We are excited to present this article, reprinted with permission from Ryan Hess, Vice President of Product Innovation at Surescripts®.

At the end of 2020, Congress passed legislation intended to drive greater price transparency for prescription medication. Part D Medicare plans are now required to implement at least one real-time benefit tool integrated into prescribers’ e-prescribing and electronic health record (EHR) systems. And, starting January 1, 2022, qualified EHR systems under the ONC Health IT Certification Program must include a real-time benefit tool that conveys patient-specific cost and coverage information.

Both regulatory mandates are an obvious win for patients who are increasingly concerned about rising medication costs. These changes will accelerate the adoption of price transparency tools at the point of care and ultimately lower beneficiary costs.  

But what’s the benefit for physicians?

For prescribers, real-time benefit tools can minimize workflow disruptions and fundamentally change patient interactions. Having cost conversations at the point of prescribing can substantially increase medication adherence, patient satisfaction and a patient’s likelihood of staying with that provider.

This legislation will improve patient care and their financial experience, but it’s only part of the equation. Educating frontline care providers on the importance of using these tools—and how they can help them initiate crucial cost conversations with their patients—remains an equally important priority.

“I’ve been involved in health IT for 20 years now, and adoption and change is really difficult,” Surescripts Chief Medical Information Officer Andrew Mellin, MD, MBA, recently shared on an MGMA podcast. “A number of doctors have said this is one of the best clinical decision support tools they’ve ever had in their EHR. But there’s still a large number of physicians who aren’t eager to do something else in the exam room – because they’re not aware the capability exists, they’re worried it’s going to take more time, or they don’t feel like it’s their responsibility. What’s really important as a practice leader is making sure they understand the value of this. I think the biggest thing is don’t expect just to flip the switch and have 100% adoption. To really see the value and benefit, it should be a systemic effort.”

Legislation and education are making a big difference in the adoption of real-time benefit tools. Today, more than 88% of U.S. prescribers are served by an EHR, like Quanum EHR, with this feature or will have it soon. In fact, in 2020 more than 400,000 prescribers used Real-Time Prescription Benefit at the point of prescribing.

                                                                                                             Source: Surescripts internal network data

Our real-time prescription benefit embedded in Quanum EHR gives users the power of price transparency and can help lower costs and improve medication adherence while also improving patient satisfaction. Real-time, patient-specific benefit information also now include the addition of data for patients with Pharmacy Benefit Manager (PBM) OptumRx®. Learn more by calling 1.888.835.3409 or contact us via email. 

Ryan manages the Medication Information Services division of Surescripts.

Disclaimer: The views expressed in this blog post do not necessarily reflect the views of Quest Diagnostics^® or any of its employees.