INTELLIGENCE IN ACTION

Older, Sicker Patients Will Benefit from Real-Time Benefit Tools, So Let’s Not Delay Using Them.

April 15, 2019

Healthcare costs are increasingly prohibitive for too many Americans, and these costs can hit older Americans especially hard. That’s why we applaud the Centers for Medicare & Medicaid Services (CMS) proposed rule on real-time benefit tools (RTBT).

We believe these tools hold the greatest near term promise for making medicine more affordable for patients, particularly for older adults who have multiple medical needs and limited resources. In 2018, prescribers used our tool, Real-Time Prescription Benefit, over 40 million times to view patient-specific prescription price and therapeutic alternative information at the point of care.

The proposed rule, published in the Federal Register late last year, would require Medicare Part D plans to make these tools available to prescribers as soon as possible, with a proposed implementation deadline of January 1, 2020.

Such a deadline will accelerate adoption, meaning vulnerable patients could see real savings much sooner than the implementation date. And when patients can afford medications, they’re more likely to adhere to them.

We know that there are concerns that this timeline is aggressive, but we believe they’re unfounded. The EHRs that have already contracted for Real-Time Prescription Benefit represent 80 percent of U.S. prescribers, and at least three additional vendors offer their own versions of a RTBT. In our comments, we urged CMS to make their decision on timing in favor of patients. Our nation's seniors should benefit from price transparency tools that have developed in the commercial marketplace and are already in widespread use by Part D plans.

To read our comments in their entirety, including more about how tools such as Real-Time Prescription Benefit can accelerate healthcare interoperability, increase price transparency and meet some of the goals of value-based care, please click here.

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