Real-Time Benefit Checks

09/05/19
by Scott Greenstone

Combining Experience With Strategy


Overview of the Author

Back in 2004, I decided to change careers and become a registered nurse (RN). I worked in various settings, from the emergency department to urgent care and surgery centers. My roles ranged from direct patient care to facility buildouts and oversight of entire departments. After a few years of the clinical life, I began to miss my pre-RN work in Information Technology (IT), so I made a switch to clinical IT consulting with a concentration in electronic health record (EHR) implementation, training and customization, and project management.

After 10 years of working in clinical IT, I moved into pharma marketing, and now develop strategies around messaging to healthcare professionals (HCPs) in the EHR and other point of care modalities. My experience with EHRs, various point of care systems and clinical nursing has really helped me offer targeted, strategic insights for our clients, allowing them to provide HCPs with relevant and timely information about disease states, drug efficacy, and financial assistance right when they are seeing patients in the office.

What Are Real-Time Benefit Checks

According to a study by CoverMyMeds in 2018, nearly half of all patients surveyed didn’t fill their prescriptions because they didn’t find out until they arrived at the pharmacy that the prescription was too expensive. Real-time benefits check (RTBC) can quickly and easily mitigate this problem, helping to ensure all patients get on therapy in the most cost-effective manner.

During the prescription process in the eRX modules of the EHR, RTBC provides the HCP with the exact cost to the patient based on his or her insurance coverage. In many instances, the EHR can also provide equivalent alternative therapies along with the exact cost to the patient. By knowing the costs up front, the HCP can have a candid conversation with the patient and make the most appropriate therapeutic decision that aligns with the patient’s clinical and financial needs.

In many instances, the EHR can also provide equivalent alternative therapies along with the exact cost to the patient.

This means no more potential embarrassing conversations with the pharmacy about affordability.

Combining Clinical Experience
With Strategic Insight

As a clinician, the well-being of the patient is always top of mind. In other words, our first and foremost thoughts are always about what is the right therapy for the given patient, condition, and overall patient health profile. This means, barring any outside influences, the HCP should be considering what is best not only for treatment, but also about ensuring patient adherence with the treatment plan.

Strategists recognize that one of the greatest barriers for adherence is the cost of treatments, with not all patients able to afford the best therapy. RTBC helps solve this problem by presenting HCPs with appropriate alternative therapies, along with the specific costs to patients based on their insurance plans. In addition, during the RTBC, strategists can develop a plan that presents HCPs with appropriate brand financial information, such as copay cards, coupons, or enrollment forms. This removes the potential for embarrassing financial discussions with the pharmacist.

Real-time benefit check insight
Source: https://www.covermymeds.com/main/insights/rtbc-scorecard/

As RTBC continues to develop, more EHRs are including price transparency for HCPs as well as messaging components to benefit potential patient outcomes. Ambulatory EHR systems are widely using RTBC and new recent integrations with inpatient and hospital network EHR systems can provide improved reach for pharma to get their product and financial messaging to a much larger audience than ever before.


To discuss how RTBC and EHR strategies can add value to your brand, reach out to: scott.greenstone@ogilvy.com.