The $300 Billion Medication Adherence Problem. Relevant Communications & Rewards Can Help.

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by Jim Techtmann, SVP, Healthcare Team Entertainment

In today’s healthcare environment, especially among senior populations, medication nonadherence is pervasive. Recent estimates state that lack of adherence takes the lives of 125,000 people a year and costs the U.S. healthcare system nearly $300 Billion annually. These studies show that half of all patients do not take medications as prescribed and adherence is lowest among patients with chronic disease.

In our work with health care plans and providers over the last ten years, we’ve come to understand that the gap in medication adherence is a huge problem for health plans, providers and physicians – but ultimately, and most importantly, patients. We have found there are proven best practices to improve compliance when facing this impediment to good health. Communicating with patients about the importance of taking medications as prescribed is a good first step. Providing relevant incentives to reward the right behavior is a great way to get results.

We have found, In most cases, with our dozens of health care plans, providers, and thousands of members, that rewards for healthy living have helped health care organizations realize 10 – 20 percent improvement in goals year-over-year. Plans that want to improve medication adherence have focused on helping members be aware of and follow a ‘prescribed treatment regimen’. Medication therapy management has contributed significantly in helping Medicare Advantage plans achieve improved Star Ratings by helping their Part C members to follow their treatment plans.

A multi-touch medication adherence campaign can deliver effective results for less than $4 – $6 per member. This is a great value considering total potential savings from adherence and related disease management, for chronic conditions, could be over $290 billion annually.

A major Midwest Medicare Advantage plan set a goal to target and increase key health measures to improve its 4.5 Star Rating. It aimed to improve medication adherence for diabetes, high blood pressure and high cholesterol in their Part C plan. The plan created a two-year strategic plan that focused on rewarding rewarded patients with savings for adhering to their prescribed treatment regimen. The communication program included a launch piece with health, wellness and prevention tips, the importance of following the treatment plan, a reminder at the midway point and a final high value incentive reward for completion of the program. By the end of the program, the plan exceeded its goals by 20 percent. The program was a key component in the plans strategy for achieving a 5 star rating. one of the components in the plan improving to a 5-Star overall rating.

Many health care organizations are looking at ways to use behavior economics to improve wellness. In general, people make bad decisions even when they know those decisions are harmful. Health care organizations like Humana are testing out new ways to change patient behavior. Humana has piloted several innovative programs, including using reminder messages from celebrities, like Queen Latifa, versus physicians to encourage healthy behaviors.

Just like messages from celebrities can be a fun way to motivate patients, so can discounts and savings on things people do every day. Discounts and coupons are universally loved – 96 percent of consumers use coupons regularly and love to save. These special healthy living rewards programs that we’ve created for our health care clients are proven motivators to engage patients and help change their behavior. It is extremely challenging to motivate patients to make the right choices, so we must get creative in how we engage and ultimately change their behaviors. Using fun versus fear to appeal and connect with patients, on an emotional level, is always a good place to start.

NOTE: As with any program that falls under the Government sector (Medicare & Medicaid) and involves Rewards and Incentives, we highly recommend you seek the advice of your Compliance team.