The most common myth we hear is that health systems only need one RTPB vendor to bring prescription price transparency to the electronic health record (EHR). However, since each RTPB vendor has connections to different sets of PBMs – and therefore only has access to a subset of patient data – it is essential that health systems connect to more than one RTPB vendor to avoid gaps in patient coverage. RxRevu works with many health systems that have upwards of 2, 3 or even 4 RTPB connections. And while RxRevu has a massive 150 million patient lives in our database, we do not have coverage information on everyone – nobody does. Many health systems think that when they turn on one prescription price transparency tool, they are done with their work. But while they may have an RTPB solution configured in their EHR, that tool might lack coverage for certain patients, or display inaccurate data altogether.
Another common myth is that health systems need the same RTPB vendor as their prior authorization vendor. While there are vendors who offer both RTPB price transparency and prior authorization clearance tools, many vendors specialize in one or the other. RxRevu for example, specializes in RTPB. This allows us to avoid conflicts of interest, especially in those instances when there might be a financial incentive to run prior authorization transactions. Instead, we work to reduce prior authorization volumes by helping doctors avoid coverage restrictions altogether. RTPB is only one piece of the electronic prescribing process, and while some tools can integrate prior authorization – they are often not one in the same.
There are a number of RTPB vendors who claim to have an ‘all-payer’ solution. While we know this is simply impossible – since not every PBM has turned on or connected to all RTPB solutions – there may be vendors who use aggregated or historic data to estimate medication costs. This creates the illusion of an ‘all-payer’ solution, but in reality, these solutions often do not do a good enough job bringing accurate pricing information to the point-of-care. This can lead to a negative provider and patient experience, since the unreliable information may give an inaccurate price – causing patients to pay more for their medications than expected.
Many IT and physician leadership teams worry that implementing an RTPB tool will disrupt their project workflow and queue, require hours of training, and create friction in the EHR workflow. In all of these cases, the opposite is true. RxRevu has developed a streamlined process for implementing RTPB within a health system’s EHR, typically needing only 8-10 hours of IT time to configure and set up medications display rules. Further, EHR vendors often provide short training modules to teach care teams about how to search for prescription costs and coverage information. In most cases, RTPB training can be grouped with other regularly scheduled EHR update sessions. RxRevu can supplement these training sessions with materials about how to use RTPB. What we’ve found however, is that providers actually leverage the simple tool without any training at all. Finally, using an RTPB solution does not require any unnecessary clicks. When submitting a medication order, providers can either request the cost estimate, or, they will be prompted to confirm the order if there are lower-cost, covered alternatives available. RxRevu understands that providers can get frustrated by complicated processes and unnecessary data. That is why we’ve built our RTPB solution to reduce friction and create a better overall provider experience.
Lastly, our team has heard from health system leaders that they do not trust RTPB tools because the pricing information displayed is not accurate. While some vendors are not able to display accurate pricing information due to lack of direct connections or historic data collection processes (as previously discussed), RxRevu brings data directly from PBMs to the EHR. We pride ourselves on our data accuracy, and because of our close relationships with PBM partners, we are able to bring patient-specific, real-time pricing to the point-of-care, more often than any other vendor.
Having price transparency information at the point-of-care can improve the overall provider and patient experience, while helping reduce medication spend. But being able to trust your data – and your RTPB vendor – is of the utmost importance. RxRevu is committed to creating the most accurate, reliable RTPB tool in the market, and we hope this post helps clarify any myths or untruths you’ve heard about RTPB.
Download our Mythbusters infographic to share this information with your team. And to learn more about RxRevu’s Real-Time Prescription Benefit solution, reach out today.
Written by: Adam Rosenberg, Director