Prescriber Tool for Health First Colorado

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.

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.

The Prescriber Tool is divided into four modules. These modules are available in approximately 100 EHRs and can provide the following information:

Prescription Benefit Modules

In June 2021, the Department implemented a real-time prescription benefit check for providers that makes prescription writing easier, helps Health First Colorado members get the medications they need to stay healthy, and saves Colorado and Coloradans money on prescription drugs.

  • Real-Time E-Prescribing: Prescribers can now send prescriptions electronically to pharmacies for Health First Colorado 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 (PDL), 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.

The real-time prescription benefit check has been adopted by many major commercial health plans already, and is now available for Health First Colorado members.

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.

Opioid Risk Module

In January 2021, the Department implemented the opioid risk module by OpiSafe. The opioid risk module helps prescribers prevent the misuse and abuse of opioids, benzodiazepines, and controlled substances. The module compiles a comprehensive patient risk profile in the EHR system. The module provides the following:

  • Easy access to Prescription Drug Monitoring Program (PDMP) data
  • Toxicology reports
  • Patient assessments
  • Access to clinical guidelines
  • Tools for overdose prevention

Please note

In order to access the opioid risk module, each prescriber must have an individual license, meaning clinics or systems will need multiple licenses.

If you have any questions, please visit https://opisafe.com/contact-us

Prescriber Tool Alternative Payment Model (APM)

Information about the Prescriber Tool APM can be found on the Prescriber Tool Alternative Payment Model webpage.

For more information