Opening the Door to the Patient Cost Conversation—and to Affordable Medications

Healthcare professionals used Greenway Health’s medication pricing tool to see cost and coverage insights at the point of prescribing—and saved patients an average of $57.77 per prescription in March 2024. This Q&A and a case study show how.

What is a real-time benefit tool? How does this tool offer prescription benefit insights at the point of prescribing? And how does that save patients money (and time) on their medications?

I asked two healthcare veterans for their perspectives: Dr. Michael Blackman, Chief Medical Information Officer of Greenway Health in Tampa, Florida, and Mary Ann Fore, Nurse Practitioner and Chief Operating Officer of Clinica Santa Maria in Brownsville, Texas.

Our conversation has been edited for length and clarity.

McNamara: Thank you for joining us today. First, please introduce yourselves, and describe your roles in healthcare.

Blackman: I am the chief medical information officer at Greenway Health and a primary care physician by background. I am trained in both internal medicine and pediatrics, and I’ve been working in health IT for a long time, since the “pre-meaningful use” days.

Fore: I’m the chief operating officer at Clinica Santa Maria, but my “real” identity is certified nurse midwife. So, I provide clinical services in addition to my administrative role. I’ve been at Clinica Santa Maria since we started the practice in 1982.

McNamara: Can you share a little about your healthcare organizations?

Fore: Clinica Santa Maria is an obstetric and gynecological practice with eight providers and two locations.

Blackman: Greenway Health is an electronic health record (EHR) that serves more than 10,000 ambulatory care practices across the nation.

McNamara: How does our medication pricing tool Real-Time Prescription Benefit fit into Greenway Health for your physician end-users, Dr. Blackman?

Blackman: It fits into the physician’s workflow each time they prescribe a medication. I believe that we should be good stewards of the patient’s money and try to control costs. This medication pricing tool is a way of doing that without sacrificing the quality of care.

McNamara: In your role as a nurse practitioner, Mary Ann, can you tell me where Real-Time Prescription Benefit fits into your day-to-day workflow at the clinic?

Fore: Each time we write a prescription. Absolutely.

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See the benefits of optimizing prescriptions up front

McNamara: How has using this medication pricing tool helped patients and providers?

Fore: It’s nice to have medication alternatives when we’re prescribing and to see how much the patient is responsible for paying. That way, I can talk with the patient about costs, and help set expectations for when they arrive at the pharmacy.

As a prescriber, if the medication is expensive, I will often choose an alternative. And we have a much better idea of what the patient’s insurance covers, so we don’t prescribe a medication that’s not on formulary. This results in better communication with the patient.

Blackman: And that increases patient satisfaction. The prescriber can initiate a conversation with the patient about costs, which saves money and time. The patient can see that the prescriber cares about the costs, and the right prescription is ready for pickup at the pharmacy, rather than having the patient wait while we make a switch.

McNamara: Dr. Blackman, the numbers at Greenway Health in March 2024 were phenomenal. By using Real-Time Prescription Benefit, the average prescription costs that your end-user prescribers saved per patient was $57.77—more than the $37 average savings we cited in our 2023 National Progress Report.

Blackman: In general, these savings speak to how prescribers, for the most part, don’t know what medications cost in a given health plan. Patients save money on their prescriptions when we do know.

“The workflow you build for prescribers should open the door to a conversation with the patient about costs...”

Dr. Michael Blackman

Chief Medical Information Officer, Greenway Health

McNamara: Do you have any advice for EHRs and other healthcare organizations about implementing medication pricing tools at their organizations?

Blackman: I start with the presumption that the medication is prescribed for a reason, but if the patient can’t pay for it, they won’t take it. The workflow you build for prescribers should open the door to a conversation with the patient about costs, and the patient will have that conversation—even though they would never bring it up themselves. This will help them get the treatment they need.

So, my advice is two-fold: (1) make the best choice in medication obvious; and (2) strike a balance between providing more information and creating simpler workflows.