The cost of medication nonadherence is staggering—both for patients and healthcare systems.

Recently, we hosted a webinar featuring experts from two leading health systems, HCA Healthcare and Prisma Health, who shared how they are partnering with CipherHealth to help patients afford their medications.

We couldn’t have asked for better panelists: Kate Kalthoff, MHA, HEC-C, Vice President of Patient Experience & Bioethics at Methodist Healthcare (HCA Healthcare’s San Antonio division), and Jennifer Bair, PharmD, Chief Pharmacy Officer at Prisma Health.

The discussion was led by Joy Avery, MSN, RN, Vice President of Clinical Services at CipherHealth.

Both leaders shared how they have implemented CipherHealth’s Medication Affordability & Adherence Program.

And it has truly made a difference. By proactively addressing cost barriers, these organizations have improved adherence, reduced hospital readmissions, and continue to drive better long-term health outcomes.

Let’s dive in. 

Medication Affordability at a Glance

Through CipherOutreach, patients receive an SMS after a healthcare visit with discounts tailored to their medications, insurance, and preferred pharmacies. Then, they can simply show the instructions at the pharmacy to get lower prices, with access to savings at over 70,000 pharmacies nationwide.

How Methodist Healthcare is Removing Cost Barriers    

At Methodist Healthcare, every discharged patient—regardless of their financial status—receives a medication savings card included with their discharge instructions. This allows them to access discounts at any pharmacy, removing financial barriers to adherence.

Within one hour of discharge from an inpatient unit or emergency department, an SMS text message is sent to the patient via CipherOutreach containing a link to a savings card for generic medications. Staff can push savings cards to patients anytime by leveraging the patient portal.

Here’s how Methodist’s program is making a difference: 

• About $50-$60 saved per prescription 
• Over $120,000 in savings across 2000 patients in 2 months
• Higher-than-expected utilization rates, proving strong community need
• Positive patient feedback, reinforcing trust in the health system

Kalthoff emphasized that this simple, automated process required minimal additional work for nurses and staff, a key factor in its success.

With the initial rollout exceeding expectations, Methodist Healthcare is now preparing for Phase 2, which will introduce a personalized approach, tailoring savings recommendations based on specific prescriptions and pharmacy locations.

The offering will also be expanded to outpatient clinics, and patients will be able to compare prices across insurance co-pays compared to the discount programs.

How Prisma Health Scaled Medication Savings with Automation 

In contrast, Prisma Health started with a small set of outpatient primary care practices before expanding to all primary care practices and specialty practices. Their strategy focused on automation and equity, ensuring all eligible patients—especially the uninsured and underinsured—have access to medication affordability solutions.

Immediately following a prescription being assigned by a provider, patients receive a CipherOutreach SMS text message with discount codes. 

Previously, Prisma Health relied on manual processes to identify patients in need of financial assistance, requiring case managers, pharmacists, and providers to refer patients individually.

This approach, while beneficial, was inconsistent and time-consuming. By automating affordability solutions, they could ensure all eligible patients received support without requiring additional staff intervention.

Here’s how Prisma’s program is making a difference: 

• 150,000 affordability messages sent since launch in October 2023
• Only 170 patients opted out—an exceptionally low number, demonstrating strong patient acceptance 
• $120 average savings per prescription, with key savings in chronic disease medications such as diabetes and hypertension treatments
• Integration with Prisma Health’s pharmacy system, reducing manual efforts for staff

A critical consideration was excluding Medicare patients initially to avoid interfering with their out-of-pocket maximums.

But as of early 2024, Prisma Health is preparing to expand the program to include Medicare patients, with messaging designed to guide them on how to maximize their benefits.

Expanding Access to Affordable Medications 

Looking ahead, both health systems have plans for expansion.

Methodist Healthcare is preparing to launch personalized, location-based savings recommendations. 

Prisma Health is expanding to inpatient and emergency department settings, ensuring affordable solutions reach more patients at critical touchpoints in their care journey.

For hospitals and health systems considering similar programs, Kalthoff offered a clear recommendation: “Do this. CipherHealth really shepherded us through any questions or concerns we had. They were so helpful in guiding us through this whole program.” 

Kalthoff added, “I’m so happy that we were able to provide this to our patients. When it comes to serving our community, we know people out there are really struggling to make ends meet, even if they don’t tell you. If you have an opportunity to make life just a little bit easier for them, this is a wonderful way to do it.”

Interested in learning how your health system can implement a medication affordability program? Schedule a demo.