WEA Trust, Predictive Health Partners and CHC Health Partner to Control Healthcare Costs and Improve Member Health
Madison, WI—WEA Trust, a local Wisconsin health plan, completed a Comprehensive Medication Therapy Management Pilot program to improve member health, lower adverse drug event risks and control costs. In total, the program saved members over $100,000 and deprescribed medications for over 500 participants—leading to a reduction in potential adverse drug events.
The program was created and managed by Predictive Health Partners and their clinical pharmacist partner, CHC Health. They collaborated with WEA Trust’s clinical pharmacy experts, care management team and data modelling analysts to enhance their already established, high-touch member experience. The new pilot program was offered to a specific segment of members who were higher risk for adverse drug events. Of the members contacted, 77% agreed to join the pilot program and participate in telephonic consultations with motivational interviewing. Through these techniques, WEA Trust pharmacists were able to recommend safer and more effective treatments and prescriptions.
“We earnestly engage members around safety, including medication safety, and ultimately this also reduces costs against members’ deductibles,” said Dr. Tim Bartholow, WEA Trust Chief Medical Officer. “The immediate value to members was compelling and also addressed the too common human tragedy of adverse drug events and high healthcare costs.”
Other highlights from the 526 participants include—
• 551 recommended deprescribed medications, including over the counter
• 172 recommended medications added or replaced
• $500,280 estimated medication savings for participating WEA Trust groups ($1,107 per participant)
• $100,056 estimated direct medication savings for members ($190 per participant)
• 17% of participants were recommended assistive digital therapeutics
• A total estimated return on investment between 140% and 700%
In the United States, research shows that for $1.00 spent on medication, at least $1.17 is spent on the unintended costs of under, over and misuse of those medications. In total, an estimated $375B is contributed to lost value and additional harm resulting from substandard treatment.
This loss includes drug-related treatment failures, new medical problems resulting in emergency room visits and hospitalizations—leading to 275,000 deaths per year.
WEA Trust has faced similar challenges. “Between 5% and 9% of members experience some form of adverse drug event in any given year. This creates a $53M medical spend, part of which is avoidable in unintended harm and in cost,” said Alan Lukazewski, WEA Trust Director of Clinical Pharmacy. Follow up calls to participants and prescribers have begun to facilitate new recommendations for WEA Trust members. “For medication therapy management to truly be effective, pharmacists, with their deep understanding of medications, should be integrated into the care continuum,” said Mike Case Haub, CEO, CHC Health.
Members were also triaged to additional WEA Trust benefits including diabetes management, telehealth, low back pain solutions and WEA Trust Care Management. “The care management team contacted each person to provide education, assist members to understand these additional benefits and to determine if the members had other gaps in care,” said Tina Brown, RN, WEA Trust Care Manager. “By obtaining these referrals, we were given the opportunity to provide the high value touch our members expect.”
Jim Lewis, CEO, Predictive Health Partners stated, “We proved the risk models and telephonic engagements, with skilled pharmacists, can reduce risk and save significant money.”
About WEA Trust
The WEA Trust provides group health insurance and administrative services to public employers throughout Wisconsin. The not-for-profit WEA Trust was created in 1970 to serve Wisconsin school district employees. Today, the WEA Trust offers its top-rated service and quality benefits to all state, county, and municipal groups.
About Predictive Health Partners
AI product, Benjamin™️, predicts & prevents wasteful healthcare spending on prescriptions and mismanaged medications.
About CHC Health
CHC Health is one of the largest providers of pharmacist services in the U.S., with medication management, synchronization and adherence programs.