Member and Physician Education Strategy
We drive compliance to improve health and reduce costs. Gaps-in-care messaging for our clinical and cost-of-care programs is included in one communication. Members don’t receive multiple letters focused on individual clinical and cost-of-care programs. And, to help ensure coordination of care and compliance, physicians also receive a consolidated communication with similar messages.
By using targeted, concise communication, we help members make good health care choices and improve health outcomes.
Once we identify a gap in care, the member receives a personalized Medication Review, which contains pharmacy messaging for our clinical and cost-of-care programs in one consolidated, health plan-branded, monthly member communication. These messages help ensure members are using medications appropriately and safely – and saving money. It includes recent claims history, up to four concise messages that cover therapy and safety gaps in care and opportunities to save money, important telephone numbers, and access to customized health information from Harvard Medical School. And Patient Highlights, our provider communications, help ensure coordination of care and compliance.
We integrate medical, pharmacy and lab data, plus member eligibility and benefit information, to create a holistic picture. Daily, weekly and monthly data feeds help ensure timely, more effective member and physician messaging, and alert us to drug-drug and drug-disease safety concerns. With our medical and pharmacy programs integrated, we can target members with specific, robust messages. We send generic and therapeutic equivalent messages with actual cost savings. And we can list alternative drugs specific to a member’s drug list.
We help ensure coordination of care and compliance. We send Patient Highlights, a consolidated communication, monthly to provide an overview of gaps in care for all of a physician’s patients. This approach eliminates the need to send multiple letters to physicians for each of their patients. We combine clinical intervention and therapeutic equivalent messaging, and encourage recommended adjustments to care plans.