IEHP Pilot Program Published in Journal of Managed Care & Specialty Pharmacy

In partnership with Surveyor Health, Inland Empire Health Plan’s Pharmacy Comprehensive Medication Management (CMM) Pilot Program, utilizing artificial intelligence (AI) to manage medication use among Members was recently published in the Journal of Managed Care & Specialty Pharmacy.

Using an advanced AI platform, health plan data, and clinical pharmacists, trained in disease management and CMM, were able to engage with Members via telephone and enhance care coordination, reducing serious drug interactions by 15.2%, emergency room visits by 15%, hospital admissions by 9%, and more.  

Noting the pilot program’s ability to significantly improve Member health outcomes and reduce utilization, the Journal of Managed Care & Specialty Pharmacy estimates that California’s Medicaid (Medi-Cal) program could save more than $1B annually by applying the program’s measures to a similar group of patients. “This study affirms that Medication Therapy Management for Medicaid patients is essential for optimizing patient care,” said Dr. Michael Blatt, IEHP Clinical Director of Pharmacy and Product Strategy.

Pilot program participants included 2,150 IEHP Members between 40 to 60 years old with an average of 25 medications prescribed to manage chronic conditions. “This comprehensive medication management program, created by pharmacists and aided by novel decision technology, enables us to engage a team of support around individual Members by connecting the right Members to the right resources at the right time,” said Dr. Edward Jai, IEHP Senior Director of Pharmaceutical Services.

To share additional learnings from this effort and to support other health plans looking to leverage AI in a CMM program, Dr. Jai will be presenting program results and lessons at the 2021 Academy of Managed Care Pharmacy Nexus Conference on October 18. His presentation will also include details from IEHP’s Medication Reconciliation Program, which also decreased readmissions and hospitalizations.

For more information about this study, visit jmcp.org.