Four Ways Health Reform Can Improve Patient Medication Adherence

The NEHI report cited several innovations that show promise in dealing with adherence, including improving drug regimens, reducing cost barriers, and tailoring programs to individual patients. From these areas, NEHI identified four of the more promising solutions for public and private policymakers to examine in addressing patient medication adherence as part of health reform efforts:

Creating healthcare teams. While physicians play key roles in improving medication adherence by their patients, the issue could be too complex for physicians alone—leading to calls for additional support through the creation of care teams that incorporate nurses, care managers, pharmacists, and other clinicians. This can be either within or outside a physician’s practice. These teams increase the number of “touchpoints” for patients--providing repeated checks on their adherence as they move through the healthcare system, Fleishman said.

Patient engagement and education. Counseling by primary care providers and pharmacists can ensure that patients understand their diseases and how their medication can improve their condition. This can prove critical to motivating patients toward sustained adherence.

Payment reform. Realigning reimbursement incentives away from rewarding volume and toward rewarding good outcomes could encourage providers to strive for improved outcomes by way of improved adherence, as would performance based or global service reimbursements, the report noted. In the long run, payment reform would encourage providers to invest in resources, such as counseling services, that would improve patient outcomes by increasing medication adherence.

Using health information technologies. More secure and reliable information flows using technologies, such as electronic health records, e prescribing, and clinical decision support systems, could ensure that complete and accurate medication data are shared among patients, prescribing physicians, and pharmacists.