Allina Health clinics across the country, including the Maple Grove clinic, have implemented a new program to help out its patients to avoid “sticker shock” at the pharmacy.
It has been reported that patients leave hundreds of thousands of prescriptions at pharmacies every year, often because they are too expensive, which means putting their own health at risk and increasing health care costs down the road.
The new program, the Epic (electronic medical record or EMR), allows doctors to provide real-time prescription pricing information.
Epic is embedded in the patient’s electronic health record. It shows the doctor how much the patient is willing to pay for prescription, based on the specific insurance coverage and the pharmacy. The tool also allows the doctor to find more affordable alternatives whenever possible.
Dr. Gary Konkol, MD with Allina Health Clinics, said the ability to compare a prescribed medication at the time it is ordered, with the patient’s health insurance formulary coverage, went live several months ago.
“This tool allows the prescriber to know if the patient’s health insurance will cover the medication in real time, and offer suggestions for similar medications that are covered by insurance if the original medication is not covered,” he said. “It is an automatic function of Epic that prescribers can access while using the program.”
Dr. Konkol added this is a very helpful function as it short circuits the back and forth communication with the pharmacy, when a medication is not covered by insurance. “It allows the primary prescriber to remain active in the prescribing process instead of an on call provider managing a denied prescription after hours, if it’s an urgently needed medication,” he said. “I use this function several times a week.”
He said this EMR function, allows for a smoother processes of helping patients obtain medication at a lower cost. “It’s not perfect, but it’s a good start,” Dr. Konkol said. “Not all insurance companies have their information loaded in the system. Even health insurance covered medications, can be too expensive for some patients and therefore remain unaffordable. For these patients, I’ll frequently print the prescription and provide a web address to a Canadian pharmacy, where prices can be up to 90% cheaper than in the USA. Although buying medications from Canada violates Federal law, Governor Palenty and Attorney General Dayton, actively encouraged Minnesotans to save money by buying medications from Canada. President Trump has been talking of encouraging this option also.”
This pricing tool is being used by 600 Allina Health primary care doctors and has the ability to save patients thousands of dollars in out-of-pocket costs each year.
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