By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    HIPPA compliance
    How Medical Office Staff Can Make Your Practice HIPAA Compliant
    October 29, 2021
    Everything you need to know about hyaluronic acid treatment
    Everything you need to know about hyaluronic acid treatment
    February 10, 2022
    Which Mushroom Capsules Are Good for Your Health?
    May 5, 2022
    Latest News
    Beyond Nutrition: Everyday Foods That Support Whole-Body Health
    June 15, 2025
    The Wide-Ranging Benefits of Magnesium Supplements
    June 11, 2025
    The Best Home Remedies for Migraines
    June 5, 2025
    The Hidden Impact Of Stress On Your Body’s Alignment And Balance
    May 22, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Yoga Improves Balance and Reduces Falls
    November 14, 2011
    NY Governor’s Plan for Trimming Medicaid Costs within Budget Nets Early Win
    August 23, 2017
    Being Your Own Patient Advocate
    December 18, 2011
    Latest News
    Top HIPAA-Compliant Messaging Apps for Healthcare Teams
    June 25, 2025
    When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
    June 20, 2025
    Preventing Contamination In Healthcare Facilities Starts With Hygiene
    June 15, 2025
    Strengthening Healthcare Systems Through Clinical and Administrative Career Development
    June 13, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Medication Non-Adherence: A $290 Billion Unnecessary Expenditure
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Health Reform > Medication Non-Adherence: A $290 Billion Unnecessary Expenditure
BusinessHealth Reform

Medication Non-Adherence: A $290 Billion Unnecessary Expenditure

Ashish Varshneya
Last updated: April 13, 2015 8:00 am
Ashish Varshneya
Share
4 Min Read
medical nonadherence
SHARE

medical nonadherence

medical nonadherence

Drug therapy problems present a serious issue in healthcare in the United States.  Industry estimates suggest total costs of unnecessary medical expenditures resulting from medication non-adherence to be approximately $300 billion, which represents more than 30% of the total waste (excluding fraud and abuse) in the healthcare system.  Failure to take prescribed medications costs over $100 billion a year in excess hospitalizations.  It is estimated that nearly one-third of patients never fill their prescriptions, and three out of four Americans do not take their medications as directed.

Medication Therapy Management (MTM) includes a broad range of activities, including but not limited to enhancing adherence through patient education, performing a comprehensive review of the patient’s drug regimen, and monitoring efficacy and safety of medication therapy, with the overall objective to enhance care outcomes and lower healthcare costs.

More Read

med school graduates
4 Barriers to Private Practice for Med School Graduates
The White House Office of Science and Technology Policy (OSTP) “Grand Challenge”
How to Manage Your Ortho Team Like the Miami Heat
Medicare Trustees Report Deficit Sooner Than Expected
High Quality, Low Cost HealthCare Video Interview Series: Daniel Wolfson and The Choosing Wisely Campaign

Market Drivers: While the Medicare Modernization Act of 2003 required Medicare Part D prescription drug plans to include medication therapy management services to be delivered by a qualified healthcare professional, lack of financial incentives and a quantifiable ROI were key challenges in implementing an effective medication therapy management.

The introduction of the 5-Star rating system by the Affordable Care Act provides the financial incentives and puts MTM in the spotlight.  Of the 53 key quality measures in the Medicare Star rating system, 17 are prescription drug specific and have a weighting of 1.5 to 3x making it a highly important component for the overall plan rating.  With Star Ratings bonus payments expected to exceed $2 billion for the large, public MCOs in 2015 alone, MTM has come into high focus.

Two Compelling MTM Case Studies: 

  • The 37-year-old female who is taking 18 medications. The patient suffered from uncontrolled asthma, plus depression, pain, and nausea.  A 30-minute MTM visit found five problems, including a duplicate therapy and overuse of a short-acting inhaler.  Three medications were added, one subtracted. The annual medication costs: $3,092. Cost reductions from avoiding an asthma-related hospital stays: $24,511 (average costs of a hospital visit by a patient suffering from asthma).  Net savings: $21,419.
  • The 54-year-old man who is taking 12 medications. The patient was a smoker who has diabetes and other problems.  The MTM check-up identified four problems, including adherence issues and a missing ACE-I therapy.  Three medications were changed; adherence was improved.  Net savings: $9,567.

Market Activity Provides Further Validation:  Market activity, as demonstrated by selected events below, further validates the MTM’s renewed focus in the minds of several market constituents.

  • CMS awarded $8.7 million to VillageCare, a community-based, not-for-profit organization, to help HIV/AIDS patients by providing a multi-layered and tailored intervention aimed at improving their medication adherence via a mobile medication planner, text reminders, social networking, peer mentoring, virtual support groups, and virtual access to health coaches.
  • First Databank (part of Hearst Health) has partnered with Polygot, a developer of cloud-based adherence platform for hospitals, ambulatory care centers, and pharmacies across the U.S. and Canada to enhance adherence through patient education and awareness tools. Providers will benefit from improved quality scores.

An ongoing and irreversible shift to ‘value-based’ care models that align reimbursement with the delivery of higher quality and more cost-effective care will have a profound impact on MTM.  In addition, an effective MTM program can dramatically improve adherence and patient health through regimented chronic condition management, eliminate fear of medication related side-effects through patient education, proactively identify medication adherence gaps, and drive appropriate interventions.

Let us know what you think.

Medical non-adherence / shutterstock

Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

women dental care
What Is a Smile Makeover and How Much Does It Cost?
Dental health
June 30, 2025
HIPAA-Compliant Messaging Apps
Top HIPAA-Compliant Messaging Apps for Healthcare Teams
Global Healthcare Policy & Law Technology
June 25, 2025
recovering from injury
Rebuilding After Injury: Path to Physical and Emotional Recovery
News
June 22, 2025
scientist using microscope
When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
Global Healthcare
June 18, 2025

You Might also Like

BYOD or BYOT

March 11, 2012

Healthcare Landing Pages That Actually Work: The What, Why and How

April 18, 2013
healthcare trends to watch 2015
BusinesseHealthFinanceHealth ReformHospital AdministrationMobile HealthWellness

3 Big Healthcare Trends To Watch in 2015

July 21, 2015
5 Tips to Protect PII in Any Industry
BusinessPolicy & LawTechnology

5 Tips to Protect PII in Any Industry

June 12, 2022
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?