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Drug and medical
coverage go hand in hand
11/12/04
Drug coverage is integral to BCN
medical coverage. It helps paint a complete picture of member
care and helps us understand ways we can help individual patients
recover. For instance:
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We follow-up when we identify members who've had a heart
attack but haven't been prescribed beta-blockers.
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We send members important health information specific to
their interests based on their prescriptions. Some examples
include mailings on depression, smoking cessation and our
weight-loss programs.
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We screen for and report when members are at risk for certain
adverse drug reactions. For example, we identify members
who receive multiple drugs that might interact with each
other or that might increase the likelihood of certain medical
problems.
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We enroll members in certain disease management programs
based on the medications they take.
Our
pharmacy program has ongoing checks that protect members from
being harmed by drugs that shouldn't be taken together or
shouldn't be prescribed because of the member's age or because
the dose is not appropriate. We also look for overuse of certain
drugs, such as rescue inhalation treatment for members with
asthma. We identify situations where members aren't taking
maintenance drugs as prescribed.
Our
monitoring means your members' health care is safer, has better
outcomes and is cost effective.
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