You likely won't have time to reach all of your Medicare patients, especially if you're a high-volume pharmacy, so you must prioritize your efforts. Amplicare helps you determine which patients to select when initiating patient engagement campaigns.
To begin, log in and go to "Opportunities" on the left side panel => select the Open Enrollment worklist
Your Open Enrollment report includes all of the patients that have filled in the last 12 months and they are Medicare eligible.
Your Open Enrollment report is customized with "Recommended Filters" to help you target high priority patients with just a few clicks! To select a recommended filter, simply click the "Recommended Filters" dropdown in your Open Enrollment report.
Top Opportunities aka "win-wins" [**Highest Priority Segment**]
This filter identifies patients that are currently enrolled in a plan that will not be the most affordable option for them next year AND the most affordable plan option for them next year will provide higher revenues for the pharmacy.
Patients included in this filter present win-win opportunities where you can help the patient enroll in a plan that's mutually beneficial for them and the pharmacy. We recommend a more direct outreach for these patients to ensure you capitalize on these needle-in-the-haystack opportunities.
[NEW] Cheapest Plan Is... [**Highest Priority Segment**]
Selecting this filter will prompt you to enter a specific plan -- enter one that is beneficial for your pharmacy. We'll identify patients who would also benefit from enrolling in that specified plan (cheapest plan for them next year). Learn more about specific use-cases for this filter.
[NEW] No Longer Preferred Next Year [**High Priority Segment**]
This filter identifies patients that are currently enrolled in a plan that will no longer be preferred with your pharmacy next year. These patients are receiving letters from their plans with misleading information, driving them to start filling at a preferred pharmacy. Make sure you engage with them so they understand their options and that you can help them find a more suitable plan next year!
More Affordable Option [**High Priority Segment**]
This filter identifies patients that are currently enrolled in a plan that will not be the most affordable plan option for them next year. You're pretty much guaranteed to save these patients money next year if you help them enroll in a new plan!
Not Covered Drugs Next Year [**High Priority Segment**]
Make it a priority to reach out to these patients as their current plan covers all of their medications this year, but their plan will NOT cover at least one of their medications next year. Make sure they enroll in a more affordable plan. Otherwise, they'll experience an unpleasant roadblock when they try to refill their medications next year...
Patients included in this filter will experience new formulary restrictions with their plan if they don't enroll in a different one for next year! Formulary restrictions include: not covered drugs, prior authorizations, day supply restrictions, quantity limit, and/or step therapy.
Most Valuable Patients [**High Priority Segment**]
Target your active Medicare patients with high total billings -- a high priority segment to maximize your retention among your high-value patient base. Ensure they enroll in a Medicare plan that incentivizes them to continue filling at your pharmacy in the coming year.
Tip: If this filter yields too many patients and you'd like to further whittle down the list, reduce the Total Billings range by selecting the "Filter" button on the top right. Alternatively, you can Sort by: Total Billings, "Select all on Page" and click through page by page, "selecting all on page" until you reach the desired number.
Target Medicare patients who haven't filled at your pharmacy in a while. "Slipping away" patients have a maintenance medication that was last filled between 4-5 months ago. Open Enrollment is the perfect opportunity to re-engage them before they completely slip away!
Filter by BIN or Current Plan
Target patients that are enrolled in undesirable plans so they enroll in a more beneficial one for next year (i.e. ones that tend to aggressively market mail-order or those with low CMS star ratings).
- Search by BIN 610502 to target your patients currently enrolled in Aetna/First Health plans.
- Search by BIN 004336 to target your patients currently enrolled in Caremark plans (SilverScript, WellCare, and in some states BCBS plans).
- Search by BIN 015581 to target your patients currently enrolled in Humana plans
- Click here for a full list of 2019 BINs, PCNs, and RxGroups!
Additional Filter Options
If any of the recommended filters results in too many patients and you'd like to further segment out the list OR if you prefer to filter your Open Enrollment report from scratch, you can select the Filter button at any point to customize/add filters:
Filter by Next Fill Between 10/15/2020 - 12/07/2020
Target patients who are expected to pick up their medications at some point during Open Enrollment. Make sure no Medicare patient leaves your pharmacy before reviewing their 2021 Medicare plan options!
Once you've decided upon a filter, simply select the opportunities and Schedule Calls/Texts and/or Print Handouts appropriately.
It's important to follow up with patients once you've reached out initially -- we all need reminders every now and then! Click here for best practices on how to target patients in your Open Enrollment report for follow-up.