Friday, May 22, 2020

Electronic Prescription Management and Enrollment for Specialty Medications—Expanding Provider Adoption of Tech-Enabled Hub Services

Today’s guest post comes from Kyle Grimslid, Market Development Director at CoverMyMeds.

Kyle describes the complications that providers and patients encounter in the specialty prescription process. He describes how AMP: Access for more Patients™ enhances access, affordability and adherence—including a reported 27% reduction in time to therapy.

Click here to learn more about how CoverMyMeds and RxCrossroads by McKesson are using technology to solve patients' medication access challenges.

Read on for Kyle’s insights.

Electronic Prescription Management and Enrollment for Specialty Medications—Expanding Provider Adoption of Tech-Enabled Hub Services
By Kyle Grimslid, PharmD, RPH, Market Development Director, CoverMyMeds

Like never before, specialty medications are transforming care in therapeutic areas with historically limited treatment options. Growth in year-over-year specialty prescription volume suggests that providers increasingly see the value of these novel therapies for helping patients live healthy lives.

With interest and utilization on the rise, ensuring that specialty brands are well-equipped to support providers and patients throughout the complicated specialty process is critical for widespread access, affordability and adherence.

AMP: Access for More Patients™—an end-to-end, tech-enabled hub services platform from CoverMyMeds and RxCrossroads by McKesson—enables prescriptions for specialty brands to be electronically started, transferred and managed. Through AMP, patients have experienced a 27 percent reduction in time to therapy.

PRESCRIPTION CHALLENGES FOR SPECIALTY BRANDS

Identifying where to send specialty prescriptions, finding and completing correct enrollment forms as well as tracking down needed eligibility and insurance benefits information are common pain points that providers experience during specialty prescribing.

In fact, 57 percent of surveyed providers (n=400) have reported lack of access and uncertainty about benefits information for starting patients on specialty therapy. Many have also described using a variety of time-consuming methods for identifying where specialty prescriptions and prior authorization (PA) requests should be sent, such as gathering input from support staff and patients.

With so many compounding issues, it is no wonder that 80 percent of surveyed providers expressed some level of difficulty for starting patients on specialty medications. Consistently, fewer than one third of providers are satisfied with their current specialty workflow.

IMPACT ON PATIENT ACCESS AND WELLNESS

Patients often experience the collateral damage from these barriers to specialty prescribing.

Over a third of patients in a recent survey (n=500) claimed to have spent more than three hours coordinating therapy on their own. Such time and effort have led some patients to describe beginning a specialty therapy as a full-time job.

Other patients may not even get the chance to experience a potentially life-changing specialty therapy. Two thirds of surveyed providers have revealed that they alter their original plan when specialty prescribing challenges are encountered, with 76 percent of those respondents indicating that they switch to a different medication.

SIMPLIFYING SPECIALTY THROUGH TECHNOLOGY

For providers, the challenges caused by specialty medications are localized to three major parts of the specialty prescribing process: prescription intake, hub enrollment and eligibility criteria. Without solving for these key pain points, a given hub program will struggle to achieve provider adoption of its services.

PRESCRIPTION INTAKE

AMP is able to meet providers where they are by supporting manual (i.e., paper- and fax-based) and electronic prescribing workflows.

Through AMP’s electronic capabilities, providers can initiate enrollment through either the familiar CoverMyMeds web portal that many already use for PA requests, or by initiating an ePrescription via the provider’s EHR. By supporting all of these prescribing channels and by leveraging CoverMyMeds’ network of over 700,000 providers, AMP can reach more providers in-workflow – helping to catalyze viral adoption of the solution.

AMP is able to utilize its connection with RxCrossroads’ free goods pharmacy so qualified patients can get their first dose of therapy as soon as possible.

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HUB ENROLLMENT AND ELIGIBILITY CRITERIA

Prescriptions for sponsored specialty medications automatically trigger patient enrollment into AMP services. The correct enrollment form is autopopulated from the ePrescription and providers can then review and submit it within the Cases Dashboard of the their CoverMyMeds account. This is a crucial, time-saving benefit in response to provider frustrations over difficulty finding the correct enrollment form.

By coupling prescribing and enrollment, AMP is accelerating how quickly case managers can begin electronically coordinating other necessary steps for starting patients on therapy. In this way, tasks related to patient eligibility, like scheduling lab tests, completing benefits investigation, benefits verification and PA, can start immediately.

Once these tasks are complete, providers can authorize for medication to be dispensed to the patient. At this point, the clean prescription is sent to an appropriate specialty pharmacy for dispense.

Learn more about how AMP and CoverMyMeds leverage technology to solve medication access challenges for patients.


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