UPMC Partnership Expands Chronic Disease Medication Adherence

UPMC Health Plan and Sempre Health’s medication adherence collaboration has expanded its chronic disease management benefits to include diabetes medicines for members of UPMC’s employer-sponsored health plans.

Since the program’s launch in 2017, members have collectively saved over $500,000 on cardiovascular medications, with the average member saving $33 per prescription refill through SMS message discounts.

The natural language processing SMS reminders and conversations with members have resulted in increased patient engagement by fostering a personalized and concierge-style experience for those enrolled in the program.

In the first year of the partnership, the program successfully enrolled more than one-third of eligible members. Improvements in cardiovascular medication adherence for these members was significant when compared to a control group. Now, UPMC is expanding the program to diabetic members in order to continue their focus on chronic disease management.

“We are expanding this program to cover nearly all of our branded formulary preferred diabetes medications because we know that medications for chronic disease can sometimes place an ongoing financial burden on patients,” said Chronis Manolis RPh, chief pharmacy officer at UPMC Health Plan. “We’re excited to build upon the strong outcomes of this program to date.”

“With this expansion of the program, members are empowered to drive down their costs and over time improve their health outcomes,” Manolis continued.

Members will be able to begin enrolling in the new expansion program in November, National Diabetes Month. Members of UPMC’s fully insured employer-sponsored group plans as well as self-insured employer group plans that do not opt out of these benefits are eligible for the program.

Nearly one-third of American patients reported that they have not taken their medicine as prescribed due to costs. Under UPMC Health Plan’s program, members receive incentives for adhering to their medications. Every time participating members fill their eligible prescriptions on time, they receive a copayment discount. 

“Patients who consistently follow their doctor’s orders by filling their prescriptions on time and taking their medications as prescribed are rewarded with Sempre’s dynamic discounts on their copay -- amounting to a ‘good driver discount’ for healthcare,” said Anurati Mathur, CEO of Sempre Health.

“Our growing partnership with UPMC Health Plan enables patients across Pennsylvania to share in the savings they generate when making healthy decisions,” Mathur continued. “We’re excited to build upon our strong outcomes to date and further improve medication affordability and access for the UPMC Health Plan members who need us most.”

Initial results from UPMC Health Plan’s partnership with Sempre Health reveal that this innovative discount model improves member engagement and increases medication adherence significantly.

Other payers are addressing chronic disease management using mHealth devices. UnitedHealth Group launched an initiative in July that utilizes remote patient monitoring for members with type 2 diabetes in order to improve their chronic disease management.

Through the Level2 program, instead of pricking their finger to gather a single data point, a member with type 2 diabetes wears a continuous glucose monitor, a passive process that is by default easier for patients. It is up to the payer to initiate contact if something about the readings indicate negative member outcomes.

“The way our signals work, we would catch that on the drop, proactively outreach before it's too late,” explained Amy Meister, DO and chief executive officer of Level2 which is part of UnitedHealth Group research and development.  

“The outreach would be directive care in that situation from our physician that would then collaborate with the extended care team to help understand why it is happening and to make sure it doesn't happen again,” Meister continued.