How to Offer Your Employees Prescription Assistance

In today's competitive job market, offering comprehensive employee benefits is crucial for attracting and retaining top talent. One often overlooked but highly valuable benefit is prescription assistance. By providing your employees with access to affordable medications, you can significantly improve their health outcomes and financial well-being. This has a positive impact on overall workplace productivity and satisfaction.

As an employer, you have several options to offer prescription assistance to your workforce. These include implementing a prescription assistance program, providing a prescription discount card, or enhancing your existing health insurance coverage. To make the most of these initiatives, it's essential to understand how they work, how to put them into action effectively, and how to educate your employees about their benefits. You'll also want to measure the impact of your prescription assistance efforts to ensure they're meeting your organization's goals and your employees' needs.

Understanding Prescription Assistance Programs

Prescription Assistance Programs (PAPs) are initiatives designed to help individuals access necessary medications at reduced or no cost. These programs play a crucial role in ensuring that employees can afford their prescribed treatments, ultimately contributing to better health outcomes and workplace productivity.

Types of PAPs

There are several types of Prescription Assistance Programs available:

1. Manufacturer-sponsored PAPs: Many pharmaceutical companies offer assistance programs for their specific medications. For example, AstraZeneca's AZ&Me™ program provides help to those unable to afford their prescribed AstraZeneca medicines .
2. State-sponsored programs: Some states offer pharmaceutical assistance programs to help residents access needed medications.
3. Nonprofit organizations: Various nonprofits provide assistance in accessing affordable medicines.
4. Medicare Part D Extra Help: This program assists people with limited income and resources to lower their Medicare Part D costs.

Benefits for Employees

PAPs offer several advantages to employees:

1. Cost savings: These programs can significantly reduce out-of-pocket expenses for prescription medications.
2. Access to necessary treatments: PAPs ensure that employees can obtain the medicines they need, even if they're underinsured or uninsured.
3. Improved health outcomes: By making medications more affordable, PAPs help employees adhere to their prescribed treatment plans, leading to better health outcomes.

How PAPs Work

The operation of Prescription Assistance Programs varies, but generally follows these steps:

1. Eligibility determination: PAPs typically have specific criteria based on factors such as income, insurance status, and prescribed medication.
2. Application process: Eligible individuals apply for assistance, often requiring documentation of their financial situation and medical needs.
3. Benefit provision: If approved, the PAP may provide free or discounted medications, copay assistance, or other forms of financial support.
4. Coordination with other benefits: PAPs often work in conjunction with existing health insurance coverage to maximize benefits for the individual.

It's important to note that while PAPs can be highly beneficial, they should operate outside of Part D benefits to ensure compliance with Medicare regulations. This separation helps maintain the integrity of both the PAP and the Medicare program.

Implementing a Prescription Assistance Program

To offer your employees prescription assistance, you need to implement a well-structured program. This process involves assessing employee needs, choosing the right program, and setting it up effectively.

Assessing Employee Needs

Before implementing a prescription assistance program, it's crucial to understand your employees' specific needs. Many patients are likely to require financial assistance with their medications, especially in specialty areas where high-cost, branded medications are common . To identify those who might benefit most:

1. Assess internal population health metrics
2. Target patients with borderline disease control
3. Prioritize outreach to those at risk of missing refills

Choosing the Right Program

When selecting a prescription assistance program, consider the following options:

1. Internal Implementation: Train and deploy your existing employees to manage the program. This approach works well if you already have a specialty pharmacy with established workflows.
2. Third-Party Vendors: These can rapidly implement a program with the right data access.
3. Manufacturer-Sponsored Programs: Many pharmaceutical companies offer assistance programs for their specific medications.
4. Nonprofit Organizations: Various nonprofits provide help in accessing affordable medicines.
5. State-Sponsored Programs: Some states offer pharmaceutical assistance programs to help residents access needed medications.

Setting Up the Program

To set up an effective prescription assistance program:

1. Coordinate Benefits: Work with patient access and prior authorization teams upstream, and with the revenue cycle team downstream to ensure proper application of funds.
2. Train Staff: If using internal employees, consider redeploying pharmacy technicians from low-census areas or student interns to support these services.
3. Implement Tracking Systems: This is essential to demonstrate a return on investment and make a case for increased resources.
4. Educate Employees: Help your staff understand their health benefits and how to use the prescription assistance program effectively.
5. Consider Alternative Therapies: Include coverage for non-drug alternatives to pain management, such as mindful meditation, acupuncture, and therapeutic massage.

By implementing a comprehensive prescription assistance program, you can help your employees access necessary medications at reduced costs, leading to better health outcomes and increased workplace productivity.

Educating Employees About Prescription Assistance

Communication Strategies

To effectively educate employees about prescription assistance programs, you need to use clear and straightforward communication strategies. Provide comprehensive information about plan and benefit provisions through workshops and educational materials. These materials should promote responsible healthcare consumerism and inform participants about the benefits of wellness programs.

Develop patient rapport and foster trust by using open-ended questions, active listening, and appropriate body language. Acknowledge employees' concerns and emotions and offer comfort and support when needed. Use paraphrased summaries to indicate understanding and allow for corrections or additions.

Enrollment Process

The enrollment process for prescription assistance programs can be complex, but you can help employees navigate it successfully. Encourage employees to review their health benefits packages to determine if they include services addressing prescription drug issues. These services may include education on prescription management, coverage for non-drug alternatives to pain management, and confidential screening for prescription drug use problems.

To streamline the enrollment process:

1. Conduct extensive research to identify relevant programs for specific medications, conditions, or demographics.
2. Help employees gather necessary documents, such as proof of income and prescription details.
3. Encourage employees to involve their healthcare providers, who can provide essential documentation and letters of medical necessity.
4. Assist employees in keeping track of deadlines and following up on application status.

Utilizing Available Resources

Inform employees about the various resources available to help them access affordable medications:

1. Free Medicare counseling from county Health Insurance Counseling & Advocacy Program (HICAP) offices.
2. Patient Assistance Programs (PAPs) offered by pharmaceutical companies.
3. Online tools like Medicine Assistance Tool (MAT), to search for assistance programs.
4. Nonprofit organizations such as MyGoodDays.org that assist patients with chronic diseases.
5. Online databases like InsideRx.com for comparing prescription prices.

Encourage employees to explore these resources and provide guidance on how to use them effectively. By utilizing these tools and strategies, you can help your employees better understand and access prescription assistance programs, leading to improved medication adherence and overall health outcomes.

Measuring the Impact of Your Prescription Assistance Program

Key Performance Indicators

To evaluate the effectiveness of your prescription assistance program, you need to track specific key performance indicators (KPIs). These metrics will help you assess the program's return on investment and develop more effective strategies. Here are some essential KPIs to monitor:

1. New scripts: This metric indicates the effectiveness of your sales and marketing efforts.
2. Enrollments: Track the number of patients joining the program and how quickly they sign up after receiving a prescription.
3. Engagement: Assess how long patients stay engaged with the program and the drop-off rate.
4. Time to fill: Monitor the speed-to-therapy to evaluate the efficiency of the prior authorization process.
5. Refills: Analyze medication refill patterns to gain insight into patient adherence.
6. Covered dispenses: Track the percentage of branded dispenses covered by insurance plans.
7. Reimbursement rates: High rates indicate financial alignment with dispensing pharmacies.
8. Coupon utilization: Monitor the rate of sponsored coupon redemptions.

Gathering Employee Feedback

Employee feedback is crucial for improving your prescription assistance program. To collect honest and valuable input:

1. Offer anonymous feedback options to encourage open communication.
2. Use surveys to gage engagement and identify areas for improvement.
3. Conduct exit interviews with departing employees to gain additional insights.

Adjusting the Program as Needed

Based on the KPIs and employee feedback, make necessary adjustments to optimize your prescription assistance program:

1. Address trends identified in the feedback, such as difficulties in project launches.
2. Implement changes based on employee suggestions to show that their input is valued.
3. Establish workgroups or shared governance councils to explore and develop solutions for identified issues.

By consistently measuring the impact of your prescription assistance program and making data-driven adjustments, you can improve its effectiveness, enhance employee satisfaction, and ultimately provide better support to your employees in managing their prescription needs.

Conclusion

Offering prescription assistance to employees has a significant impact on their overall well-being and productivity. By implementing a well-structured program, employers can help their staff access necessary medications at reduced costs, leading to better health outcomes and increased job satisfaction. The key to success lies in choosing the right program, setting it up effectively, and educating employees about its benefits and how to use it.

To make the most of a prescription assistance program, it's crucial to measure its impact and make adjustments as needed. By tracking key performance indicators and gathering employee feedback, employers can fine-tune their offerings to better meet their workforce's needs. This approach not only helps employees manage their health more effectively but also strengthens the employer-employee relationship, creating a more supportive and productive work environment.

Partner with Inside Rx

Partner with Inside Rx to provide employees with a prescription discount card and help them save up to 80% off brand and generic medications. The Inside Rx prescription discount card can be used at 60,000 pharmacies nationwide and is easy to download and take to the pharmacy. Learn more about how to save with Inside Rx today.