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Surescripts
In a fragmented healthcare system, it can be hard to exchange information efficiently
As a health plan, you’ve built up tremendous expertise in healthcare management. Your data gives you a unique opportunity to improve members’ health. But when providers and care managers don’t have up-to-date patient insights, expenses balloon—and the member experience suffers.
Communication gaps hinder care management.
It can be hard to connect with providers promptly and securely with medication updates or member care concerns. And the data your own care management teams need is often delayed.
Only 17% of physicians can easily find medication adherence data electronically.1
62% of patients say privacy protections are more important than easier access to their health data.2
Clinicians prescribe without seeing the full picture.
When your members’ prescription benefit plan details aren’t easy to find, prescribers make medication decisions without a clear view of patient costs and coverage.
Cost has deterred 53% of patients from taking a medication.3
Moving to electronic prior authorization could save health plans $99 million a year in labor costs.4
Solutions
Enable fully informed, cost-effective care decisions
Intelligent Prescribing
Lay the groundwork for safe prescriptions that align with your members’ benefit plans by sharing coverage information with clinicians.
Clinical Interoperability
Inform treatment and transitions of care by giving clinicians and your own care managers more patient insights and better communication channels.
Benefits & Authorizations
Protect quality and control costs with tools to supply cost-effective therapeutic alternatives and reach swift prior authorization decisions.
Care Team Evolution
As care delivery evolves, help your members receive exceptional care wherever they seek it with more clinical and cost information in practitioner workflows.
Value-Based Care
Help pinpoint opportunities to improve adherence, avoid unnecessary costs and close gaps in care with a sharper view of your members’ medication history, care activity and benefits.
Specialty Medications
Help ensure healthcare professionals have the trusted intelligence they need to get specialty medications to your members quickly, with less paperwork and lower costs.
Real-world results
Power care management & more with a QHIN™ connection
Enhance your care management, risk adjustment, utilization control and population health programs. As a QHIN candidate, Surescripts Health Information Network is preparing to help you access more data through TEFCASM with Interconnect.
One powerful connection to the point of care
A trusted network with nationwide reach
Surescripts processes 23.8 billion health data transactions per year.5
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One channel to reach nearly every prescriber
Surescripts connects 2.14 million healthcare professionals and organizations.5
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Collaborating to drive change through healthcare
Surescripts works closely with organizations such as AHIP and NCPDP to advance innovation.
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Keep pace with healthcare innovation
- Surescripts, “Data Brief: Physician Perspectives on Access to Patient Data,” April 2018, p. 1.
- Morning Consult and America’s Health Insurance Plans, “Price Transparency Polling Presentation,” January 2020, p. 3.
- Surescripts, “Prescription Price Transparency and the Patient Experience,” February 2020, p. 2.
- CAQH, “2019 CAQH INDEX: Conducting Electronic Business Transactions: Why Greater Harmonization Across the Industry Is Needed,” 2020, p. 17.
- Surescripts, “2023 National Progress Report,” March 2024.