To be informed health care consumers, patients need tools that display cost and options to afford medications. At CBI's 11th West Coast Real-Time Benefit Check & ePrior Authorization Summit, experts weighed-in on this idea of patient consumerism and available solutions for promoting informed health care decision-making by providers and patients.
Brent Schwartz, Executive Director of Marketing for Allergan Dermatology, spent time discussing real-time benefit check (RTBC), a technological innovation that surfaces prescription benefit details for patients and providers at the point of prescribing.
Electronic solutions for RTBC can be integrated into a provider’s electronic health record (EHR) system and are designed to surface information on patient out-of-pocket cost, drug alternatives and prior authorization (PA) requirements. Through RTBC, patients gain visibility into how much a prescription will cost before going to the pharmacy and some solutions even offer options for affording medications.
While Brent acknowledged the value of RTBC for patients, he went a step further to explain how RTBC can benefit providers and pharmacies as well. According to Brent, patients now consider themselves consumers in the health care marketplace, as other industries have made strides to protect and empower consumers through information and options for making educated purchasing decisions. A lack of such transparency and options in health care may negatively influence patients’ decisions to remain with their current providers or pharmacies.
When a patient goes to the pharmacy, sour experiences can reflect poorly on the provider and the pharmacy – sometimes prompting the patient to change doctors or home pharmacies.
“The intent [of technologies like RTBC] is to prevent the patient from showing up at the pharmacy and having a bad experience: [The medication] is not covered, it’s $500, there’s a prior authorization which has not been completed…”- Brent Schwartz, Allergan
With RTBC, providers can inform patients if a PA is needed and start the PA electronically at the point of prescribing so miscommunications at the pharmacy are less likely to happen. Brent applauded RTBC solutions, like RxBenefit Clarity™, that are able to leverage pharmacy connections to surface the cash price for medications, so that patients get more options on how to best afford their prescriptions and avoid sticker-shock at the pharmacy.
“…there are opportunities to get product off benefit for cash… providing more of a complete picture of what all the options are [for the patient]. Also bringing in co-pay assistance options to show what the out-of-pocket is net of any co-pay assistance that’s available.”- Brent Schwartz, Allergan
Brent also covered a range of other topics, including electronic prior authorization (ePA), the value of centralized teams for completing PA requests and important questions to consider when selecting a vendor for RTBC and ePA solutions.
Check out the full talk below and learn more about how technology can be leveraged to help patients get the medications they need to live healthy lives.
CBI Hubs Conference Recording of Brent Schwartz
Opinions expressed are solely those of the speaker and do not necessarily reflect the views of the employer.