posted by Greg Gierer, SVP, Policy, AHIP
on June 4, 2019
Patients who suffer from chronic conditionsâ€”such as arthritis, cancer, diabetes, heart disease and hypertensionâ€”rely on prescription drugs to help manage their disease and stay out of the hospital. Unfortunately, all too often, those with chronic conditions face gaps in care that can lead to poor health outcomes and unnecessary costs.
To address these issues, health insurance providers in collaboration with health systems and pharmacists, are taking a patient-centered approach to coordinating and managing medications for patients with chronic conditions. This smarter approach to care, called comprehensive medication management, ensures each patient is evaluated holistically to ensure every medication they take is indicated, effective, safe, and convenient. It also ensures there are no untreated medical conditions. Patients with multiple chronic conditions are at increased risk for non-optimal medication use and medication errors, making this practice essential.
Key elements of comprehensive medication management include:
As the health system continues to embrace value-based care, medication management programs offer promise in improving patient health, patient safety, and affordability. We can see this in action with the HealthPartners-Fairview Health collaborationâ€”where the success of this initiative and other plan-provider collaborations was the focus of a recent summit held at the University of North Carolina Eshelman School of Pharmacy in Chapel Hill, N.C.
HealthPartners, a non-profit integrated care organization based in Bloomington, Minn., covers more than 1.8 million people nationwide. It has partnered with Fairview Health Network in a shared savings network that includes comprehensive medication management. Patients get a holistic assessment of their drug regimen, while the clinical pharmacist and other care providers work together and with the patient to develop a care plan and meet regularly to monitor progress. An added benefitâ€”comprehensive medication management is available at no cost to the patient.
Fairview Health Services, a non-profit organization with a network of over 5,000 providers, has seen great resultsâ€”including a 33% drop in readmission rates for patients. Among high-risk patients with multiple chronic conditions, the return on investment was even higher.
In addition to the successful collaboration with Fairview Health Network, HealthPartners has significantly expanded its comprehensive medication management program so that nearly everyone enrolled in coverage is eligibleâ€”over 800,000. The success of this initiative shows the power of plan-provider collaborations. Working together, we can meet some of the toughest health care challengesâ€”protecting patients and improving care for some of Americaâ€™s most vulnerable patients.