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Survey: Managed care companies hope to improve medication adherence with predictive analytics

A majority of managed care organizations would like to begin using predictive analytics to monitor […]

A majority of managed care organizations would like to begin using predictive analytics to monitor patient medication adherence, an issue that accounts for $290 billion in annual, avoidable healthcare spending, according to a new survey.

The survey, conducted by New York data-analytics startup AllazoHealth, found that many insurers are still addressing the issue of medication adherence mostly through more traditional means, such as by phone calls, snail mail and in-person meetings with either pharmacists or physicians. Yet 67 percent of the 30 payers surveyed said their efforts to fix adherence were only “moderately effective.”

At the same time, a majority indicated that predictive analytics is something they’re interested in and think can be a better mechanism in ensuring adherence. Currently, only 7 percent managed care payers are fully using the tactic, which can much more accurately inform payers and providers which patients are a likely risk, thereby letting them target those who need interventions and leaving alone those who do not.

“We really looked at some of the different ways (managed care organizations) were targeting patients,” AllazoHealth CEO Clifford Jones said. “And only a small portion are using predictive analytics. That’s something that over half of the companies said they wanted to do . It’s something that is really taking off.”

Most MCOs perform their intervention programs through some combination of in-house and outsourced interventions, according to the survey, while most measure their programs’ effectiveness through one or more of the following: quality measures, hospitalization and ER rates, biological/clinical measures and claims-based measures.

Cardiovascular diseases are among the most commonly targeted conditions for medication non-adherence. That will likely remain a top priority, but a majority of MCOs also plan to expand their intervention efforts to other diseases, most notably asthma, depression and COPD, according to the survey.

The survey included 30 CMOs across the country, with 19 small companies with fewer than 200,000 members and 11 large companies with more than 200,000 members.

Of those 30 companies, 60 percent said they planned on using predictive analytics in the near term, while 75 percent of all respondents said they intend on expanding medication adherence altogether.

The survey was focused on Medicare and Medicaid prescription drug users, a key part of any MCO’s efforts to reduce health spending given the Medicare payment incentives and penalties.

Jones said that while it’s clear companies wish to move into the predictive analytics arena, it’s hard to say exactly when it might take hold for some because of existing contracts with outsourced companies that might handle adherence issues. Still, he expects it will catch on within a relatively short time frame.

“It’s going to be pretty wide-scale adoption in the next couple of years,” he said. “The incentives are aligned and it makes a lot of sense. Now things are moving really fast. I would expect definitely over 50 percent of the market.”

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