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Health Payer Incentive Program Supports Patient Drug Price Shopping

The rewards program aims to motivate patient price shopping for low-cost and high-quality prescription drugs, according to UnitedHealthcare.

rewards program

Source: Thinkstock

By Sara Heath

- UnitedHealthcare has announced plans to offer a rewards program for patients who seek out lower-cost drug options. This comes as part of the health plan’s efforts to put a cap on prescription drug spending and empower patients to make healthcare decisions.

The My ScriptRewards program will offer incentives to patients who have sought out information about lower-cost medication alternatives.

Healthcare industry experts agree that high cost does not always equate to high quality. Price shopping is critical for ensuring patients obtain medications that will address patients’ healthcare needs without adding a considerable cost burden for both the patient and payer. Because of common cost-sharing policies, patients and payers both bear significant financial responsibility for prescription drug costs.

This latest move from UnitedHealthcare aims to overcome those cost challenges by providing patients with the information necessary to make informed decisions about purchasing prescription drugs. Additionally, My ScriptRewards will leverage a popular patient motivation tactic aimed at ensuring patients access best-value drugs.

Patients may earn up to $500 in pre-paid debit cards through the program. Patients can use the debit cards on other health-related items or services, UnitedHealthcare said.

READ MORE: How Motivation Tactics Spark Meaningful Patient Portal Adoption

Patients interested in the program should first consult their doctor to choose the best low-cost prescription drug plan for their health needs. If patients choose an eligible prescription, they may fill it for a $0 out-of-pocket payment.

After filling the prescription, patients can activate My ScriptRewards either through an online portal or via the phone. Just for shopping around, patients can receive a $250 debit card.

If the patient continues using the eligible medication for six months, they will receive a second debit card.

The promise of the rewards debit card has numerous benefits. Foremost, it can motivate patients to make better healthcare decisions based on cost and quality.

The debit cards can also close the loop and help patients continue to make positive healthcare decisions. Patients often face financial barriers to seeking necessary care, or cannot afford other healthy lifestyle decisions. Pre-paid debit cards that are allowable on health-related expenditures can help patients overcome of the cost-related obstacles to achieving good health.

READ MORE: How Out-of-Pocket Drug Costs Impact Patient Treatment Access

Ultimately, this program is rooted it better patient education and access to care, according to Richard Migliori, MD, chief medical officer at UnitedHealth Group.

“My ScriptRewards helps make prescription drugs more affordable and promotes access to clinically effective medications so that people can achieve their best health,” Migliori explained. “We are educating people on lower-cost medications that may be right for them, encouraging them to talk to their doctor and ultimately helping them engage in decisions about their health care.”

UnitedHealthcare will rollout the rewards program with certain antiretrovirals used to treat HIV. HIV is known to be an extremely high-cost medical condition, costing patients and providers nearly $380,000 over a patient’s lifetime.

Patients on employer-sponsored UnitedHealthcare plans can currently access My ScriptRewards, and individuals enrolled on self-insured plans will gain access come November 2018. UnitedHealthcare also announced plans to expand the program to other high-cost conditions in the future.

Industry experts have long touted incentive programs as effective patient motivation and behavior change tactics. Patients who could win gift cards for health behaviors that already interest them tend to be more likely to participate in rewards programs. Additionally, rewards programs are typically more effective when gift cards are worth a substantial sum.

READ MORE: Top Strategies for Collecting Patient Financial Responsibility

Other healthcare payers have implemented similar incentive program strategies to motivate beneficiary behavior. In July 2018, BlueCross BlueShield of North Carolina (BlueCross NC) created a price comparison tool that rewards patients when they select care that the payer deems high quality and low cost.

The BlueCross NC SmartShopper tool will allow patients to earn up to $500 for selecting high-value providers. The payer hopes the SmartShopper tool will help patients see that there is not always a correlation between cost and quality, said Blue Cross NC chief growth officer John Roos.

“In many industries, a higher price tag often means better quality or value, but many consumers don’t know that this is not the case in health care,” Roos noted in a statement. “Today, we’re the only insurer in the state with a program that offers cash to shop for high-quality care in lower-cost settings. This has an immediate payoff for our customers and lowers their overall health care costs.”

As noted above, incentive programs can be useful for motivating patient behavior, so long as the program design is attractive to patients. This means payers and providers need to offer rewards patients want for activities they have already shown interest in integrating into their lifestyles.

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