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Point-of-care price transparency: improving workflows, meeting provider demand, and lowering patient costs

RxRevu | December 7, 2020

The price of a medication is a major factor in a patient’s willingness – or ability – to adhere to their prescribed treatment plan. But unlike nearly every other product a consumer might purchase in their typical day, the price of a medication is often unknown until checking out at the pharmacy counter.

While legislation is driving much of the urgency around price transparency, patients still reach the pharmacy not knowing what they might owe, and care teams must deal with the additional work and frustration of getting patients on affordable treatment plans. Fortunately, there has been a recent push for decision support tools to make the prescribing process more seamless and transparent. These tools are often described as Real-Time Prescription Benefit (RTPB), and can bring coverage information to EHR workflows, allowing providers to have informed conversations with their patients about the cost of medications – before they reach the pharmacy.

In order to more deeply understand what impact price transparency can have on the provider and patient experience, RxRevu commissioned a survey (download below) of prescribers to look at their current use of prescription decision support tools, what information they want at the point-of-care, and how they would benefit from having best-in-class RTPB solutions.

Survey Results

Not surprisingly, 88% of those surveyed want pricing information at the point-of-care in order to discuss affordable medication options and alternatives with their patients. However, only 11% of providers surveyed find their EHR’s current prescription decision-making tools to be helpful. Shockingly, more than three-quarters of those surveyed (77%) said that they must frequently change, manage, or resend a prescription order once it has been sent to the pharmacy.

The survey results demonstrate that simply having access to pricing information is not enough, since not all RTPB solutions are created equal. While some tools display patient-specific medication costs to providers, others show more vague, obsolete information. There is clearly confusion in the industry about what price transparency tools should accomplish.

Why Prescription Price Transparency Matters for CEOs

Both qualitative and quantitative responses from the survey demonstrate that health systems must think strategically about how they implement prescription price transparency tools, since provider satisfaction and patient safety fall in the balance. At a macro level, RTPB can bring outsized benefits to a health system, including:

  • Improving the provider workflow at the point-of-care; reducing time spent on prior authorization clearance and pharmacy callbacks downstream
  • Meeting the patient demand for price transparency to improve the overall care experience
  • Enabling systems to move toward risk by lowering the cost of care and driving medication adherence

RTPB tools are essential in making price transparency a reality, but building a strategy around medication costs and pharmacy is only the first step. As payer data becomes more readily available, healthcare leaders must consider how to effectively inform providers to allow for better point-of-care interventions. Better data can not only drive positive behavior change and improve the overall quality of care, but it can also help organizations move toward value. Without payer data informing care decisions, value-based care becomes more difficult – making it necessary to have tools to measure and manage costs at the point-of-care.

RxRevu works closely with health systems, PBMs, and EHR vendors to deploy the most accurate RTPB solutions available. Health system partners leverage the RTPB solution to display patient-specific pricing information at the point-of-care, taking into consideration copay, deductible, and coverage status information. By displaying the actual price a patient will pay at the pharmacy, health systems have been able to improve their provider workflows, reduce pharmacy callbacks, and create a more positive prescribing experience.

While this survey demonstrates the need for prescription pricing at the point-of-care, leaders need to think about where this trend is heading, and how to prepare for a more transparent future. Download the full whitepaper to learn more about the current state of prescription decision support technology and how best-in-class RTPB tools can improve the prescribing workflow.

Download RxRevu’s whitepaper:

About the Author

RxRevu, Author

RxRevu is a Denver-based company focused on improving healthcare through more informed, consistent and frictionless prescribing. Our Prescription Decision Support technology, SwiftRx®, promotes condition-appropriate prescribing, provides real-time patient cost, and allows health systems to holistically manage and measure clinicians prescribing behavior. RxRevu helps clinicians quickly and easily find affordable alternatives to costly medications, specific to each patient's health and financial needs.