The $337 billion question: "What is the most significant driver of health care costs in the United States?" It is not the cost of prescription drugs, doctor salaries or government regulations--It is how we (fail to) act. According to Express Scripts research, medication nonadherence is one of the costliest health care problems in the U.S.
A 2018 survey conducted by Russell Research showed that nearly one-third of those taking prescription medications for chronic conditions say they are not concerned about forgetting to take their medications, despite the fact that almost one-half believe it is the most important thing they can do to protect their health. (1) And they're right in believing that taking preventive and management medications for chronic conditions can ward off a lot of pain and suffering, not to mention cost.
That $337 billion represents health care waste--emergency room visits, hospitalizations and extra tests--all to treat health complications that might have been avoided through medication adherence and proper preventive care. (2)
To bridge the widening gap between health care plan members' best intentions and worst behaviors, health care providers should consider a more direct, cost-effective approach that promotes convenience: leveraging digital solutions to develop personalized health outcomes through precision-based care. By complementing data and behavioral sciences with clinical specialization, digital innovation can expand choice and enhance the health care experience for all plan members, making certain that the healthiest decisions are also the easiest ones to make.
With this in mind, the new question becomes, "How can providers engage with members to end nonadherence?" The answer may be in the palm of members' hands.
There are plenty of consumer gadgets and digital applications available and no shortage of vendors knocking on benefit administrators' doors with promises of better health care for all. But simply making everything available to everyone or, worse, becoming overwhelmed and providing none of these potentially useful tools to anyone is not a solution. Health plan sponsors faced with making benefit design decisions--including whether to provide digital apps and other high-tech tools to members--need a better way.
The better approach may be using data analytics to truly personalize health care. What if plan sponsors could engage solutions that help prescribers and other clinicians identify which patients are most likely to become nonadherent, figure out why and deploy the right individualized technology to help? Through machine learning and predictive modeling--the use of advanced analytics and computer modeling to mine patients' medication, lab and clinical data for actionable insights--plan sponsors can address medication non-adherence. Data analysis can help providers select the right high-tech adherence intervention to get results, patient by patient, especially in chronic illnesses such as diabetes and asthma.
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