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NDHI NAT IONAL DIALOGUE FOR Healthcare Innovation Asthma and Depression Medication Adherence Outreach Organization Overview • BlueCross BlueShield of Tennessee (BCBST) is a not-for-profit health insurance organization • BCBST provides benefits to about 12,000 companies and serves 3.3 million people • BCBST offers BlueCare Tennessee, a managed Medicaid program that serves over 600,000 members Background Failure to closely adhere to medication treatment plans can result in poorly controlled symptoms, relapse, and ultimately, high costs to the healthcare system. Some of the identified barriers to medication adherence include: • Failure to educate patients about the need for medication adherence, even when asymptomatic • Patient discomfort with medication side effects • Lack of communication between patients and practitioners about medication use BCBST aims to foster medication adherence through better patient education and follow-up practices. A multidisciplinary workgroup was established at Blue- Care Tennessee to address these barriers, including members from Quality Improvement, Member Education and Outreach, Information Delivery, and executive leadership. The group developed a targeted medication adherence outreach program for asthma and depression in November 2015, which continues to be improved upon today. Program Details The Asthma and Depression Medication Adherence Outreach Program targets BCBST Medicaid populations (including BlueCare Tennessee East, Middle and West, as well as TennCareSelect member populations) who have been diagnosed with asthma or major depression and have become non-compliant with their medication regimens. For these patients, the program has the following objectives: • Initiate follow-up on non-compliance with telephonic outreach to educate the member about the importance and benefits of medication adherence • Identify the patient’s barriers to medication adherence • Develop solutions with the patient to overcome identified barriers • Ensure that any additional services needed are available such as transportation, access to practitioners (follow-up appointments), access to medication refills, etc. An Initiative of the 53 | Asthma and Depression Medication Adherence Outreach
NDHI NAT IONAL DIALOGUE FOR Healthcare Innovation Adherence or compliance is assessed through the following quality indicators: • Asthma –– Medication Management (percentage of asthma-diagnosed members who remained on treatment during the treatment period) –– Medication Ratio (ratio of long-term controller medications to total asthma medications) • Depression –– Treatment initiation (percentage of members initiated on an antidepressant drug and who received adequate acute-phase trial of medications) –– Continuous treatment (percentage of members who were initiated on an antidepressant and completed a period of continuous treatment over 6 months) Value Delivered This program improved patient outcomes for both asthma and depression by promoting prescription refills and medication adherence. Results of 4th Quarter 2015 outbound calls conducted by the Pharmacy Outreach Specialist Unique members contacted about adherence Percent of contacted members who filled a script on or after the contact date Percent of script-filling members who were compliant for HEDIS 2016 medication management measures Asthma Depression 719 16 83% 75% 68% 92% Path Forward • BCBS of Tennessee will continue to monitor and evaluate the success of the Asthma and Depression Medication Adherence Outreach Program • In the long term, BCBST aims to demonstrate increased improvement in asthma and medication adherence Asthma and Depression Medication Adherence Outreach | 54
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