Elation Health, Surescripts partner to provide medication cost, coverage details during patient visits

Elation Health, a company that developed electronic medical record technology for primary care clinicians, is expanding its partnership with Surescripts to bring more transparency around prescription drug costs and coverage to the point of care.

The company integrated Surescripts' real-time prescription benefit tool directly into its EHR to give providers and clinical staff access to patient-specific medication coverage and cost data during patient medical visits, helping to inform conversations around medication therapies between clinicians and patients in real-time, according to the companies.

"This feature is part of our overarching mission and goal to reduce the administrative overhead for our physicians, especially as it relates to opportunities to improve their relationships with patients," Kyna Fong, Ph.D., Elation co-founder and CEO, said in an interview.

The cost of medications and the lack of transparency around drug prices can be major hurdles for patients. Cost-related medication nonadherence is prevalent in the U.S. In a 2022 national opinion poll, 18% of adults of all ages reported not filling a prescription medication due to costs in the past year.

Studies have shown that real-time benefit tools that present patient-specific drug price information, such as the patient’s expected out-of-pocket costs, to prescribers at the point of prescribing, can facilitate both choosing lower-priced drugs and engaging in informed cost conversation. These conversations can help patients avoid "sticker shock" when filling medications at the pharmacy.

"We saw in the last month a provider prepared a prescription for a brand name drug that would have cost close to $1,000, but when they switched to mail order pharmacy, they got the exact same brand name drug, but fully covered for the patient," Fong said. "It's these little things that help the patient navigate to be able to get the care that they need. When the primary care physician can add this additional value it just improves the relationship with the patient and also reduces downstream work that the doctor won't have to do if the patient calls back and has an issue with paying for the medication."

Surescripts is a health information network and a major player in the electronic prescription market. The company has been a long-time e-prescribing partner of Elation Health. In 2022, Surescripts processed 2.34 billion electronic prescriptions filled by pharmacies nationwide, and, as of October 2023, more than 777,000 prescribers in the U.S. use its real-time prescription benefit solution.

Surescripts' real-time prescription benefit includes on-demand formulary data, providing in-workflow access to patient-specific medication coverage benefits as well as cost data for all prescribing providers using Elation’s EHR. This feature also has information including prior authorization requirements, lower-cost alternative medication options and out-of-pocket cost estimates for patients, according to the companies.

This point-of-care integration gives clinicians visibility into lower-cost medication alternatives that patients are more likely to fill, according to Surescripts' data.

"This feature ensures they when physicians are prescribing medications to patients they are optimized, not just from a clinical perspective, but also from the perspective of benefits coverage and cost. When they do prescribe medications to patients, they can have the highest confidence that patients will follow through by going to the pharmacy, getting the medication filled and then taking it home and following instructions. This is, in our view, a big step forward to supporting our primary care physicians to enable that care for their patients," Fong said.

Elation Health serves 30,000 clinicians caring for more than 12 million Americans, including thousands of small independent practices and large prominent digital health innovators.

“Given that so many medications have been in a shortage situation, it’s nice to have real-time views regarding costs of the alternatives so we can get the medications sorted out for patients when they’re in the office for their visits or when they are calling in, without having to play cat and mouse with the pharmacy,” Dr. Elena Christofides, an Elation EHR customer in Columbus, Ohio, said. 

“Arming prescribers with patient-specific cost information enables them to have better-informed conversations with their patients, helping them to find medications that are both therapeutically appropriate and more affordable," said Andrew Mellin, M.D., vice president and chief medical information officer for Surescripts.

"Together with Elation, Surescripts is simplifying patient intelligence sharing, removing burdens on clinicians and helping them focus on what they do best –providing quality, safe and less costly care for their patients," Mellin said.