Performance Metrics & DIR Fees:
With the increase in value-based third-party payer contracts factoring medication adherence rates into overall reimbursement, pharmacies have a unique opportunity to engage patients, modify behavior, and lower cost for everyone. Acquiring the right solutions and understanding the tools needed to measure and track results can not only improve the health of your patients…it can improve the financial health of your pharmacy.
From 2019 to 2021, through a partnership with PSAO, Pharmacy First, Medicine-On-Time piloted a program with Germ’s Thrift Clinic in Opelousas, LA with the goal of measuring the impact of Medicine-On-Time on Medication Adherence Metrics, DIR fees, and performance-based bonus programs. The results of the two phases of the pilot are detailed below. Continue reading on Page 9 to learn how Medicine-On-Time can help your pharmacy achieve similar results.
Pilot – Phase 1
Increasing Patient PDC Scores
During the initial phase of the pilot, Pharmacy First measured the impact of Medicine-On-Time on Patient PDC scores. They measured PDC scores for patients for 6 months prior to starting Medicine-On-Time and for 6 months on Medicine-On-Time. The overall average increase in PDC scores for poor performing patients was 30.2%. Here is how the numbers broke down by disease state:
Overall Improvement in PDC Score for low- performing patients:
Pilot – Phase 2
Lowering DIR Fees
Phase 2 of the pilot focused on mitigating CVS Caremark DIR fees. From 2019 to 2020, Germ’s Thrift Clinic’s CVS Caremark DIR Fees moved from the highest end of the contract’s variable range to the lowest end of the variable range. This means they are now paying the lowest DIR fees available under their contract with CVS Caremark!
Increasing Performance Payout
Medicine-On-Time’s impact on PDC scores also increased the Performance Payout CVS Caremark makes available to qualifying pharmacies. From 2019 to 2020, Germ’s Thrift Clinic’s performance payout dollar amount increased 500%!