Hyphen App Seeks to Bring Pharmacists into Value-Based Care

Sept. 8, 2023
Pharmacy Assistant app works to give pharmacists the real-time information and insights they need to improve patient care and receive quality incentives

Last October Healthcare Innovation wrote about a technology platform called Hyphen that is using FHIR data standards to connect longitudinal data from claims, quality measures and EHRs to identify gaps in care and share that information with clinicians.

Now Hyphen has launched a Pharmacy Assistant app that the company says presents community pharmacists the real-time information and insights they need to improve patient care and experience and receive quality incentives for taking action while remaining in their own system and workflow. 

Hyphen is a wholly owned subsidiary of HF Management Services LLC, a management services company, and is an affiliate of Healthfirst, the largest nonprofit health insurer in New York State, with 1.8 million members.

Healthfirst is the first payer using the Pharmacy Assistant app to power its Pharmacy Incentive Program. The program is designed to empower pharmacists within Healthfirst’s network to help improve medication adherence rates, increase members’ understanding of their health plan benefits, and get compensated for those actions.

Pharmacists participating in the Pharmacy Incentive Program receive compensation for educating members about aspects of their health insurance benefits and for completing tasks around medication adherence, such as reaching out to members to refill prescriptions and converting medications to a 90-day supply. Pharmacists can also receive quality bonuses for improving medication adherence and member experience.

Healthfirst’s Pharmacy Incentive Program targets medication adherence rates and patient experience scores for Healthfirst Medicare members taking medications that help control cholesterol, hypertension, or diabetes. Given that a typical Healthfirst member will connect five to 10 more times annually with their pharmacist than with their primary care physician, Healthfirst said that this program is an essential part of its commitment to advancing health equity and value-based care.

“We’ve long recognized that many of our members rely on their local and independent pharmacists for both medication assistance and a friendly source of reliable health information, both of which impact health outcomes and satisfaction,” said Bhavesh Modi, vice president of pharmacy, Healthfirst, in a statement. “Historically, it has been challenging to incorporate pharmacists into value-based programs, but Hyphen’s cutting-edge technology is changing that.” 

In a statement, Priyank Patel, pharmacist/owner of Felicity Pharmacy located in the Bronx, discussed why this program is appealing from the community pharmacist perspective. “Being a pharmacist isn’t just about dispensing prescriptions; it’s also about being a reliable, trusted, and accessible resource for health information in our communities. People come to us every day with questions about medications, chronic disease management, healthcare costs, and more. The Hyphen Pharmacy Assistant App gives us greater insight into individual member needs, so we can easily provide more meaningful information and customized support — within our workflow and at the point of care.”

Hyphen’s Pharmacy Assistant app is in use at more than 150 pharmacies that serve Healthfirst Medicare members in New York City. These pharmacies all use Micro Merchant Systems’ PrimeRx software, and the Pharmacy Assistant app integrates with that existing software. The app helps pharmacies track completed patient education activities and receive quality incentives for specific services performed that improve medication adherence and patient satisfaction. 

In addition to the patient-level Pharmacy Assistant app, Hyphen expects to launch an enhanced version of the app that includes a worklist that showcases a population-level view of Healthfirst Medicare members who are served by the pharmacy. This will allow pharmacies to proactively reach out to patients to schedule a flu vaccine or follow up on new to therapy medications and in general address gaps in care to help improve care quality. 

In speaking to Healthcare Innovation last October, GT Sweeney, CIO of Healthfirst, said that Hyphen builds on Healthfirst’s business model, which has always fostered collaboration. “If you believe that the healthcare ecosystem is going to be disrupted by digital ways of collaborating in the future, we want to be at the forefront of that. Everybody's got their own starting point, their own set of investments,” he said. “The one thing that we know from talking to providers is that nobody wants to redefine the way they collaborate with an insurance company or anybody else in a way that only works with that insurance company. We have to have a payer-agnostic strategy and vision.”

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