rxeffect training · • provides both patient-level predictions and contract-level forecasts...

© 2017 RxAnte, LLC All Rights Reserved. Confidential. 1© 2 0 1 5 R x A n t e , L L C A l l R i g h t s R e s e r v e d .

C o n f i d e n t i a l .

RxEffect® TrainingUpdated January 2017

© 2017 RxAnte, LLC All Rights Reserved. Confidential. 2

Agenda

Introductions

RxAnte and RxEffect overview

Training walk through

Getting started


Overview of RxAnte

Who we are. Founded in 2011, RxAnte® is the leader

in improving medication use and drug therapy

outcomes through predictive analytics and targeted

clinical programs

What we do. We provide predictive analytics and

targeted clinical solutions to help our clients know the

future of each patients’ medication use—and change it

Our clients. We currently serve 4 of the 10 largest

MAPD plans, and more than 150 Medicare contracts

Our approach. Using highly accurate models, we can

predict the likelihood that a member will be adherent to

a specific therapy at the end of a specific time frame

• RxAnte Adherence Score™

• Uses widely available payer data

• Blends subject matter expertise and modern data science

• Provides both patient-level predictions and contract-level

forecasts

WON’TScore 15

MIGHTScore 62

WILLScore 97

0

RxAnte Adherence Score


4

Direct-to-Member Interventions

Provider Engagement Solutions

Population-Level Analytics

Member-Level Targeting

Identification of memberswho are at-risk of suboptimal medication outcomes early in

therapy

Deployment of decision rules to guide available

interventions

Tools & information to activate, equip, and support

accountable healthcare professionals

Direct outreach to members performed by the plan or vendors

(e.g., clinical calls, customer service reps, and interactive voice response

services) to discuss members’ medication adherence or other medication related outcomes

RxAnte offers an innovative, end-to-end service platform

A N A L Y T I C S &

D E C I S I O N S U P P O R T

P L A T F O R M


RxEffect – Right Patients, Right Time, Right Action

Targeted patient lists

• Predictive analytics choosing a subset of patients to optimize outreach efforts

Timely and regular updates

• Data is updated daily and adjusted based on user feedback

Easy to use and document

• Simplistic design and documentation makes it easy to use and train others

Strong workflow support

• Intuitive platform and flexible features adapt easily to your workflow


RxEffect Training


Training Overview

By the end of today’s training you should be able

to answer these four questions:

• Where can I find my highest priority patients?

• What type of information is available to support my outreach?

• How should I document my work?

• What are the best practices to discussing adherence?


RxEffect: Prioritized and timely

Contact soon list

All patients

Claims updated

daily

Patients selected

every other week

Only includes patients with

open opportunities

Patient list is intelligently prioritized by RxAntepredictive analytics

Refill info updated

daily


Patient List & Attributions

Will be a subset of your patients, not all patients

• Only patients that are at risk for non-adherence and on Medicare

Will be a subset of providers, not all providers

• Providers are selected based on the patients selected. If the provider does not

have patients on the prioritized list, they will not be included

Contact Soon logic is based on numerous factors, not just refill

status/date

• This includes predictive factors such as number of opportunities, probability of

adherence, etc.

Attributions determine which patients/providers you will be able to

view within the tool

• WC provided files attribute members to their PCP, IPA, then LOB

• User attributions then determine the TIN or IPA each user has access to


RxEffect: Strong support for your workflow

Default view shows all practices you have access to• To view one practice, select the Practice filter and apply the filter

Multiple filtering options, favorites list• Providers, opportunity type, contact status, patients per page

Print and download features available for offline work• To ensure patient lists are current and manageable, only 250 patients can be

printed at a time and 500 patients in a downloaded report

10

Create Detailed Excel File

Create a Favorites

List

Set Patient Status


Example of downloaded list – Patient List


Types of Opportunities - Adherence

Three therapy areas:

• Diabetes, cholesterol (statins), hypertension

(RASAs)

These are patients that are at risk for

non-adherence by the end of the year

• Adherence is defined at 80% proportion of

days (PDC) covered, based on CMS

standards

Missed Days & Refill Status

• How many days can be missed this year and

patient remains adherent

• When is the next refill due

• Updated daily


Missed Days Calculation

The targeted number of

missed days is how

many days this year the

patient can miss that

therapy and still remain

adherent.

Fred can miss

65 days

of his blood

pressure med

this year He can miss

72 days of his

cholesterol

med this year

And can miss

73 days of his

diabetes med

this year


Types of Opportunities - Alerts

30 to 90 Day Alerts

• Patient has a 30 day Rx and could switch to

a 90 day Rx for improved adherence

High Risk Medication Alerts

• Patient taking a medication considered high

risk in the elderly

Statin Prescription Recommended

• Patient has diabetes medications but no

statin prescription filled


Opportunity Resolution

Achieved opportunities

• Green checkmarks indicate the

patient has enough pills on hand to

remain adherent that year OR have

started/stopped the recommended

med

Missed opportunities

• Red Xs indicate the user will not

achieve their targeted number of

missed days for that year or will not

start/stop the recommended therapy


What information is available to support outreach?

You can click

on a therapy

card and view

the information

this way, going

through each

therapy once at

a time

Or click on the

patient’s name

to be taken to

their profile and

see all at once


What type of information is available to support my outreach?

Patient view• Demographic

• Contact status

• Prescription including

pharmacy and

prescriber information

• Missed days

• Refill by date

• Fill history

• Refills Remaining


DocumentingBarrier assessments

• This is a critical in any

patient outreach –

determine the patient’s

barrier, or reason, to not

adhere to their medication

and assist them in

resolving it and taking their

meds as prescribed

Remove therapy

options

• Discontinued meds ONLY

• Cash, VA, samples, etc.

option

• Splitting pills

• Removes therapy

permanently. Use with

caution

Therapy removal options

Barrier assessment

options


How should I document my work?

Practice notes

• Must select “Add

note”

Contact status

• Update this!!

• Continuity of care!

Remove patient

from list

• Takes 24 hrs to

update

Contact status & practice notes shared to all users with access to that practice


Best Practices – Adherence Discussions

Start by asking if they are having any troubles

with their medications

• Even if they answer no – Don’t stop there!

Sample questions to ask:

• How were you prescribed this medication?

• How are you taking it?

• What questions or concerns do you have about your

medication?

Try to discern the adherence barrier

• Access? Education? Reminders?

• Help to resolve the barrier as possible

Remember this is a targeted list – all patients are at risk for non-adherence!!

Helpful tips

• State the name

of the drug

• Use missed

days as

appropriate

• Use open-ended

questions


Patient Case 1 – Josie Burton

Josie is first on your

contact soon list and has

a cholesterol opportunity

with 48 of 59 days missed

and a refill in 2 weeks.

During the outreach she

says she has no problems

with her medications but

you discover she misses 2

days a week

Upon further discussion

you find out that Josie does

not take her pravastatin

when she eats healthy,

since she “didn’t eat much

cholesterol and doesn’t

need it”

06/15

2016-07-16

2015-05-16 3

59

08/15


Poll Question 2

What Barriers does Josie have to taking her medications?

(select all that apply)

Does not believe this medication is important

Does not understand this disease state

Has concerns about side effects

Does not understand dosing instructions

Forgets doses, leading to delayed refills


Josie’s Barriers

Does not understand this disease state:

• Josie doesn’t understand that her

high cholesterol is not only

dependent on what she eats or the

cholesterol content of it

Does not understand dosing instructions:

• Josie doesn’t understand she needs

to take this medication daily for the

biggest benefit

Does not believe this medication is important:

• There might be some education

issues here with Josie since she

doesn’t understand the importance

of taking her medication daily

Others??


Finishing with Josie

Discuss dosing instructions and educate on her medications

Document barrier and consider adding a note

Update contact status

Complete necessary provider and/or patient follow up to fully

resolve medication adherence barriers

Josie


Getting Started


Resources Tab

Access to this

presentation

RxEffect highlight

video

Adherence

outreach

information and

references

Support contact

information


What Next?

Sign on to RxEffect.com and get started

Get familiar with your patient list, updates every other

week

Email the helpdesk at [email protected] with any

issues you encounter

http://www.rxeffect.com/

mailto:[email protected]


Thank You

rxeffect training · • provides both patient-level predictions and contract-level forecasts...

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