MetroHealth has increased patients' refill retention rate from 35% to 80% — thanks to a few shifts in its operating model.
Ryan Mezinger, RPh, MetroHealth System's senior vice president and chief pharmacy officer, joined the Cleveland-based company in 2015 and focused his work on patient prescriptions and refills. At that time, 30% to 35% of patients never filled their prescriptions nationwide.
"If they don't fill a prescription, they're not going to achieve the outcome they want; they end up coming back for readmission or to the ED," Mr. Mezinger told Becker's.
Mr. Mezinger started by extending the pharmacy hours and pharmacy availability.
"We're focusing on locations with very few pharmacies in the area and clinics with patients who truly need prescriptions in hand, such as urgent care centers, family practices, and internal medicine facilities," he said.
The team has opened 11 patient-facing pharmacies, with three more expected to open in the next 18 months.
Those two changes made a big difference in prescription numbers. When Mr. Mezinger began, the system had a 6% capture rate for prescriptions written. Now it's around 58%.
As the data came in, Mr. Mezinger identified the next major issue: refills.
"We saw that we were only capturing around 30% of refills with most being transferred to external pharmacies or simply not filled by patients," he said.
To improve refills, the team implemented a few strategies, including rolling out an app with patient alerts, phone calls 8 to 10 days before the patient's refill is due, and offering home delivery.
The early reminders helped patients get refills in a timely manner, but also allowed pharmacists to connect with patients about why they might not want a refill. If the team learned of affordability or side effect issues, they were able to directly address the issue with the patients' physician to ensure the best patient experience, he said.
"Many pharmacies are purely transactional, but we wanted to disrupt that model and bring back a truly patient-centric approach," he said. "We've established a call center and a prior authorization team to handle behind-the-scenes work, allowing pharmacists at the counter to focus solely on patient care. That personal touch has been a significant factor in our success."
Patient-centered work also found its way into the home delivery system. About half of daily prescriptions are delivered directly to patients' homes and the pharmacies offer same-day delivery for medications.
Now, refill retention is over 80% and the pharmacy has a five-star adherence rating. The system is on pace to fill over 2 million prescriptions this year, "largely due to our ability to keep patients on track with their refills," Mr. Mezinger said.
"Ultimately, pharmacy is financially viable for healthcare systems and is critical for patient outcomes," Mr. Mezinger said. "Hospitals have a responsibility to ensure patients receive the treatment they deserve, regardless of their social or economic status. Medication access and affordability are key factors, and investing in pharmacy services benefits the organization and the patients. I'm proud of what we've accomplished for our Northeast Ohio patients and hope to see more hospital systems recognize the value pharmacists bring to the table."