A lack of medication adherence can lead to poor clinical outcomes, higher hospital admissions and rising spend for your organization. On top of that, CMS Star point rates are also increasing year after year, making it increasingly difficult to obtain a 5 Star rating. It can be tough thinking about how to start building an effective strategy to increase adherence in your population. We will overview the top struggles with medication adherence in populations and how to use predictive analytics, tailored outreach and patient engagement, and behavior change programs to overcome them.

1. TACKLING THE TOP 5 BARRIERS
TO MEDICATION ADHERENCE

2. To empower people to improve their health
while reducing unnecessary healthcare costs.
OUR MISSION

3. TODAY’SAGENDA
1. The real cost of poor medication adherence and how it affects a population
2. Increasing CMS Star cut points each year and the impact on both finances and marketing
3. Overcoming barriers to adherence
4. Engaging difficult-to-reach segments of your population with personalized, multi-channel
communications and interventions
5. Patient case study overcoming medication adherence with personalized health coaching
3

4. 50%
of patients with chronic
conditions do not take their
medications as prescribed The real
cost of
poor
adherence
75%
of patients who are
prescribed statins stop
taking them after 2 years
Of all medication-related
hospitalizations that occur
in the U.S.,
1/3 to 2/3
are the result of poor
medication adherence
Poor medication adherence
takes the lives of
125,000 people
a year and costs the
U.S. healthcare system
$300 Billion
4
Up to

5. CMS STAR RATINGS

6. Health plans must allocate more
resources to keep up with the
competitive ratings each year.
Year after year, CMS
Star ratings cut points
continue to increase.
6

7. MEDICATION
ADHERENCE
FOR DIABETES
MEDICATIONS
7

8. Top 5 Barriers to Adherence

9. TOP 5 BARRIERS
1. Understanding which characteristics of non-adherence affect your population
2. Difficulty reaching and engaging segments of your population
3. Overcoming barriers to adherence
4. Patient-provider relationships and communication
5. Complex medication-taking behavior
9

10. Understanding which
characteristics of non-adherence
affect your population
OBSTACLE 1
10
Predictive analytics
SOLUTION

11. Difficult-to-reach and engage certain
segments of your population
OBSTACLE 2
11
Multi-channel engagement
SOLUTION

12. Difficult-to-reach and engage certain
segments of your population
OBSTACLE 2
12
High-touch interventions
SOLUTION

13. Difficult-to-reach and engage certain
segments of your population
OBSTACLE 2
13
Personalization
SOLUTION

14. Overcoming barriers to adherence
OBSTACLE 3
14
Motivational interviewing and
obstacle identification
SOLUTION

15. 15
BARRIER
DISTRIBUTION
BY MEASURE
FY 2018 and FY2019 to date

16. Overcoming barriers to adherence
OBSTACLE 3
16
Health literacy
SOLUTION

17. Patient-provider relationships and
communication
OBSTACLE 4
17
Provider involvement and
coordination of care with follow-up
and outreach
SOLUTION

18. Complex medication-taking behavior
OBSTACLE 5
18
Complex behavior change:
motivational interviewing and barrier
identification, health literacy, and
improving patient-provider
relationship and communication
SOLUTION

19. Ready?
1. Assess readiness
2. Explore understanding
3. Build an alliance
4. “Make it personal”
Set.
1. Set goals
2. Explore barriers
3. Collaborate on strategies
4. Address ambivalence, pros, and cons
Go!
1. Assess progress
2. Set long-term goals
3. Begin maintenance and sustainability discussions
BEHAVIOR CHANGE

20. Details
PATIENT CASE STUDY

21. Meet Jodi
Overview
• Age 74
• Conditions: Diabetes, hypertension, and
hypercholesterolemia
• Predictive analytics were used to identify Jodi as
non-adherent to 4 medications
Barriers Uncovered
• Lack of knowledge
• Lack of social support
• Transportation
Meet Jodi
• Age 74
• Conditions: Diabetes, hypertension, and
hypercholesterolemia
• Predictive analytics were used to
identify Jodi as non-adherent to
• 4 medications
PATIENT CASE STUDY

22. CASE STUDY RESULTS
Personalized Health Coaching uncovered that Jodi:
• Lives alone and her children live out-of-state
• Doesn’t feel comfortable driving or leaving the house
• Only takes her Diabetes medications when her blood
sugar is high
A care plan was implemented
to give Jodi the resources
and education she needed.

23. IMPROVED OUTCOMES

24. OUR HEALTH DIALOGCLIENT SAW:
15%
higher rate of individuals achieving 80% days
covered for diabetes medication
15%
higher rate of individuals with diabetes filling
at least one statin prescription
20%
higher rate of individuals achieving 80% days
covered for hypertension medications

25. SUMMARY
25
• Understanding your population is
essential for implementing effective
interventions
• Personalization of each and every
interaction is key
• Setting SMART goals and achieving
behavior change provides a long-term
solution for improving medication
adherence

26. THANKYOU
Questions? Contact us at info@healthdialog.com
SS-MA-0919