Saving Money on Prescriptions
Prescription drugs are the leading contributor to rising health care costs. This affordability impact has a direct impact on patients. In fact, 1 in 3 Coloradans either cannot fill a prescription, cut pills in half, or skip doses because of the cost.
The Prescriber Tool helps employers and Coloradans save money on healthcare by empowering providers with information on prescription drug costs and affordable alternatives. It reduces re-work and administrative burden for providers while improving convenience for patients, too.
The goals of the Prescriber Tool are to help improve patient health outcomes and service, reduce administrative burden for prescribers, and improve prescription drug affordability.
Prescriber Tool Overview
Colorado is the first in the nation to provide a cohesive Prescriber Tool that supports patients and health care providers in both Health First Colorado (Colorado’s Medicaid program) and commercial health plans. This shared tool makes it easier for all stakeholders to work together to make prescription therapy more affordable and thereby improve patient health to the benefit of Coloradans, employers, payers like Medicaid, and the State.
The Prescriber Tool is a multifunctional platform accessible to prescribers through most electronic health record (EHR) systems. It provides patient-specific benefit and cost information to prescribers at the point of care, and eases administrative burden and rework for prescribers while improving service to patients as well.
The Prescriber Tool is being implemented in modules:
Opioid Risk Module
Implemented January 2021, the Department has contracted with OpiSafe to administer an opioid risk module that helps prescribers prevent the misuse and abuse of opioids and benzodiazepines. The module provides the following:
- Easy access to Prescription Drug Monitoring Program (PDMP) data,
- Identification of risks related to opioid misuse,
- Access to clinical guidelines, and
- Tools for overdose prevention.
In order to access the opioid risk module, each prescriber - or user - must have an individual license, meaning clinics or systems will need multiple licenses. The Department is providing a limited number of one-year licenses at no cost to Medicaid providers. The license enables prescribers to use the opioid risk module for ALL patients – such as those covered by commercial plans, Medicare, Medicaid and those who are uninsured.
To inquire if no-cost licenses are still available, please contact hcpf_Colorado.SMAC@state.co.us
If you have any questions, please visit https://opisafe.com/contact-us
Prescription Benefit Module
In June 2021, the Department implemented a real-time prescription benefit check for providers that makes prescription writing easier, helps Medicaid members get the medications they need to stay healthy, and saves Colorado and Coloradans money on prescription drugs.
The module is in approximately 100 EHRs and will provide the following:
- Real-Time E-Prescribing: Prescribers can now send prescriptions electronically to pharmacies for Medicaid patients, increasing convenience and saving time for patients, prescribers and pharmacies.
- Real-Time Benefits Inquiry: Prescribers now have rapid insight into preferred medications from the preferred drug list, empowering them with drug affordability and cost options.
- Real-Time Prior Authorization: Prescribers can now get rapid prior authorizations, reducing workload and avoiding manual entry, forms, faxes and lists.
By making sure the medication is preferred before prescribing it, prescribers will make it easier for patients to get their needed medications - for patients, this is more convenient and avoids unnecessary delays and confusion.
The real-time prescription benefit check has been adopted by the major commercial health plans already, and is now available for Medicaid members, too.
Please contact your IT Support Staff, EHR Training Team or EHR vendor to access the “Real-Time Prescription Benefit” or “Real-Time Benefit Check” and get training and education materials.
For more information: