Easing open enrollment uncertainty for patients

For many patients, the start of the new year means new insurance policies. Updated plans can cause confusion for anyone, but for patients with complicated therapy regimens, it can be especially challenging. Patients may question whether their existing prescriptions will be covered, if their insurance will force them to select another medication, and if pricing will change. Patients need a trusted advisor who can ensure they are understanding and using their benefits correctly without experiencing any undue financial burden. Pharmacists, because of their expert understanding of healthcare benefits, are uniquely poised to counsel patients during this potentially unclear time.

Pharmacists can utilize the following tips to support patients as they navigate new plans or changes in their existing coverage, solidify their relationships with those they serve, and bolster loyalty to cultivate a positive business and patient-care environment.

Schedule surge support: Pharmacists can expect to see an increase in patient conversations about coverage changes at the start of the new year, following the open enrollment period, and it is important to ensure the business and staff are well positioned to deliver a positive customer service experience during this time. Pharmacists may want to consider surge support to have more experts available to work with patients. In anticipation of peak activity, pharmacists can develop a frequently asked questions resource with responses to common patient questions.
By encouraging conversations with patients, pharmacists reinforce their position as a community resource and demonstrate their value through added services — ultimately helping to grow the business.

Communicate digitally: While opportunities for conversation may occur organically as patients visit pharmacies to fill prescriptions or seek other services, it is important to consider a multichannel approach to best communicate with patients and encourage them to consider the pharmacist as the primary point of care. For example, incorporating digital media into a holistic outreach plan can increase awareness of services available through their local pharmacist.

A pharmacy with a strong digital presence, including strategic social media platforms and email outreach plans, can simultaneously support patient health and extend their impact beyond pharmacy. Pharmacists can use social platforms and email to share customized communications with patients to prompt them about relevant pharmacy offerings, including new insurance plan consultations.

Start conversations early: When insurance plan changes come into effect, costs can be a major source of confusion for patients. In some cases, existing prescriptions may no longer be reimbursed at the same rate as they were under previous plans. By proactively engaging patients in conversations about selecting new coverage, pharmacists serve as a vital source of care. One way pharmacists can start conversations early is to work with their Medicare-eligible patients prior to selection of a new plan to help them understand how each option would impact the expected out-of-pocket costs for their entire portfolio of medications.

Capitalizing on peak-visit times earlier in the year allows pharmacists to reach a critical mass of patients before they need to make decisions. Each fall’s flu season presents an opportunity to discuss potential plan changes with patients visiting the pharmacy for immunization prior to the close of the open enrollment period.

Pharmacists also can leverage technology to assist patients as they explore new plans. Setting up a tablet with Internet access or a kiosk for patients to review coverage details through plan selection tools allows patients to familiarize themselves with options prior to consulting
a pharmacist.

With early conversations, prepared staffing and teaching tools, patients will feel their pharmacist is a trusted partner in their healthcare journey.

Kelly GasperKelly Gasper is vice president of customer development at AmerisourceBergen