Highlights from AHIP 2023: How Regence works to improve the health care experience
Main image, L-R: Tony Barrueta of Kaiser Permanente, Mihir Patel of Regence, Caroline Carney of Magellan Health and Steven Pearson of Institute for Clinical and Economic Review
Last week, leaders across Regence health plans convened in Portland at AHIP 2023, a key industry conference, to discuss ideas and solutions for making health care better, more affordable and accessible for all.
Heidi Kriz, director of medical policy and medical management at Regence, spoke about Regence’s first-in-the-nation partnership with MultiCare to streamline and make the prior authorization process faster, more secure and more convenient.
Kriz said the project was seeded from conversations with company leadership six years ago about the need to reduce prior authorization’s impact on members. Regence knew that “we need to be interoperable with our providers; we need to have a direct connection to them,” Kriz said.
Soon, Regence was partnering with MultiCare on the nation’s first implementation of the HL7® FHIR® (Fast Healthcare Interoperability Resources) Prior Authorization Support Standard. Kriz highlighted that the partnership represents Regence’s desire to collaborate closely on projects that improve the patient experience. “My goal is to collaborate with providers at the end of the day,” she said. “The more conversations we have with providers, the more collaboration, the more the walls break down and we build trust.”
In another panel, Regence’s Chief Pharmacy Officer Mihir Patel highlighted innovative approaches for ensuring medications reach everyone who needs them. Adoption of biosimilars, which cost 15 to 30 percent less and are highly similar and as safe and effective as the originator biologic, is one example of how Regence is helping to drive down health care costs while increasing access and affordability for important treatments.
Regence leads the nation in biosimilar utilization with 95 percent adoption, reducing specialty drug spend by $37 million annually. Patel noted that strong communication with both members and providers to help educate them about the safety and effectiveness of biosimilars is key to high adoption, leading to tremendous savings.
Patel also highlighted Regence’s efforts to address health inequities related to drug access by reaching out to patients who live in pharmacy deserts. “They live more than 15 miles away from a pharmacy, and we made an effort to reach out to these patients and let them know about alternatives, especially mail order, to get their medications,” Patel said. “There’s been really great uptake and patients are thankful that there’s another outlet for them to access their medications. It’s been a great pilot so far and we’re looking to expand that.”
