Providing Care Managers with Patient Medication History Data Could Help Increase Adherence and Save U.S. Healthcare $3.76 Billion

Surescripts®, the nation's leading health information network, projects more than $3.76 billion in savings across healthcare in the U.S. for health plans, employers and patients, when care managers have access to a patient’s medication history, better enabling them to support patients, close gaps in care, and improve Star Ratings.

An analysis conducted by Surescripts examined the cost savings that could be realized if care managers leveraged Surescripts Medication History for Populations technology to simplify the medication review process with dispensed medication data that informs gaps in care and member risk, assesses adherence, reconciles medications and reduces the likelihood of adverse drug events.

The projected savings across stakeholders over the course of three years is significant:

• Patients: $1.88 billion saved nationwide for patients enrolled in health plans due to lower healthcare spending and fewer workdays missed.
• Employers: $1.23 billion saved in reduced healthcare spending in addition to greater employee productivity and from fewer days missed at work.
• Payers: $648.3 million in estimated savings for U.S. health plan populations, stemming from lower medical costs and higher Star Ratings.

More than a quarter of U.S. adults face multiple common chronic conditions, like diabetes and hypertension, and a population seeing the largest and fastest increase among people ages 65 and older in more than a century, care providers are managing more at-risk patient populations than ever before.

The CDC reports that in the U.S., nearly seven in 10 adults aged 40–79 used at least one prescription drug in the past 30 days and more than one in five used at least five prescription drugs in that timeframe.

“Technology that provides clinicians and care managers with visibility into a patient’s medications can help tackle one of the costliest challenges in healthcare – helping patients, especially those with chronic conditions, get the routine care they need to manage and avoid more serious, costlier care events,” said Dr. Lynne Nowak, Chief Data & Analytics Officer for Surescripts. “Given how often medications are part of a patient’s care plan, Innovations that help care providers get on the same page with access to timely, complete and accurate patient medication information can meaningfully improve adherence, support safer prescribing and deliver overall better quality, less costly care for patients.”

For several years, provider organizations have been using Surescripts Medication History for Populations to make their care management programs more efficient. Patient data that once took a full month to reach them now arrives in one to three days.

“The ability to access complete medication history for all partners supporting a patient’s care but is especially critical to reducing risks for those patients with multiple chronic conditions like diabetes and hypertension,” said Tara Dragert, Chief Product Officer for Surescripts. “When care teams have the full, up-to-date picture of their patient's medication histories, they can better support and close gaps in their care with targeted interventions and meaningful medication management support between provider visits. Having this information can also mean more successful value-based care programs and most importantly, improved care outcomes for patients.”

Health plans experience member turnover at the new year and throughout the year, which means they have very little data—or none—on new-to-plan members, making it more difficult to identify higher-risk members. This technology provides access to this information, helping care managers identify patients who may benefit from additional outreach and support in chronic disease management programs.

About the analysis: Projections of future experience based on reasonable assumptions. The assumptions used in the modeling of prepared scenarios are reasonable, both individually and in aggregate. Results may vary from these projections based on the emergence of actual experience.

About Surescripts

Our purpose is to serve the nation through simpler, trusted health intelligence sharing, in order to increase patient safety, lower costs and ensure quality care. At Surescripts, we align healthcare organizations across the nation and convene the Surescripts Network Alliance® to give healthcare professionals the trusted insights they need to serve patients. Together, we're bringing more intelligence to prescribing, informing treatment and care management with interoperability, and making it simpler to handle benefits and authorizations so patients get high-quality, affordable care sooner. Visit us at surescripts.com and follow us on LinkedIn.

View source version on businesswire.com: https://www.businesswire.com/news/home/20250219497477/en/