentation, Ms Reed noted that payers and other stakeholders need to consider how they are communicating with their members. In a list of questions to consider, she included:

• How personal are your interactions?

• Are you calling them at the right phone number?

• Are there trusted advisors in the community that can speak to your members in their language?

• Are your communications invasive?

• Are they really hearing you?

She explained that retail pharmacies can be used as an effective means of member engagement, and referred to retail pharmacy as one of the most underutilized channels for member engagement.

Ms Reed claimed that connecting directly to retail pharmacy can allow payers to customize care through modifications and reminders. She noted that the pharmacy is a location that offers “high-touch” member traffic, because most member visit the pharmacy more frequently than any other health care destination. According to her presentation, 60% of Americans take at least one prescription drug.

Ms Reed cited research showing that interventions via pharmacists reduce costs and improve adherence. She recommended patient contact platforms as a means of strengthening relationships between pharmacists and members. Ms Reed highlighted RelayHealth’s Intervention MessagingRx platform for payers, which allows payers to connect with pharmacists to deliver tailored treatment, management, or prevention messages/interventions directly to their patients.

Ms Reed also explained that because pharmacists are authorized to administer vaccines in all 50 states, this strategy can be applied to improve vaccination immunization rates
among members. —David Costill