Confidential. RxEffect ® Training Updated January 2017
© 2017 RxAnte, LLC All Rights Reserved. Confidential. 1© 2 0 1 5 R x A n t e , L L C A l l R i g h t s R e s e r v e d .
C o n f i d e n t i a l .
RxEffect® TrainingUpdated January 2017
© 2017 RxAnte, LLC All Rights Reserved. Confidential. 2
Agenda
Introductions
RxAnte and RxEffect overview
Training walk through
Getting started
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Overview of RxAnte
Who we are. Founded in 2011, RxAnte® is the leader
in improving medication use and drug therapy
outcomes through predictive analytics and targeted
clinical programs
What we do. We provide predictive analytics and
targeted clinical solutions to help our clients know the
future of each patients’ medication use—and change it
Our clients. We currently serve 4 of the 10 largest
MAPD plans, and more than 150 Medicare contracts
Our approach. Using highly accurate models, we can
predict the likelihood that a member will be adherent to
a specific therapy at the end of a specific time frame
• RxAnte Adherence Score™
• Uses widely available payer data
• Blends subject matter expertise and modern data science
• Provides both patient-level predictions and contract-level
forecasts
WON’TScore 15
MIGHTScore 62
WILLScore 97
0
RxAnte Adherence Score
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4
Direct-to-Member Interventions
Provider Engagement Solutions
Population-Level Analytics
Member-Level Targeting
Identification of memberswho are at-risk of suboptimal medication outcomes early in
therapy
Deployment of decision rules to guide available
interventions
Tools & information to activate, equip, and support
accountable healthcare professionals
Direct outreach to members performed by the plan or vendors
(e.g., clinical calls, customer service reps, and interactive voice response
services) to discuss members’ medication adherence or other medication related outcomes
RxAnte offers an innovative, end-to-end service platform
A N A L Y T I C S &
D E C I S I O N S U P P O R T
P L A T F O R M
© 2017 RxAnte, LLC All Rights Reserved. Confidential. 5
RxEffect – Right Patients, Right Time, Right Action
Targeted patient lists
• Predictive analytics choosing a subset of patients to optimize outreach efforts
Timely and regular updates
• Data is updated daily and adjusted based on user feedback
Easy to use and document
• Simplistic design and documentation makes it easy to use and train others
Strong workflow support
• Intuitive platform and flexible features adapt easily to your workflow
© 2017 RxAnte, LLC All Rights Reserved. Confidential. 6
RxEffect Training
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Training Overview
By the end of today’s training you should be able
to answer these four questions:
• Where can I find my highest priority patients?
• What type of information is available to support my outreach?
• How should I document my work?
• What are the best practices to discussing adherence?
© 2017 RxAnte, LLC All Rights Reserved. Confidential. 8
RxEffect: Prioritized and timely
Contact soon list
All patients
Claims updated
daily
Patients selected
every other week
Only includes patients with
open opportunities
Patient list is intelligently prioritized by RxAntepredictive analytics
Refill info updated
daily
© 2017 RxAnte, LLC All Rights Reserved. Confidential. 9
Patient List & Attributions
Will be a subset of your patients, not all patients
• Only patients that are at risk for non-adherence and on Medicare
Will be a subset of providers, not all providers
• Providers are selected based on the patients selected. If the provider does not
have patients on the prioritized list, they will not be included
Contact Soon logic is based on numerous factors, not just refill
status/date
• This includes predictive factors such as number of opportunities, probability of
adherence, etc.
Attributions determine which patients/providers you will be able to
view within the tool
• WC provided files attribute members to their PCP, IPA, then LOB
• User attributions then determine the TIN or IPA each user has access to
© 2017 RxAnte, LLC All Rights Reserved. Confidential. 10
RxEffect: Strong support for your workflow
Default view shows all practices you have access to• To view one practice, select the Practice filter and apply the filter
Multiple filtering options, favorites list• Providers, opportunity type, contact status, patients per page
Print and download features available for offline work• To ensure patient lists are current and manageable, only 250 patients can be
printed at a time and 500 patients in a downloaded report
10
Create Detailed Excel File
Create a Favorites
List
Set Patient Status
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Example of downloaded list – Patient List
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Types of Opportunities - Adherence
Three therapy areas:
• Diabetes, cholesterol (statins), hypertension
(RASAs)
These are patients that are at risk for
non-adherence by the end of the year
• Adherence is defined at 80% proportion of
days (PDC) covered, based on CMS
standards
Missed Days & Refill Status
• How many days can be missed this year and
patient remains adherent
• When is the next refill due
• Updated daily
© 2017 RxAnte, LLC All Rights Reserved. Confidential. 13
Missed Days Calculation
The targeted number of
missed days is how
many days this year the
patient can miss that
therapy and still remain
adherent.
Fred can miss
65 days
of his blood
pressure med
this year He can miss
72 days of his
cholesterol
med this year
And can miss
73 days of his
diabetes med
this year
© 2017 RxAnte, LLC All Rights Reserved. Confidential. 14
Types of Opportunities - Alerts
30 to 90 Day Alerts
• Patient has a 30 day Rx and could switch to
a 90 day Rx for improved adherence
High Risk Medication Alerts
• Patient taking a medication considered high
risk in the elderly
Statin Prescription Recommended
• Patient has diabetes medications but no
statin prescription filled
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Opportunity Resolution
Achieved opportunities
• Green checkmarks indicate the
patient has enough pills on hand to
remain adherent that year OR have
started/stopped the recommended
med
Missed opportunities
• Red Xs indicate the user will not
achieve their targeted number of
missed days for that year or will not
start/stop the recommended therapy
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What information is available to support outreach?
You can click
on a therapy
card and view
the information
this way, going
through each
therapy once at
a time
Or click on the
patient’s name
to be taken to
their profile and
see all at once
© 2016 RxAnte, LLC All Rights Reserved. Confidential. 17
What type of information is available to support my outreach?
Patient view• Demographic
• Contact status
• Prescription including
pharmacy and
prescriber information
• Missed days
• Refill by date
• Fill history
• Refills Remaining
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DocumentingBarrier assessments
• This is a critical in any
patient outreach –
determine the patient’s
barrier, or reason, to not
adhere to their medication
and assist them in
resolving it and taking their
meds as prescribed
Remove therapy
options
• Discontinued meds ONLY
• Cash, VA, samples, etc.
option
• Splitting pills
• Removes therapy
permanently. Use with
caution
Therapy removal options
Barrier assessment
options
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How should I document my work?
Practice notes
• Must select “Add
note”
Contact status
• Update this!!
• Continuity of care!
Remove patient
from list
• Takes 24 hrs to
update
Contact status & practice notes shared to all users with access to that practice
© 2017 RxAnte, LLC All Rights Reserved. Confidential. 20
Best Practices – Adherence Discussions
Start by asking if they are having any troubles
with their medications
• Even if they answer no – Don’t stop there!
Sample questions to ask:
• How were you prescribed this medication?
• How are you taking it?
• What questions or concerns do you have about your
medication?
Try to discern the adherence barrier
• Access? Education? Reminders?
• Help to resolve the barrier as possible
Remember this is a targeted list – all patients are at risk for non-adherence!!
Helpful tips
• State the name
of the drug
• Use missed
days as
appropriate
• Use open-ended
questions
© 2017 RxAnte, LLC All Rights Reserved. Confidential. 21
Patient Case 1 – Josie Burton
Josie is first on your
contact soon list and has
a cholesterol opportunity
with 48 of 59 days missed
and a refill in 2 weeks.
During the outreach she
says she has no problems
with her medications but
you discover she misses 2
days a week
Upon further discussion
you find out that Josie does
not take her pravastatin
when she eats healthy,
since she “didn’t eat much
cholesterol and doesn’t
need it”
06/15
2016-07-16
2015-05-16 3
59
08/15
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Poll Question 2
What Barriers does Josie have to taking her medications?
(select all that apply)
Does not believe this medication is important
Does not understand this disease state
Has concerns about side effects
Does not understand dosing instructions
Forgets doses, leading to delayed refills
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Josie’s Barriers
Does not understand this disease state:
• Josie doesn’t understand that her
high cholesterol is not only
dependent on what she eats or the
cholesterol content of it
Does not understand dosing instructions:
• Josie doesn’t understand she needs
to take this medication daily for the
biggest benefit
Does not believe this medication is important:
• There might be some education
issues here with Josie since she
doesn’t understand the importance
of taking her medication daily
Others??
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Finishing with Josie
Discuss dosing instructions and educate on her medications
Document barrier and consider adding a note
Update contact status
Complete necessary provider and/or patient follow up to fully
resolve medication adherence barriers
Josie
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Getting Started
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Resources Tab
Access to this
presentation
RxEffect highlight
video
Adherence
outreach
information and
references
Support contact
information
© 2016 RxAnte, LLC All Rights Reserved. Confidential. 29
What Next?
Sign on to RxEffect.com and get started
Get familiar with your patient list, updates every other
week
Email the helpdesk at [email protected] with any
issues you encounter
© 2016 RxAnte, LLC All Rights Reserved. Confidential. 30
Thank You