Value-Based Care: The New Normal

[V7] Regulation to Outcomes: The Impact of Real-Time Prescription Benefit Checks

ACPE UAN: 0233-0000-19-050-L04-P | Contact Hours: 1.25 | Activity Type: Knowledge-based

Faculty(s)

• 

  Jacqueline Hager, BS

  Product Manager
  Surescripts
  Minneapolis, Minnesota
• 

  Roger G. Pinsonneault, RPh

  Vice President, Product Innovation
  Gemini Health
  Alpharetta, Georgia

Moderator(s)

• LF

  Louis J. Fayant, MBA

  National Account Manager – West
  ALK Abello, Inc
  Fairfield, California

One of today’s most popular concepts in managed care pharmacy is “real-time benefit checks.” The goal of this program is to improve price transparency to both providers and patients to help them make therapeutic choices based on an individual’s pharmacy benefit coverage. Several organizations have implemented this program and are seeing positive outcomes. How are these programs implemented? What types of impact do they have?

This session will provide a review of a real-time benefit check program, and then delve into the regulatory and operational aspects of implementing such a program. Our faculty will also share results from their programs including outcomes such as the impact on adherence, prior authorization change rates and prescribing provider satisfaction.

Learning Objectives:

At the completion of this activity, participants should be able to:

1. Define the role of a real-time prescription benefit check program.
2. Summarize the various options available in implementing a real-time benefit check program.
3. Describe how real-time benefit checks are addressed in the Medicare Part D rule for 2020.
4. Discuss the types of outcomes seen from established real-time benefit check programs in place today.