Digital tools can help providers proactively lower employee costs

When providers have visibility into a patient’s care and coverage information, more informed decisions, better outcomes and lower costs may result.

The high cost of health care may be a growing concern for employers and employees — but providers may be able to help. 

In addition to supporting employees across their health journey, providers can also play a pivotal role in reducing costs. The ability to access patients’ specific plan information in real-time, as they build out care plans, can have a big impact on both employee and employer costs.

How is this done? Through digital price transparency and comparison tools that are embedded into providers’ workflows. These “point of care” or “point of prescribing” tools can help providers assess their patients’ costs when recommending next best care or prescribing medications — all while the employee is still in the examination room.

“Having data in the hands of somebody who’s trusted by the patient at the moment that decisions are being made is critical," says Craig Kurtzweil, chief data and analytics officer for UnitedHealthcare Employer & Individual. "It can make the difference in where they go, who they see, what drugs they receive and the outcome and cost of their care.”

Digital tools to inform provider decision-making

When providers have real-time access to digital tools that give them visibility into patient-specific data, they have the potential to reduce confusion, streamline care and recommend cost-effective medical and pharmacy options to their patients. This may help providers give patients the best care options possible, while navigating an increasing volume of administrative tasks, which can take up nearly as much time as caring for patients.1

“Giving providers access to an employee’s specific benefits information in real-time enables them to coordinate the best possible care at the best possible price point.”

— Dr. Rhonda Randall, Chief Medical Officer, UnitedHealthcare Employer & Individual

At the point of care

Health care price transparency tools are a valuable resource for providers seeking to extend quality care at affordable costs to their patients. These tools present information about the costs of health care services, giving providers the ability to make more cost-effective decisions about their patients’ care.

Point of Care Assist® is a platform that integrates an employee’s benefit information with a provider’s electronic medical records (EMRs), offering up-to-date insights into clinical, pharmacy, lab and cost data.

Point of Care Assist also works to reduce providers’ administrative burden by making it easier to check everything from prior authorization and referral requirements to patient eligibility — all while patients are still in the examination room. This transparency may help improve quality of care and health outcomes for employees, leading to higher satisfaction levels.

It can also lead to lower costs for both employers and employees, especially given the price differences across various sites of care for lab work, non-emergent surgeries and radiology scans.

When combined with UnitedHealthcare Insights — a digital interface providing end-users access to aggregated data in real-time — providers can review clinical performance and provider-level channel interactions with UnitedHealthcare for simplified and personalized reporting. The interface also includes trend analysis tools to help providers reach affordability and quality targets.

Point of Care Assist by the numbers:2

  • 267K providers activated Point of Care Assist
  • 6.6M members impacted by providers using the Point of Care Assist tool
  • 59M unique member encounters resulted in 14.2M members using quality care opportunities

At the point of prescribing

Another area where providers can proactively help manage employee costs is at the point of prescribing. Tools that allow physicians access to patient-specific pharmacy information can improve affordability, medication adherence and health outcomes.

For instance, PreCheck MyScript®, a real-time benefits data tool from Optum Rx and UnitedHealthcare, helps providers access prescription costs, prior authorization requirements and patient coverage details directly through their EMR platform. This convenient access to patient data can help providers focus more on patient care, while enabling patients to get medications faster.

When a provider prescribes a medication through PreCheck MyScript, a trial claim is run through the Optum Rx pharmacy claims data base. Providers are given the employees’ coverage status, medication options and information about whether alternatives are available. It also lists the cost to employees based on their specific health plan, deductibles and out-of-pocket obligations — information that is critical in helping employees make the best financial decision for their situation.

PreCheck MyScript by the numbers:

  •  $119 on average saved by patients per prescription fill3
  • 4% improved medication adherence for diabetes, hypercholesterolemia and hypertension4
  • $41 saved by providers per prescription, per patient5
  • Up to 50 minutes saved by providers per patient by avoiding prior authorizations5

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