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A Bolder Vision of
Healthcare Efficiency

A proven way to control healthcare costs is by ensuring patients take their medicine as prescribed.
DrFirst tools for price transparency help increase adherence with accurate, timely price information.

Giving Patients and Providers a Window into Better Health

Healthcare costs keep spiraling up. In an effort to reign them in, patients are being asked to do more, know more, and play a greater role in their own care decisions. That starts with the right tools.

DrFirst is unique in our ability to deliver both pharmacy and medical price transparency functionality to providers AND patients. Our tools help to educate patients on the cost of their care and their medications, so they understand everything and are aware of all their options.

The DrFirst suite of price transparency tools represents a breakthrough, empowering everyone across the Healthiverse—payers, providers, acute and ambulatory care centers, pharmacists, and other caregivers—to help educate patients on the cost of their care and their medications, so they are informed and engaged at every step.

Knowledge is power.  With DrFirst, it’s good for your health as well.

Price Transparency Solutions

DrFirst tools bring the Healthiverse together to share pricing information. As a result, healthcare costs are controlled, health outcomes improve, and patients win.

We want to avoid readmissions resulting from patients not following their treatment plans.

26% of hospital and long-term care facility admissions are related to non-adherence. Besides forgetting to take their medications or not understanding why or how to take them, many patients fail to adhere to following their care plans because they can’t afford their medications.

Currently, most patient find out about medication costs at the pharmacy, when it is too late to intervene. myBenefitCheckSM (mBC) provides the most comprehensive real-time prescription benefits information available today. In addition to Surescripts sources that cover CVS and Express Scripts, mBC adds an additional 46% of benefits information (United Healthcare, Humana, DST-Cigna, MedImpact, Prime Therapeutics, and more) for US insured lives, which helps doctors identify the most clinically appropriate therapy, and the most affordable cost to drive adherence, while with the patient.

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My patients are not following their care plan because they don’t understand the need for their medication and cannot afford their medications.

The Cause and Effect of Non-Adherence:

  • 28% of first-time prescriptions are never filled.
  • 65% of pain medications are never filled.
  • 31% of prescriptions for chronic conditions are never filled.

This leads to $2,000 in additional costs to the U.S. healthcare system per person and over 125,000 deaths per year.

Without ever leaving the e-prescribing workflow, myBenefitCheck℠ allows physicians to virtually go to the pharmacy with their patients, selecting the best prescription and pharmacy options based on the patient’s formulary and benefit design; thereby ensuring the best course of action with the patient’s budget, well-being and medication adherence in mind.

What Information Does the Real-Time Benefit Check Return?

  • Drug coverage and pricing
  • Personalized formulary alternatives
  • Alternative pharmacy pricing
  • Enhanced electronic prior authorization (ePA)

Sources: Centers for Disease Control; SAMHSA; DrFirst analysis of data obtained from Definitive Healthcare, SureScripts, DrFirst customers and other publicly available material; National Institute on Drug Abuse; State of New York Department of Health

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Medication costs are soaring and sticker shock is killer. It can keep my patients from picking up their new meds or get refills. And it can drive my patients to another pharmacy. 

Growing out of pocket prescription costs like insurance copays and deductibles have the biggest impact on medication adherence. But when they have to pay $30 or less, patients only abandon their medications 11% of the time.

Abandonment not only impacts patient health it also jeopardizes patient loyalty for your pharmacy and risks additional front of store sales.

myBenefitCheck℠ for pharmacies helps reduce sticker shock at the pharmacy by displaying the cost of the drug, possible therapeutic alternatives, and provides coupons to help offset costs when the patient arrives at the pharmacy.

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To help our clients succeed at value-based care, we must deliver provider-facing real-time patient-specific prescription and medical benefit information.

As an integrator across hundreds of solutions, DrFirst is uniquely positioned to normalize PBM and payer data and present it in a format complementary to all clinical workflows, across all EHR vendors.

The shift from fee-for-service to value-based care dominates healthcare activities.

To meet the new care delivery, reimbursement, and quality requirements, EHRs need to deliver more than just large quantities of data to providers. They need to present high-quality, relevant patient information at the right time during the encounter when it can have the most significant impact, without disrupting clinical workflow.

To realize the promise of improved care, EHRs need seamless, direct connections with PBMs and Payers, and efficient presentation of patient-specific information to providers at the point of care. DrFirst’s CareComplete, myBenefitCheckSM, and ePriorAuthorization fulfill this need by integrating encounter-based clinical data into your EHR and delivering a consistent user experience regardless of the source of data. It ensures Doctors using your solutions have unprecedented access to real-time actionable patient-specific information, including both prescription and medical benefit plan coverage.

Deliver More Value to Clients When It Comes to Patients’ Medical Benefits

DrFirst’s CareComplete solution fulfills this need by integrating encounter-based clinical data from payers into your EHR. Doctors have unprecedented access to real-time, actionable, patient-specific information, including benefit plan coverage.

CareComplete is Payer-Agnostic and Delivers:

  • Patient-specific medical benefit price transparency for labs, procedures, orders, and referrals
  • Medical ePA: e-prior authorization for labs, procedure, and orders
  • Automated and secure CCD exchange

Clinical Benefits

  • Delivers actionable data at the point of care
    • Built into existing physician, hospital, and staff workflows
  • Identifies gaps to support recommended care
  • Communicates prior auth needs immediately
    • Drives better population health

Administrative & Workflow Benefits

  • Eliminates use of portals and other non-EHR applications
  • Eliminates costly, inefficient chart chase
  • Stops unnecessary phone calls and manual interactions
  • Reduces rework and administrative cost of prior auth

Patient & Practice Benefits

  • Provides cost transparency for labs, referrals, and procedures
  • Facilitates in-network use to lower out-of-pocket costs
  • Facilitates discussion and patient engagement
  • Improves patient satisfaction and NPS scores

Medication Adherence and Price Transparency

According to an FDA study, 25% of new prescriptions are never filled. The major causes of inaction are financial, clinical, and behavioral in nature. 26% of hospital readmissions are related to non-adherence. Besides forgetting to take medications or not understanding why or how to take them, many patients fail to adhere to following their care plans because they can’t afford their medications.

Currently, most patients find out about medication costs at the pharmacy, when it is too late to intervene, myBenefitCheck™ (mBC) provides the most comprehensive real-time prescription benefits information available today. In addition to industry sources, mBC adds additional benefits information, covering over 96% of insured lives. This helps doctors identify the most clinically appropriate therapy, and the most affordable cost to drive adherence, while with the patient.

ePrior Authorization (ePA)

Time to treatment is a critical measure for driving better health outcomes. But when patients don’t make appointments or follow their treatment plans right away due to delays or confusion related to prior authorization (PA) requirements, they get frustrated and may even abandon their care plan or therapies.

According to a 2019 study by the American Medical Association study, more than two thirds of physicians reported difficulty determining if a medical service or prescription required a prior authorization. Because a PA can consume 14.9 hours/week of staff time, it’s critical that PAs are only submitted when required.

DrFirst’s ePA automates the process of verifying the need for a prior auth at the point of care. If required, your providers can submit electronic PAs with information extracted from their EHR, eliminating the need to log into portals, relying on faxes, or making phone calls.

Our real-time response eases the PA burden, improves the efficiency of provider staff, and helps patients get the timeliest care.

Offer your providers the most seamless and comprehensive electronic prior authorization functionality in the marketplace. Our ePA solution will:

  • Decrease your business and development costs while attaining multiple ePA feeds through a single connection
  • Reduce the administrative burden of providers by as much as 70% when processing prior authorizations
  • Enable you to obtain scalable, transaction-based revenue for your system
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Our PCPs have no direct sight line to specialist costs or quality, or to facility costs, so members could pay too much for care that doesn’t deliver the best outcomes. 

The more informed your provider network and members are, the better their dialogue about affordable care. CareComplete integrates member-specific information into the EMR to share costs clearly.

  • Care Estimator identifies in-network physician referral options by specialty and displays them with their anticipated costs, quality rating (when available from payer), and office location.
  • Lab Selection guides doctors to the payer-preferred lab for a prescribed medical test. The Lab component also flags potential open care gap tests, and returns results based on network status, payer-preferred indicator, cost, and location.
  • myBenefitCheckSM delivers industry-leading eligibility information, prior authorization requirements, and price transparency for preferred drugs directly within providers’ e-prescribing workflows. When doctors have this information while they are meeting with patients, they can eliminate members’ sticker shock at the pharmacy and improve first-fill adherence.
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