PHARMACY

Cost, quality and transparency drive insurer, health system interest

BY DSN STAFF

There are very logical reasons that a growing number of health systems, large payers and insurers continue to embrace the retail clinic model: cost and quality.

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According to a recent Robert Wood Johnson Foundation study, there are currently more than 100 partnerships between retail clinics and health systems. “Some delivery systems seeking to improve primary care access and manage total cost of care are using retail clinics to reduce unnecessary emergency department visits. One study estimated that up to 27% of ED visits could be handled appropriately at retail clinics and urgent care centers, offering cost savings of $4.4 billion per year,” noted the April 2015 RWJF study, “Building a culture of health: The value proposition of retail clinics.”

“The cost of providing care for commercially insured patients has been found to be significantly lower when care was initiated at retail clinics ($110) than when it was initiated in physician offices ($166), urgent care centers ($156) and EDs ($570),” according to the RWJF report. “Studies have also found that for five common conditions treated at retail clinics — pharyngitis, otitis media, acute sinusitis, conjunctivitis and urinary tract infections — cost savings of $50 to $55 per episode could be realized and that cost of care for consumers who visited a retail clinic on aggregate was $262 less than those who did not.”

Retail clinics also are starting to emerge in new patient care models like the Accountable Care Organization and Patient-Centered Medical Home models. “BlueCross BlueShield of Minnesota has created an ‘aligned incentive’ ACO program that now accounts for 40% of its network spend. They have developed an ACO-like product with Allina Health Network and have ‘wrapped’ AHN’s network with other providers, including retail clinics,” according to the RWJF study.

It’s not just all about dollars and cents. The other critical reason that payers and providers are aligning with retail clinics is simply that the quality of care delivered at retail clinics is as good or better than most other practice settings. Retail clinics had almost 93% compliance with quality measures for appropriate testing of children with pharyngitis versus the Healthcare Effectiveness Data and Information Set (HEDIS) average of less than 75%, according to the Convenient Care Association.

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PHARMACY

The value of retail clinics

BY DSN STAFF

With the expansion of coverage to millions of more Americans in the years since the Affordable Care Act was fully implemented, access to care is becoming more strained than ever before, seemingly creating more interest among payers, insurers, health systems and patients in the use of retail clinics.

(Click here to view the full Category Review.)

“Retail clinics are increasingly expanding their service offerings to include behavioral health screenings, more comprehensive primary care and chronic care management,” noted the Robert Wood Johnson Foundation’s April 2015 report, “Building a culture of health: The value proposition of retail clinics.” The RWJF study sought to “examine the potential value proposition in building a ‘Culture of Health’ in the United States.” This ‘Culture of Health’ is the RWJF’s own version of the Triple Aim goals first introduced by the Institute of Health in 2008: to provide better access to care for individual patients; to improve health outcomes for large patient populations and lower costs.

There are currently about 2,000 retail clinics in operation, a number that is expected to grow to some 3,000 locations by 2016, according to research from the Convenient Care Association. Annual clinic visits totaled more than 10.5 million last year.

According to Kalorama Information, retail clinics generated sales of more than $1 billion in 2014 — this, of course, only measures the sale of retail clinic services and procedures, and excludes any impact to the host pharmacy in terms of pharmacy and OTC sales. One-third of those visits were driven by a prescription refill, according to Kalorama.

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Tagging authentication: Q&A with TruTag Technologies’ Kent Mansfield

BY DSN STAFF

TruTag Technologies is looking to impact the food and drug industry with its edible security platform. “TruTags,” the company's microtags, can help to authenticate products without packaging or labels. For example, the surface of every pill could be encoded with a TruTag, according to the company, that could hold all of the information from a drug package insert. DSN spoke with Kent Mansfield, president of TruTag Technologies.

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DSN: Why edible bar codes?

Kent Mansfield: The term “edible bar code” was coined as a descriptor for our coded silicon dioxide material that is used in the drug and food industry. We chose this term because our specialized, coded material acts like a traditional bar code in that it contains a unique serial identifier. However, the spectral codes associated with our microtags are covert, and these tiny particles are made of silica, a completely safe, edible material that has been used for decades in food and drugs. TruTag’s ability to batch code serial identifiers into our specialized SiO2 material enables any product to ‘self identify’ without the need for a package … . For example, TruTag has developed an application for solid oral dosage form products where the TruTag coded SiO2 material is added during the manufacturing process and becomes ‘embedded’ in the pill’s outer coating, thus enabling a scan of any pill that will identify and reveal the product, dosage, image of pill, image of package and other key attributes, such as lot number and date of manufacture.

DSN: What are some of the applications?

Mansfield: Applications of TruTag include tagging and authenticating high-volume, low-cost items, such as pharmaceutical products, medical devices, food products and packaging, industrial products, auto parts, electronics, batteries, aerospace and consumer goods.

DSN: What can TruTag do for retail pharmacy and manufacturers?

Mansfield: Over time, TruTag’s patented SiO2 coded material can change the entire pharmaceutical industry. Initially, manufacturers and brand owners will be able to have better control over specific high-profile drugs by understanding the provenance of the medicine in the supply chain and where compromise or diversion may be occurring. Further, this tool will help with administration of returns and recalls since it can quickly identify where and when the specific product at issue was made. On-dose authentication can even help drug manufacturers in the drug development process by invisibly marking drug product used in clinical trials, where placebo and active batches are designed to look identical, but where simple mix-ups could jeopardize major new drug development research.

As more drug products become ‘tagged’ in the marketplace, the TruTag authentication platform could revolutionize the prescription and OTC drug business by enabling the interrogation of drugs directly by point-of-dispensing outlets, such as pharmacies or clinics, to confirm authenticity, dosage, manufacturing origin, inventory count and more. This also could significantly bring credibility to legitimate online pharmaceutical outlets by enabling participation in the tagging program. Ultimately, as TruTag becomes more pervasive in the industry, pharmacies will be able to scan and confirm multiple pieces of product intelligence automatically at the time of prescription fulfillment. Also, this could play a major role in patient compliance and provide data interaction between the patient, the pharmacist and other stakeholders.

DSN: What does it mean for patients?

Mansfield: Once tagging is used by retail outlets, the next step in the value chain is consumer participation. At that point, TruTag would be launching a consumer reader where patients could interrogate their own medicine to verify that it is authentic, that it has been properly prescribed, and that there are no adverse interactions between the various medicines that the patient is taking. Through this activity, the various stakeholders in the healthcare ecosystem could build more direct relationships to end-users. The use by patients of these readers would provide massive amounts of product intelligence and behavior trends. For example, in the area of patient compliance, doctors, drug makers and health insurance providers would have access to information about if and when patients are taking their medicine, which would allow each of them to better understand the effectiveness of the drug regimes.

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