Outcomes-Utilization: Mail-Order Pharmacy Article
Pharmacy and mail-order benefits allow for a streamlined and convenient patient experience
Prescribers increasingly rely on mail-order services to help keep their patients well and close adherence gaps. In fact, 2021 proved to be a year of growth for CenterWell Pharmacy, formerly Humana Pharmacy, with activity driven largely by primary care physicians in value-based care arrangements.
Some 70% of the 32.4 million prescriptions for Humana MA members were written by physicians in value-based care agreements.
“A little more than half of Intermountain Healthcare’s 47,000 Humana MA patients are regular CenterWell mail-order customers. Its prescribers routinely tout the pharmacy as a means for overcoming potential physical and financial hurdles,” says Dr. Maged Makar, the group’s Pharmacy Director.
Why it matters
Using the mail-order benefit entails zero copays for many generic medications, reduced copays for a number of brand pharmaceuticals and no shipping costs on medicines. Prescriptions are mailed directly to the patient’s address, meaning they only need to go to the mailbox for retrieval instead of potentially several miles to a retail location.
When it comes to utilization and copays of generics and name brands combined among Humana total MA membership, value-based members are prescribed about 7% more medication than non-value-based members but pay roughly 11% less per month, due to the prevalence of generics in member medication regimens. Much of that lower cost is attributable to higher uses of generics, where value-based members are spending 16% less per month.
The way forward
“Mail-order pharmacy represents a tool physicians can use to break down roadblocks and build confidence among those they serve,” says Dr. Lindsay Botsford, Texas Medical Director for Iora (OneMedical). It provides a seamless process for Iora care teams to order prescriptions at the site of care and keep patients satisfied.
A little more than 55% of Humana MA members with Iora use CenterWell mail-orders.
Intermountain Healthcare has worked with CenterWell over the last couple of years to boost the efficiency of its collaboration. Prescriptions are inputted into a spreadsheet and sent each day electronically to the pharmacy, which fills them all at the same time. The procedural change allows Intermountain to redirect resources.