UPMC, a health care organization that includes UPMC Health Plan, the largest health insurer in western Pennsylvania, implemented a new technology in partnership with RxRevu to enable its physicians to help patients lower prescription drug costs based upon their insurance coverage.
By giving UPMC physicians real-time access to a patient’s benefit levels through UPMC Health Plan, doctors can consider lower-cost alternatives when writing prescriptions.
In addition to potentially lower costs, patients can also avoid delays associated with obtaining prior authorizations needed for certain prescriptions.
“This really is about getting the script right the first time by having physicians view a patient’s insurance benefits in real-time to make informed decisions,” said Chronis Manolis, RPh, senior vice president, Pharmacy and Chief Pharmacy Officer for UPMC Health Plan. “This will be a useful tool to help patients avoid delays and save on out-of-pocket prescription costs.”
UPMC and UPMC Health Plan operate as an integrated delivery and finance system, improving the outcomes and experiences of patients and members by seamlessly integrating the clinical and payor experiences.
Using SwiftRx Direct, a real-time prescription benefit developed by RxRevu, UPMC physicians will have an enhanced ability to view patient-specific coverage information, formulary-driven alternatives, and lower-cost drug options during office visits.
The drug pricing data that the physicians see is a true representation of what that patient would be asked to pay out-of-pocket at the pharmacy.
“By displaying patient-specific cost and drug coverage information within our prescription decision process, at the point of care, we enable physicians to prescribe the right medications that our members can afford,” Manolis said. “This enhances the overall patient and physician experience and aligns with our value-based philosophy by providing data transparency in real-time.”