Optimize MyCare -Draft

Optimize MyCare, available in partnership with Tria Health, offers enhanced support for diabetes management

Diabetes is consistently a top-three cost driver for pharmacy spend, particularly with the explosion of high-profile and high-cost GLP-1 medications. Historically, achieving optimal medication adherence among diabetes patients has been a challenge. Adherence is critical to ensuring better health outcomes and preventing costly and serious adverse events and complications.

Pharmacist Led, Human to Human

Many programs focus on meter readings to drive outreach. The Tria Health approach focuses on proactively engaging members with a designated pharmacist as their personal advocate, providing disease education, care coordination, and support.

$12,022

of total gross pharmacy spend for a plan

(Source: RxBenefits Book of Business, 2023)

2.6 times

higher medical costs for people with diabetes than those without

(Source: Economic Costs of Diabetes in the U.S. in 2022 | Diabetes Care | American Diabetes Association)

Proactive Outreach Improves Engagement

High-risk members are identified through pharmacy claims analysis on an ongoing basis. Once identified, members receive proactive outreach via mail, email, and phone to schedule a telephone appointment with a Tria Health pharmacist. An incentive is offered to members to encourage participation in the program. This multi-channel outreach maximizes engagement for these high-risk members.

Pharmacist Consultations Optimize Diabetes Management

Chronic conditions are managed with medications, making pharmacists the best resource to conduct confidential consultations with members. During each consultation, Tria Health’s pharmacists take the time to understand a patient’s background, behavior, and beliefs – all important factors in how they manage their health. By understanding a member’s motivations, along with a comprehensive medication and lifestyle review, Tria’s pharmacists work with members to develop a personalized care plan. Care plans are shared with the member’s primary care physician and other treating physicians and are used as the baseline for continuous management.

The results speak for themselves

For additional information, please contact your RxBenefits Account Team or Business Development Representative

Choose to Lose Weight Management Program

Obesity impacts a significant portion of the adult population, driving up healthcare and plan costs. While GLP-1 medications are highly effective for diabetes and weight management, their high price tags can strain employer budgets.

Through our partnership with Tria Health, employers can offer a personalized weight management program as a stand-alone option or alongside Optimize MyCare. Choose to Lose prioritizes lifestyle and behavior modifications by providing participants with a dedicated health coach, personalized plan, mobile nutrition app, and ongoing support from pharmacists. And the program offers employers a choice of scalable coverage options for GLP-1s or other anti-obesity medications, when appropriate.

Proven Weight Loss. Measurable Impact