PBMI recognizes pharmacy program that improved medication adherence rates by 18.5 percentage points, Medicare star rating

ORANGE, Calif. (March 7, 2017) – Population health management company Alignment Healthcare has received the Pharmacy Benefit Management Institute (PBMI) Excellence Award in Quality Improvement for improving medication adherence among chronically ill Medicare members in California through real-time data analytics and concierge clinical interventions.

Taking medicine as prescribed – the right medicines at the right time in the right way – is what health care professionals call “medication adherence.” Non-adherence can lead to treatment failure and unnecessary hospitalization to the tune of $290 billion in wasted spending every year, according to the New England Healthcare Institute.

Adherence is worse among patients with chronic disorders like diabetes, hypertension and high cholesterol. Alignment developed a program that, in two years, improved medication adherence rates by an average of 18.5 percentage points among members prescribed medicine for those three disorders. The company went from 9.5 percentage points below national average to 5.6 percentage points above average, which is projected to boost the Medicare rating used to determine company revenue for those measures.

“Our pharmacy team recognized an opportunity and led a program that achieved significant improvement in patients taking their medications as prescribed,” said Ali Farrokhroo, Pharm.D., MBA, Alignment Healthcare vice president, pharmacy services. “Medications are an important part of health care, and pharmacists are uniquely positioned to help patients get and stay well, especially when they are integrated into the patient’s front-line care team like at Alignment.”

Alignment developed a database that measures and displays membership adherence in real time and also identifies members who are most likely to become non-adherent in the future. Alignment’s pharmacy team takes a pro-active approach to identify the root cause of non-adherence and provides concierge-level support to remove barriers and coordinate care for the member.

“Alignment Healthcare recognizes the importance of medication adherence, specifically in their Medicare population," said Jane Lutz, executive director of PBMI. "PBMI is pleased to honor Alignment Healthcare with our Excellence Award in Quality Improvement for the great results they’ve attained through their new health care delivery model.”

In 2014, Alignment Healthcare acquired a Medicare Advantage Prescription Drug (MAPD) plan in California, now called Alignment Health Plan. Three of every four plan members have diabetes, hypertension or high cholesterol.

“This recognition confirms that Alignment Healthcare is member-focused, helping patients overcome unique challenges,” said Dawn Maroney, Alignment Healthcare president of markets. “We have made great strides since acquiring this Medicare Advantage plan in California, and we are already applying lessons we’ve learned to all our markets, so our members can lead healthier and happier lives.”

About Alignment Healthcare

Alignment Healthcare is redefining the business of health care by shifting the focus from payments to people. We’ve created a new model for health care delivery that cuts costs and improves lives by unraveling the inefficiencies of the current system to drive patients, providers and payers toward a common goal of wellness. Harnessing best practices from Medicare Advantage, our innovative data-management technology allows us to commit to caring for seniors and those who need it most: the chronically ill and frail. With offices and care centers across the country, Alignment Healthcare provides partners and patients with customized care and service where they need it and when they need it, including clinical coordination, risk management and technology facilitation. Alignment Healthcare offers health plan options to California residents through Alignment Health Plan, and partners with select health plans in North Carolina and Florida to help deliver better benefits at lower costs. For more information, please visit alignmenthealthcare.com.

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