Data-Driven House Calls...To Doctors

May 2, 2017
Visits from Express Scripts physician engagement teams spur lower costs and better care.

Ashley Article 

In this age of smart phones, artificial intelligence and all-around connectivity, it’s easy to overlook the impact of personal interactions. While we continuously invest in technology at Express Scripts, we strive to incorporate the personal touch whenever we can. When high tech and high touch are in sync, the result is the best possible patient care.

A personal connection

Every year, our Express Scripts physician engagement teams make thousands of visits to physicians’ offices. These clinical teams of pharmacists and technicians build relationships with prescribers and their staffs, performing on-site and telephone consultations to inform physicians and support our clients’ clinical and financial goals. The results: improved patient care and reduced client costs.

Our pharmacists and technicians share helpful industry information with physician’s office staff to reduce their daily administrative burdens. Through the efforts of the physician engagement team, use of electronic prior authorization (ePA) among physicians they visited increased by 18% last year, saving offices hundreds of administrative hours that can now go toward patient care.

Feedback shows that physicians appreciate unbiased information that simplifies their workload. Physicians are now being held more accountable for the cost and quality of the care they deliver to their patients, so they also value the patient-specific reports focused on opportunities to close gaps in care or switch patients to lower cost medications when they can. Physicians also know they can go to their physician engagement team if an issue arises or they have a comment for us to pass along to the client.

Data informs our interactions

Express Scripts maintain strict privacy and security standards to protect client and patient data and privacy. Access to this information is limited to only those who require access in order to carry out their job responsibilities. Our pharmacists use data and our proprietary analytics tools to share individual prescribing patterns with physicians and compare them to their peers as well as to national benchmarks. Our data also enables our pharmacists to identify top prescribers of high-cost medications so they can focus on reducing the number of prescriptions written for certain high-cost drugs when a clinically-appropriate lower-cost alternative is available.

For example, some metformin products have soared in price by 800%, to as much as $90,000 a year per patient. For one client alone, our data insight tool identified 109 top prescribers of these high-cost metformin products, which are used to treat diabetes. Our pharmacist visited all 109 prescribers and educated them about lower-cost, clinically equivalent alternatives. In the four months following those visits, our client’s plan costs dropped by $1,402,940, compared with the previous four months.

Improving HEDIS performance for health plans

The Healthcare Effectiveness Data and Information Set (HEDIS) is a scoring system used by most U.S. health plans to measure their performance on important dimensions of care and service. These plans report HEDIS data to employers or use the results when enhancing service and care. Employers, consultants and consumers use HEDIS data when selecting the best health plan for their needs.

In late 2015, a health plan client leveraged our high-touch physician engagement model to help improve their scores for monitoring patients on specific long-term medications. Using patient data and direct outreach to providers, our team helped drive a 43% improvement in compliance in just two months. As a result, more than 1,000 patients got their required lab work completed and our client reached its HEDIS goal.

A partner for an uncertain future

As therapies become more complex and drug prices continue to rise, our clients rely on Express Scripts to partner with physicians and simplify the pharmacy experience. We are proud to lead the industry with innovative solutions and bold action that support physicians face to face so they can provide the best patient care.

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