Helping Physicians by Creating a Simpler Pharmacy Experience
Creating a simpler pharmacy experience begins at the point-of-care, when physicians are making crucial decisions with their patients. At Express Scripts, we employ the industry’s most comprehensive effort to champion a simpler pharmacy experience by improving connectivity and easing the administrative burden for physicians and their staff. Our physician-minded portfolio of programs and digital tools streamline and improve the prescribing process, helping physicians and providers make better clinical and cost-effective decisions with their patients right at the point-of-care.
Our industry leading technology platforms are powered by data and analytics from billions of claims. Through the use of machine learning and AI, coupled with high-touch interactions with our pharmacists, we are helping physicians make the most appropriate, cost-effective prescribing decisions with significantly reduced administrative burden.
Greater Care Coordination, Safety and Cost Clarity
Digital solutions, such as electronic prior authorizations, clinical direct messaging and real-time prescription benefit information improve connectivity and reduce costs for both members and plans. Using real-time data, we inform prescribing decisions by sharing the patient’s out-of-pocket cost, formulary coverage, therapy options, generic vs brand pricing and pharmacy channel pricing differences. The information also helps physicians address safety concerns, such as drug interactions, over-utilization and adherence gaps for patients who are late to fill a medication.
More than 85 percent of physicians use electronic health record (EHR) technology in their practice, and increased adoption of this technology has allowed us to further innovate in this space. In 2016, Express Scripts was first in the industry to collaborate with Surescripts to bring real-time prescription benefit information directly into the physician workflow via the EHR. By the end of 2018, we expect more than 100,000 prescribers will have access to this information.
Prior Authorization in Under Two Minutes
Express Scripts also has the most comprehensive electronic prior authorization (ePA) technology for physicians, with more than half of all prior authorizations coming in electronically. Using ePA is 11 times faster than traditional prior authorization processes, with decisions returned to prescribers in under two minutes. Nearly 80 percent of prescribers who treat Express Scripts members are submitting prior authorization requests electronically. Greater adoption of this technology is critically important as new, high-cost therapies come to market and require plans to better manage appropriate use via prior authorization.
Face-to-Face Prescriber Engagement
In addition to our efforts to inform prescribing decisions before the patient reaches the pharmacy counter, we are working with physicians to inform future patterns of prescribing.
Our high-touch approach to prescriber engagement is led by a team of more than 200 pharmacists and physician engagement specialists who interact in-person with prescribers and office staff. Our pharmacists help physicians stay well-informed about lower-cost therapy options, and help identify patients who have critical gaps in care or other medication concerns. Our team also assists physicians with optimizing their EHRs and Express Scripts’ digital tools to make prescribing simpler, faster and more cost-effective for patients and their plan.
For one of our clients, our clinical team visited physicians who care for their members, which resulted in more than $1 million in savings for the plan in just nine months.
We know physicians’ time is limited, so we tailor our interactions with them based on data from our proprietary provider analytics platform, MediCUBE®, and our predictive modeling and population health analytics tool, HealthPredictSM. With this information, we can optimize our time with each physician and pinpoint the greatest opportunities to help them and their patients.