The power of connection: Outreach improves medication use and safety

Connection is key.

The Healthcare Effectiveness Data and Information Set (HEDIS®) is one of health care's most widely used performance monitoring tools for quality improvement. An important area within the HEDIS measure set is the medication management and adherence domain.

To ensure our IEHP Members have access to – and understand the importance of – medications to help manage their chronic conditions, the pharmacy team at IEHP uses a variety of approaches to coordinate care with Providers and remind Members about their prescriptions.

These actions include Targeted Medication Reviews (TMRs) through Member outreach calls, Provider communications and pharmacy support tools (i.e., 90-day supply, mail order, auto refill, etc.) – all to encourage appropriate use of important chronic care medications and improve overall Member care.

In 2021, the TMR Member telephonic outreach pilot program began. Pharmacists contacted a total of 784 IEHP Members who needed assistance with filling their antidepressants and cholesterol lowering medications (statins). As a result, the following successes were achieved:

Statin Therapy For Patients With Diabetes

• Medicare Members with diabetes who needed a statin medication, 22% of Members contacted had a statin added.

Statin Therapy For Patients With Cardiovascular Disease

• Medi-Cal Members with cardiovascular disease who needed a statin medication, 19% of Members stayed on their medications for more than 80% of the time.

Antidepressant Medication Management

• Medicare Members taking an antidepressant medication for the first time, 15% of Members had a continuous fill of their antidepressant medication.

In 2022, the team further expanded this program, engaging over 3,000 Members who needed help to ensure effective medication management to support a chronic condition.

The TMR program also includes directed Provider guidance communications for supporting their patients who were not filling needed medications to manage their chronic conditions. These TMRs provide a summary of recommendations to encourage medication adherence as well as a summary of the Member’s current progress and goal.

In 2021, over 2,700 TMR communications were sent out to more than 500 Providers to support optimal Members’ medication use.

Thanks to making these connections, IEHP is helping Members to effectively manage their chronic conditions.