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Surescripts Deal Connects EMR Vendors And PBMs To Improve Price Transparency

Posted on November 22, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

I’m no expert on the pharmacy business, but from where I sit as a consumer it’s always looked to me as though pharmaceutical pricing is something of a shell game. It makes predicting what your airline ticket will cost seem like child’s play.

Yes, in theory, the airlines engage in demand-oriented pricing, while pharma pricing is based on negotiated prices spread among multiple contracted parties, but in either case end-users such as myself have very little visibility into where these numbers are coming from.  And in my opinion, at least, that’s not good for anyone involved. You can say “blah blah blah skin in the game” all you want, but co-pays are a poor proxy for making informed decisions as a patient as to what benefits you’ll accrue and problems you face when buying a drug.

Apparently, Surescripts hopes to change the rules to some degree. It just announced that it has come together with two other interest groups within the pharmacy supply chain to offer patient-specific benefit and price information to providers at the point of care.

Its partners in the venture include a group of EMR companies, including Cerner, Epic, Practice Fusion and Aprima Medical Software, which it says represent 53% of the U.S. physician base. It’s also working with two pharmacy benefit managers (CVS Health and Express Scripts) which embrace almost two-thirds of US patients.

The new Surescripts effort actually has two parts, a Real-Time Prescription Benefit tool and an expanded version of its Prior Authorization solution.  Used together, and integrated with an EHR, these tools will clarify whether the patient’s health insurance will cover the drug suggested by the provider and offer therapeutic alternatives that might come at a lower price.

If you ask me, this is clever but fails to put pressure on the right parties. You don’t have to be a pharmaceutical industry expert to know that middlemen like PBMs and pharmacies use a number of less-than-visible stratagems jack up drug prices. Patients are forced to just cope with whatever deal these parties strike among themselves.

If you really want to build a network which helps consumers keep prices down, go for some real disclosure. Create a network which gathers and shares price information every time the drug changes hands, up to and including when the patient pays for that drug. This could have a massive effect on drug pricing overall.

Hey, look at what Amazon did just by making costs of shipping low and relatively transparent to end-users. They sucked a lot of the transaction costs out of the process of shipping products, then gave consumers tools allowing them to watch that benefit in action.

Give consumers even one-tenth of that visibility into their pharmacy supply chain, and prices would fall like a hot rock. Gee, I wonder why nobody’s ever tried that. Could it be that pharmaceutical manufacturers don’t want us to know the real costs of making and shipping their product?

Hospital EHR

Posted on June 20, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

To kick things off on the Hospital EHR and EMR blog, I decided I’d do a Google search for the term “hospital EHR.” I thought it would be fun to see what Google lists as the top resources online for hospital EHR software. I must admit that I’m mostly disappointed with the result.

There was a “Hospital EHR Adoption Database” for $3550. Sounds like a great deal, but I think HIStalk was putting out the info they had for free. At least that resource was from 2011 along with a couple KevinMD blog posts about hospital EHR. One of which was very recent. I guess Google’s rewarding it for being so recent.

I won’t go over all of the links. Some required a registration which I didn’t want to do. Others were from 2007 or talking about the hospital EHR certification being open for public comment. I did like this post by Fred Trotter about “What does it mean to have a hospital EHR?” That article is a little dated too, but I always love Fred’s in your face style of writing. He calls it the way he sees it and I love that about him.

I also have to admit that I was happy (and a bit surprised) that EMRandHIPAA.com had the category for Hospital EHR posts listed 10th on the Hospital EHR search as well. That’s particularly interesting, because I just created that category on EMRandHIPAA.com about 10 minutes before I did the search.

What’s probably more interesting is the EHR vendors and other EHR related companies that are advertising for the keyword Hospital EHR. Here’s a list of the EHR vendors that came up with my search:
Clear Practice
Athena Health
eClinicalWorks
Care 360 (Quest Diagnostics)
Allscripts
Practice Fusion

Pretty interesting list of “Hospital EHR.” Ok, I am being facetious. How many of those even have a hospital EHR software? Allscripts does. I think Athena Health and eClinicalWorks have some services for hospitals, but they don’t really get in the hospital EHR space. I think they are interested in the ACO stuff which is what the Athena Health ad was really about. I do find it interesting that none of the major hospital EHR software vendors are doing advertising on Google. Plus, it seems that some of the ambulatory EHR companies might want to work on their Google Ads targeting.

There were also 3 “EMR List” websites that had paid ads on there as well:
EMR Consultant
Business Software EMR List
Capterra

Then, it made sense why Accenture would want to sell their hospital EHR consulting services. I’m not sure what Bio Visual Tech is, but it was on there as well.

There you go. Now we’ve got this blog kicked off. It’s taken a while to get this blog started, but now we’re ready to go. In fact, I have 3 other writers that are planning to write on this blog. So, check back often to see the latest and greatest info on hospital EHR software.

If you have any must read resources and/or perspectives on the hospital EHR world, please do share them in the comments.