Historically, pricing information displayed in the EHR has been an estimate, meant to generally guide provider conversations with patients. However, incomplete or obsolete data can frustrate providers and lead to decreased satisfaction, utilization, and trust of EHR tools.
Meanwhile, new price transparency technologies allow physicians to see accurate coverage and cost information in real-time. With the right tools in place, providers can view patient-specific information and have confidence in the data they use to make care decisions.
With the complexity around health plan design and consolidation of pharmacy benefit management, many EHR vendors have started their price transparency journey with prescription cost data. Here are our top three reasons why you need to prioritize a prescription price transparency strategy for your EHR:
1) Patients are demanding it.
- For years, patients have demanded the healthcare experience align with other consumer experiences. They feel empowered by knowing the cost of their medications upfront, and will often shop for lower prices when it comes to their care.
- The COVID-19 pandemic and recent market fluctuations have forced millions to be more cost-conscious and financially aware, and surveys have shown that patients hope to decrease their prescription drug spending over time. This makes it more important than ever that providers have conversations with patients about medication costs.
- Research has shown that price is a primary driver of medication non-adherence. By providing prescription cost data upfront, EHR vendors can help avoid sticker-shock, increase medication adherence, and improve overall patient health.
2) Providers can’t live without it.
- Arrive Health research shows that providers overwhelmingly desire better cost and coverage information at the point-of-care. The majority of surveyed providers do not find their EHR’s prescription information accurate or helpful, and over three-quarters reported needing to change, manage, or resend a prescription order once it was sent to the pharmacy – wasting valuable time and causing unnecessary frustration.
- Often times providers order medications without confirming patient coverage information. They may search for coupons or discounts outside of the EHR, creating a disjointed, friction-filled prescribing experience. Providers want more accurate, robust data to allow for better patient conversations and to drive more informed decision-making.
- Prior authorization clearance and pharmacy callbacks waste time, which could be better spent interfacing with patients. With accurate cost and coverage data presented in workflow, teams can more easily avoid administrative hassles and reduce operational workloads.
3) Legislative mandates and the move to value-based care are imminent.
- CMS has put its weight behind price transparency and interoperability policies to bring awareness to care costs. These rules provide tailwinds that show no signs of slowing – and complete transparency is going to be an imperative in the near future.
- In the prescription space specifically, rules mandate that EHRs and Part D plans offer ‘real-time benefits comparison tools’ to allow physicians – and eventually patients – access to real-time medication pricing information. Again, these rules are just the beginning of a trend toward complete price transparency requirements for all stakeholders.
- There is no stopping the transition to value-based care. Prescription price transparency can play an integral part of that transition, and teams will be required to provide high-quality (clinically-relevant, timely, covered, and safe), low-cost medication options for patients. If the EHR can support teams in the transition, it is a win-win.
It is clear that prescription price transparency is a necessary – and mandated – capability. But while many EHRs have implemented prescription price transparency solutions, not all are created equal. It is essential that EHRs consider the breadth of the data being supplied to understand if they will be getting partial or complete patient coverage connectivity (in most cases, having more than one vendor connection is a necessity). Additionally, EHRs should understand the accuracy and quality of the data within their systems, to know if they are displaying patient-specific prices vs pricing estimates, as well as unnecessary alerts and noise.
Arrive Health provides pharmacy – and medical benefit – cost and coverage data within integrated workflows, helping EHR vendors differentiate their services, increase utilization, and improve the end-user experience. Additionally, connections with numerous coupon and discount vendors allow for the selection of lowest-cost options for uninsured patients or when an eligibility check fails. This cash-pay network plays an essential role as EHRs build out their price transparency functionality.
To learn more about how Arrive Health can help support your price transparency strategy, reach out today.