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QUALITY CORNER: Provider outreach pilot aims to increase generics' prescribing

There is an LHP provider outreach project currently being piloted that aims to improve patient safety and decrease costs to patients, the health system and payors.

Using clinical and payor claims data, the Legacy Care Transformation Cost and Use (C&U) committee identified increased utilization of brand name medications as one of the primary drivers of increasing per-member, per-month prescription costs in our value-based contracts. The C&U committee also recommended that LHP focus on improving patient safety by letting providers know which of their patients may be at risk for their use of opioids. 

With help from LHP’s Care Support Resources pharmacists, LHP identified commonly prescribed medications for which effective generics are available at a lower cost. The LHP analytics team then used claims data to identify patients who had filled a prescription with a brand name drug that could have been filled with a generic (January 2018 data). 

A small number of LHP providers are receiving a letter that lists patients for whom they have prescribed – or the patient or pharmacy filled – a brand-name medication that has an equivalent, lower-cost generic medication available. The letter includes a link to a single-page flyer on the LHP team site designed to give patients information about the efficacy of generic medications. Additionally, some providers’ letters also include a list of attributed patients who are taking a prescribed medium- to high-risk opioid. For providers with patients on prescribed opioids, the letter includes links to best practices.  

While individual providers may only have a few such patients, the impact of 2,400 providers in the LHP Network working to increase the rate of generic medication prescribing and closely monitoring their patients’ opioid use can be significant. We look forward to hearing feedback from the providers who are receiving these letters. Throughout the year LHP will be looking for other opportunities to engage providers in developing strategies that can increase efficiency and lower costs.


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