With Americans facing an increasingly dire healthcare affordability crisis, discussing cost has become an essential part of the clinical decision-making process. What good is a prescribed medication going to do if the patient can’t afford to fill it?
Real-Time Prescription Benefit (RTPB) tools are intended to solve this challenge: giving providers access to cost and coverage information they can use to prescribe affordable medications.
Unfortunately, without investment in a high-quality experience for providers, RTPB solutions fall flat. There are results that are dangerous: a 90-day supply of opioids, results that don’t make sense (like a 90-day supply for an antibiotic that is exclusively prescribed as a 5-day supply), and results that, unless modified, don’t make it to the provider clearly.
Arrive Health’s Behind-the-Scenes Work to Improve RTPB Results
Since its creation, Arrive Health set out to build a better RTPB solution – one that delivers reliable information and rebuilds provider trust in the tool. If you don’t work with Arrive Health, you might not know that we have a dedicated data quality team to partner with providers, understand issues they’re experiencing, and to resolve them. (More on this below, but most recently our team worked to eliminate 87% of RTPB noise due to “unknown” or confusing pricing results.)
Due to our quality improvements:
- Providers see results that are easy to understand. We normalize messages, regardless of the PBM partner, so providers see results they can use.
- Results are surfaced within seconds. Time is valuable, which is why our connection usually delivers results in under 2 seconds.
- Access to cost and coverage information is easy and accurate. Using proprietary logic, we work behind the scenes to provide meaningful alternatives and return accurate pricing for originally requested medications.
Most importantly, these enhancements are driving provider engagement and behavior change as evidenced by our provider partners seeing switch rates double as a result of our partnership and continued investment in creating a better user experience.
Spotlight Improvement: 87% Reduction of Unknown Results
One health system client recently shared the experience of seeing “unknown” and confusing pricing within RTPB results. Despite receiving a price from our PBM partners, the price was not making it to end users. Working with the client, we tied the root cause to the methods some electronic health record (EHR) vendors use to display pricings to end users. We then developed a process to proactively translate certain RTPB data points to reduce these “unknown” and/or confusing pricings to end users.
When applied to 750,000 RTPB transactions across a 60-day period, 87% of the noise due to “unknown” or confusing pricing results was resolved. The impact? We observed major switch rate improvements – between 100-200+% increases – at multiple health systems by applying this logic.
The Value of User Experience Upgrades
Everyone benefits when accurate pricing information is used to prescribe the right medications. Providers and patients can talk about what medications fit a patient’s budget, they can avoid unnecessary prior authorizations, patients have a better overall experience, and there’s more opportunity for patient and plan savings.
Curious to learn more about these and other initiatives Arrive Health is working on to improve the user experience? Contact us to talk with a member of our team.
