Improve Member Experience With Real-Time Benefit Tools and Drug Price Transparency

Faegre Drinker Consulting Principal Mike Adelberg co-authored an article for Compliance Today addressing how real-time benefit tools (RTBTs) and steps to provide drug transparency at the point of care provide an opportunity to lower the cost of drugs for both health plans and their members.

First, Adelberg explains that Medicare Advantage (MA) and Part D plans are required to offer an RTBT to all plan members on Jan. 1, 2023. He also discusses the Transparency in Coverage rule, which puts commercial health plans on a path toward a required cost-estimator tool similar to RTBTs by Jan. 1, 2024.

Adelberg further outlines results from a recent survey assessing plans’ readiness for meeting the new RTBT and Transparency in Coverage requirements and shares considerations. In conclusion, he notes that particularly for Medicare plans facing an earlier deadline, MA and Part D plans should be actively moving toward meeting RTBT requirements.

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