Pharmacy navigation solutions are your secret weapon against soaring healthcare costs! These services help employees manage their treatments and find cost-effective meds, all while making healthcare less confusing and more efficient. With top companies like Quantum Health, Accolade, and Liberty Rx, you can streamline the healthcare experience and save big—it's a win-win for everyone!
In our previous posts, we've explored how carve outs and international sourcing can help you battle the never ending influx in healthcare costs (if you missed them click here). While these strategies are great, they aren't always the perfect solution for every situation. So, in this post we are going to turn elsewhere– pharmacy navigation solutions.
These specialized services leverage the cost saving potential of patient care management, because, the sad truth is that most people in the U.S struggle with health literacy and that is losing you a lot of money. Data (see table 1) shows that 88% of U.S. adults do not have skills sufficient enough to manage their healthcare needs, which results in poor treatment adherence and missed preventative care opportunities. This adds a striking 7–17% on top of your existing healthcare expenditures.
The good news is that pharmacy navigation solutions are really good at tackling these unnecessary expenses. In fact, the healthcare navigation company, Quantum Health, reported an impressive return on investment (ROI) of 3.3 in the first year and 5.3 after three years for employers using their platform. So, if you want to know how to secure these returns for yourself follow along as we explain what pharmacy navigation solutions have to offer!
Pharmacy navigation solutions are all about giving you a personalized healthcare experience. They use patients' medical information to find the best ways to prevent or treat any medical issues in a fast but informed way. As summarized byScott Doolittle, chief financial officer of Quantum Health:
“When we think about what we’re uniquely qualified to do, it’s these complex problems [pharmacy navigation] because we have people that are trained in healthcare.”
With such a good understanding of their clients medical situation, these solutions can go ahead and track patients treatment progress, helping them stay on track, purchase cheaper medical equivalents of their prescriptions and navigate them towards appropriate and cost-effective therapies. For instance, if a patient fails to pick up their prescription, they will flag their behavior and contact them to make sure the patient adheres to their treatment.
What is more, patients also receive a team of Patient Care Advocates (PCAs) who will assist them with any type of inquiry or request. They will even advocate for the patients rights, and manage administrative burdens associated with insurance and medication access. What an upgrade from the otherwise multi-step complex process where patients have to contact their PBM, pharmacy, or insurer with questions or issues!
With such support and information, patients are finally sufficiently educated on their healthcare coverage to make well informed decisions about their treatment. This can not only lead to better treatment adherence (as we mentioned many times) but also more confidence when facing new or changing treatments. Patients are more aware of treatment options and resources making them comfortable changing to more cost effective medications or providers.
In essence, pharmacy navigation solutions streamline the healthcare experience, making it more accessible, cost-effective, and less overwhelming for patients. It's a win-win for your employees health and your budget!
While pharmacy navigation solutions bring a lot of convenience and benefits, they do come with some potential downsides. One thing to be aware of is their heavy reliance on data and technology. These systems are very sophisticated, however they cannot pick up on all patient nuances like an in-person doctor can. For instance, if the system doesn't get a patient's medication history right or overlooks an allergy, it might suggest inappropriate medication, which could lead to some issues or delays in treatment.
It's also easy to get a bit too comfortable relying on pharmacy navigation systems because of their convenience and service selection. They make everything feel super streamlined and easy, but it's important to remember that they're just tools. They’re not a substitute for real healthcare professionals. Doctors and therapists are essential for ensuring patients get the best care possible. So, while these solutions are great for guidance and support, patients should still be reminded about their purpose to fully benefit from their services.
If you're thinking about using pharmacy navigation solutions but aren't sure where to start, we've got you covered. We've picked three standout companies that we believe can help you achieve your savings goals. Each company has a unique focus and approach, so the best choice for you will depend on your specific objectives. No matter which one you choose, you’ll be in good hands! Let's take a look at what makes each of these options great.
Quantum Health’s Premier Pharmacy navigation solution has an in-house clinical pharmacy team that provides personalized guidance on cost-effective medication options. They also use their sophisticated technology that catches intervention opportunities right at the point of care with a 91% success rate. If your employees require complex treatments or your plan includes intricate pharmacy benefits, Quantum Health is for you!
Accolade takes a more holistic approach to healthcare. Their platform goes beyond just pharmacy navigation; it integrates various healthcare services to offer a full package. Think virtual primary care and a collaborative care model where primary care physicians team up with mental health professionals. If you're looking for a one-stop-shop for all your healthcare navigation needs, Accolade is ideal for providing that experience!
Liberty Rx is known for its easy-to-navigate interface and automation features. They also put a big emphasis on compliance which is essential as pharmacy regulations can become complex and very challenging to navigate. This is very important given the increased legal scrutiny that insurers and plan sponsors are under. So, if you value fast delivery, a streamlined service and legal reassurance, Liberty Rx is a great option!
And there you have it! Pharmacy navigation solutions are a fantastic tool for uncovering cost-saving opportunities. They’re tailored to your needs, offering a smooth and streamlined experience that prioritizes both your employees health and your company's budget. That’s a great deal!
To get you started, we've highlighted a few standout companies with unique strengths. But if these options don't quite fit your needs, don’t worry—there are plenty of other great choices out there. It's all about finding the one that aligns perfectly with your specific goals and requirements.
Contact the TrueClaim team to learn more!
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