Value-Based Care News

BCBSAZ Tackles Medication Adherence Through Mobile Health

BCBSAZ’s new approach aims to increase medication adherence by using text messages to remind members to refill their prescriptions and conferring copay discounts.

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By Kelsey Waddill

- Blue Cross Blue Shield Arizona (BCBSAZ) is using text message-based patient outreach to address prescription drug affordability and medication adherence, BCBSAZ announced.

The healthcare payer has partnered with health IT company Sempre Health to push refill reminders out to members.

“Medication adherence is an ongoing process that can continually improve. We see the Sempre program as being a very high tech, modern, simple and effective addition to our overall initiative to improve medication compliance,” Chris Hogan, chief pharmacy officer at BCBSAZ, told HealthPayerIntelligence.com.

Members encounter organizational, personal, and societal barriers to adhering to their medications.

Behavioral patterns are strong indicators that a member may struggle to adhere to their prescribed medications. Members who tend to forget, procrastinate, or who may be confused by lengthy medication lists may fail to adhere to their prescription plan.

Additionally, there are other challenges outside of member behavior. One of the major disincentives continues to be high prescription drug costs.

According to a CDC report, 70 percent of drugs prescribed in 2017 resulted in out-of-pocket costs. These bills prevent 11.4 percent of Americans from taking their prescribed drugs. Decreasing costs for members can impact overall health and prevent unnecessary, costly emergency department visits and hospitalizations, the report explained.

BCBSAZ faced a common problem for payers when learning how best to help members consistently meet their prescription requirements.

“A typical adherence program had been either letters to members or providers or phone calls, and particularly those two methods have not been super effective in terms of reaching members,” Hogan said.

When it became clear that these approaches were not having as significant of an impact as BCBSAZ hoped, the payer decided instead to use mobile messaging to enforce adherence.

The new program targets members with cardiovascular, respiratory, and diabetes chronic illnesses, covering 13 drugs. All of these drugs are on a BCBSAZ formulary and the goal of the program is to align members with that formulary.

BCBSAZ first contacts members by mail or email to alert them to the new offering. Once members opt in, communication continues mainly by text message.

Members will receive a message to remind them to refill their prescriptions. This immediate, timely contact helps combat behavioral barriers to adherence, such as forgetfulness or procrastination.

By refilling their prescriptions on time, members who use BCBSAZ’s new messaging program will receive a discount of up to $45 or $50 off their copay. This helps reduce the price barrier, encouraging greater adherence.

The discount may come in addition to the drug’s formulary status. A drug that is preferred on the formulary has a lower copay.

“We have three goals,” Hogan summarized. “We certainly want to make healthcare simpler. We want to make our products overall more affordable and so the discount that the Sempre program provides is critical. And then I'd say that the third category would be the general overall health and wellbeing of the patient in terms of improving their health outcomes. We believe a proxy to that is medication adherence. If there's increased medication adherence, then it’s more likely to improve the patient's outcome over time.”

Some payers, such as another Blue Cross Blue Shield company located in Pennsylvania, have tried the mobile approach and found it to be less effective due to a seeming lack of relevance or alert fatigue. BCBSAZ believes that they will be leveraging the technology more impactfully by pairing it with the discount.

BCBS AZ will continue to use medication adherence programs such as lettering and calls out to patients. Like most health plans, the payer also offers disease management programs that include adherence components. These programs address not just prescription adherence but also encourage annual physicals and other healthy, preventive actions that members should engage in regularly.

The payer started enrolling members in the program the week of August 12.