Medicare Open Enrollment is a time of significant opportunity for pharmacists and patients alike. On one hand, Medicare beneficiaries have the chance to compare their plan options and potentially switch to a plan that may be more cost-effective for their medication regimen. From the pharmacy perspective, this period, which lasts from October 15 to December 7, provides an avenue for pharmacists to demonstrate expertise and care by helping patients navigate the plan selection process. That said, it’s also an incredibly busy time for pharmacies.
Luckily, there are tools to help set you up for success and ensure a seamless experience for patients and pharmacy staff during Open Enrollment. Here’s a look at some of our favorite Amplicare tools and features you can employ this Open Enrollment.
Open Enrollment Report
The Amplicare Open Enrollment report is first on this list because it provides a good overall snapshot of which patients you need to focus on leading up to and during Open Enrollment. A key feature of Amplicare Match, it identifies patients who have filled a prescription at your pharmacy in the past 12 months and are Medicare eligible. When using this report, you have the option to filter results so you can prioritize certain segments for patients. For instance, say you’re interested in launching a communications campaign to patients on plans that will be out-of-network for your pharmacy in the coming year. This report will help you easily identify these patients so you can reach out to them.
Newly added this year, the Doctor Lookup tool is noteworthy given the growing popularity of Medicare Advantage (MA) plans — by 2029, the Congressional Budget Office expects 47% of all Medicare beneficiaries to be enrolled in MA plans. As these plans have limited doctor networks, it’s important that patients are able to confirm the doctor network for plans they may be considering. Doctor Lookup lets you do just that and identify any network restrictions as they occur. This tool pulls information from the national doctor database, which is regularly updated, but keep in mind that it is advisable to still confirm network status directly with doctors when possible.
Formularies change each year, but patients are not always aware that this can affect their out-of-pocket expenses. Open Enrollment is a great time to help them weigh their options and take the effects of changing formularies into account when selecting a plan. With the Formulary Lookup tool, you’re able to easily compare medications across plan formularies and potentially recommend alternatives that could help them save money. Using this tool can help save you time during Open Enrollment while demonstrating a high level of patient care.
Patient Engagement Portal
During the busy Open Enrollment period, time is a highly valuable resource. If your pharmacy serves a large number of Medicare patients, it may be challenging to find time to conduct plan comparisons with everyone. This is where the CMS-approved Patient Engagement Portal comes in. The portal provides the opportunity for patients to compare plans for home, improving their overall experience and helping you serve a larger number of people. Your pharmacy provides access to the portal, which has medications pre-populated to reduce the risk of error from manual entry. Patients see a plan comparison (similar to your pharmacist view in Amplicare but with a few key differences), including plans that are affordable and in-network with your pharmacy, and all the information they need to consider their options. Once they’ve made a choice, they can either enroll directly online or reach out to a licensed representative to finalize enrollment. Be sure to let them know you’re available to answer any questions that may arise.
Communication is important for a positive patient experience, particularly during Open Enrollment. Once you’ve used tools like the Open Enrollment report to prioritize patient segments, consider scheduling targeted calls and/or text messages. Whether you’re reminding them to come in for a plan comparison, notifying them of their eligibility status, or informing them their plan may be going out of network, automated messages help you save time on manual communications. With Amplicare Connect, you can also print informative handouts to share with patients when they come in to the pharmacy.
In addition to the resources above (almost all of which are available through Amplicare Match), Amplicare pharmacies also have access to a Resources center with marketing materials to help you spread the word about your plan comparison services. During the busy Open Enrollment period, taking advantage of the right tools can help you improve the patient experience and emphasize your concern and expertise.