Medicare AdvantageSeptember 1, 2024
Real-time prescription benefit
Want to reduce administrative burden and help your patients save on prescription costs?
With real-time prescription benefit (RTPB), care providers can access patient-specific drug benefit information within the e-prescribing process. This functionality allows care providers to proactively identify barriers to cost and improve medication adherence.
"Prescription pickup rates have increased 3.2% and saved patients on average $40 per prescription with using real-time prescription benefit.” — Surescripts.2
When using real-time prescription benefit during e-prescribing, care providers can see patient-specific benefit information including:
- Formulary status of selected medication.
- Patient cost share of medication at a retail and mail order pharmacy.
- Up to five formulary drug alternatives.
- Coverage alerts, including prior authorization and step therapy.
Benefits you and your patients will experience when using RTPB:
- Clearer, faster information
- Opportunity to lower cost barriers
- Decreased administrative burden
- Reduced time to therapy
- Enhanced patient experience
How real-time prescription benefit works:
- Prescriber enters prescription information through e-prescribing.
- The e-prescribing system triggers a data call to the pharmacy benefit manager (PBM).
- The PBM receives the real-time prescription benefit request.
- The PBM delivers cost, formulary, and utilization information for the selected pharmacy back to the prescriber’s electronic health record (EHR).
- Prescriber and patient make a choice together.
Help your patients save money on their prescriptions with EHR access to patient-specific drug coverage and out of pocket costs. Find out if your EHR vendor provides real-time prescription benefits information. There’s no charge for the service; however, you will need the latest version of your EHR.
References:
- Kleinsinger F. The Unmet Challenge of Medication Nonadherence. Perm J. 2018;22:18-033. doi: 10.7812/TPP/18-033. PMID: 30005722; PMCID: PMC6045499.
- Giaquinto K. Prescription Pickup Rates 3.2 Percentage Points Higher with Surescripts Real-Time Prescription Benefit, Saving Patients an Average of $38 Per Prescription. Surescripts. September 2022.
- Rodriguez S. Surescripts real-time prescription benefit drove medication adherence. EHRIntelligence. https://ehrintelligence.com/news/surescripts-real-time-prescription-benefit-drove-medication-adherence?_hsmi=226935530&_hsenc=p2ANqtz--HlMXEGIqFp9czAfA3_Z5V1uCL8ujtrmfRv3mTJ3EhaA0VCsVpQQmK9ifNmgQw4ApI_6rb1_AvlNFyilc9FXXymEO4zpPLFQUikhqNsjxAAA_8INg. Published September 21, 2022. Accessed November 2, 2022.
Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
MULTI-BCBS-CR-065105-24
PUBLICATIONS: September 2024 Provider Newsletter
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