Legislative and Regulatory Trends

(L5) Assessing & Overcoming Barriers to Real-time Benefit Check Adoption in the Real-World

Thursday, March 23, 2023

2:45 PM – 4:00 PM

Location: B4

ACPE UAN:0233-0000-23-018-L04-P | Contact Hours: 1.25 | Activity Type: Knowledge-based

Faculty(s)

Michael Burger

Senior Consultant
Point-of-Care Partners LLC
Hollywood, FL
Rick Jennejahn, MS

Director, Pharmacy Innovation Programs
Excellus Health Plan
Syracuse, NY

Moderator(s)

Greg Low, RPH, PhD

Director, MGPO Pharmacy Program
Massachusetts General Hospital
Boston, Massachusetts

Real-time benefit tools are a requirement in The Centers for Medicare and Medicaid Services Part D rule and have great potential to improve outcomes. Many health plans have already invested heavily in enabling access to real-time benefit check (RTBC) via electronic health records. However, provider adoption has been less than optimal. This session will outline the strategy of one health plan to assess and overcome the barriers to RTBC adoption. Topics covered will include the approach, what has worked, and what are hurdles yet to be conquered.

Learning Objectives::

At the completion of this activity, participants should be able to:

List at least one key barrier to real-time benefit check adoption.
Name at least one internal barrier payers face when offering real-time benefit check tools to providers.
Recognize effective value propositions for RTBC to providers.
Describe provider educational approaches for that positively impacted real-time benefit check tool adoption.