FutureFocus February 7, 2018 Post-Acute Cost By Care Settings For The Dual Eligible: Eight Things To Know

Lisa Remington

In this week’s FutureFocus, we explore post-acute costs by care settings for the dual eligible. Important data helps to understand why costs are higher within the entire post-acute discharge period and in particular areas of post-acute. This important data ties back to Medicare Spending per Beneficiary. In another article, we discuss medication non-adherence solutions for Medicare patients. Our Washington Report addresses how CMS is launching a low volume appeals initiative.

Lisa Remington, President, Remington Health Strategy Group

Non-adherence is a major concern in the management of chronic conditions such as hypertension, cardiovascular disease, and diabetes where patients may discontinue or interrupt their medication for a number of reasons.

Providers have tried a variety of tactics to increase compliance, from email reminders to automatic 30-day or 90-day refills. What are providers doing to get better results?

A new study in the journal of mHealth shows positive results.

  • Patients who get text prompts to refill their medications are more likely to adhere to treatment regimens than those who don’t.
  • The three-month pilot program looked at refill rates for 88,340 partially compliant and non-compliant Medicare patients of Kaiser Permanente Southern California, a large integrated health system. While all of the patients received phone, secure email and robo-call reminders to order refills, 12,272 also got text messages. 
  • Slightly more than 44% of those in the text message group refilled their medicines versus 30% in the control group.

Patient Communications

Refill reminder texts were sent on Wednesday and Thursday mornings to permit time for patients to respond. Of those who then refilled their medication, 38% did so within two hours, 49% within 24 hours and the rest following the 24-hour reminder, the study said.

The researchers also measured user experience. A majority of patients receiving text message reminders were neutral (1,8129), followed by positive (1,057), very positive (434), negative (301) and very negative (5).

The results showed a strong benefit of using this text messaging solution to improve medication refill rates among Medicare patients. These findings also support using interactive text messaging as a cost-effective, convenient, and user-friendly solution for patient engagement. Program outcomes and insights can be used to enhance the design of future text-based solutions to improve health outcomes and promote adherence and long-term behavior change.