Access to Better Information at the Point-of-Prescribing Leads to:
Increased use of preferred medications
Higher in-network pharmacy utilization
Lower drug costs for patients and payers
High rates of medication adherence
Improved outcomes for patients
Better Information = Better Outcomes
BenMedica partners with Health Plans to improve formulary information through Electronic Health Records (EHRs). Access to better information such as copay, alternatives, and coverage restrictions enables prescribers to make more effective medication decisions for their patients at the point of prescribing. This increases the use of preferred medications and in-network pharmacies, lowering drug spending for all stakeholders.
Even for health plans that use PBMs, many prescribers only receive basic formulary information through their EHRs, leaving them without the necessary details to prescribe clinically effective drugs that patients can afford. Without access to robust formulary and benefit information:
Prescribers lose time selecting appropriate drug treatments
Health plans pay for non-preferred prescriptions
Patients are more likely to abandon prescriptions they cannot afford
PBM + Health Plan Formulary Data…Better Together
Traditional PBM information can be supplemented with more complete formulary and benefit data from a health plan. BenMedica integrates data from PBMs with enriched secondary formulary data created for a specific health plan. By leveraging our proprietary systems and ePrescribing expertise, our team can work in conjunction with health plan staff to create more robust formulary data and improve prescribing decisions through better information.
Our ongoing participation in developing the National Council for Prescription Drug Programs (NCPDP) standards that govern how formulary data is created, transmitted, and displayed in EHRs is critical to supporting prescribers in making the smartest drug decisions for their patients.
The Impact of Better Information
Health plans that work with BenMedica realize tangible results. Providing better information to clinicians supports improved Healthcare Effectiveness Data and Information Set (HEDIS) and Medicare Part D Star Ratings, both of which leads to higher reimbursement and better outcomes.
Health plans can also be confident in the output of working together, will understand the changes made to formulary and benefit data, and will have the right tools and data to measure the impact.