One of the ways that Blue Cross & Blue Shield of Rhode Island (BCBSRI) works to control and reduce rising medical costs is through our Medical Expense Trend (MET) program, which identifies cost savings opportunities in our day-to-day operations. Over the last couple of years, we’ve expanded this opportunity to include our providers through our Provider MET Summit.

Through the Provider MET Summit, we invite our participating providers to submit innovative proposals and suggestions to reduce rising and unnecessary medical costs. One of the winning submissions at our last summit was a pilot program to reduce adverse drug events, mainly in Rhode Island adults age 65 or older.

The EQUIPPED program—short for Enhancing Quality of Prescribing Practices for Older Adults Discharged from the Emergency Department—is a partnership between BCBSRI and Brown Emergency Medicine that intends to reduce the occurrence of prescribing potentially inappropriate medications (PIMs) that could cause harmful side effects for older patients and lead to increased (but preventable) healthcare use.

Additional goals of the EQUIPPED program are to provide education to emergency department physicians across the state about medication safety, as well as to lower healthcare costs by reducing adverse drug events. By combining education, provider feedback, and clinical decision support, we and our partners at Brown are confident that we’ll be successful in reducing the number of PIMs being prescribed across this patient population by 20 percent.

The American Geriatrics Society reports that 35 percent of older adults experience an adverse drug event each year, resulting in an estimated $30 billion in healthcare costs annually. Adverse drug events also account for more than 3.5 million physician office visits and 1 million emergency department visits each year, as well as 125,000 hospital admissions. The EQUIPPED program will have a positive impact on the health of older adults, as well as on the healthcare system, especially on a local scale – by 2040, the population of Rhode Islanders 65 and older is expected to double.

This program is the first of its kind to be launched in New England. Originally designed by doctors at Emory University, EQUIPPED has been implemented at 11 Veterans Affairs Medical centers and three civilian hospitals. Almost all of those sites have seen a significant and sustained reduction in PIM use. Work is already underway at three local Lifespan hospitals—Miriam, Newport, and Rhode Island Hospitals—to build lists of preferred medications into electronic health records for older populations, to make it easier for providers to select safe and effective medications upon patient discharge (it will vary according to diagnosis).

This is exactly the type of collaboration and patient-focused solution we were hoping for when we created the Provider MET Summit, and we look forward to many more beneficial ideas to come in the future by partnering with our provider community. If you have any ideas, we’re all ears!