For health plans, the fourth quarter isn’t always a smooth coast to the finish line. Instead, it’s often defined by urgency and intensity, a period when the year’s work converges into one critical push. By the fourth quarter (Q4), health plans are working to complete member consultations, close lingering care gaps, and demonstrate measurable progress toward quality benchmarks.
The stakes could not be higher. Year-end performance drives everything from contractual obligations and compliance requirements to Star Ratings, HEDIS measures, CAHPS scores, and SUPD adherence. Falling short in these areas can put both financial incentives and member health outcomes at risk. In other words, Q4 is not simply about checking boxes, it’s about protecting plan performance and making sure members receive the high-quality care they deserve.
Yet, the reality is that the convergence of deadlines and outstanding consults creates enormous pressure on internal teams. Without the right strategy and resources, health plans can find themselves scrambling in the final weeks of the year.
The challenges health plans face in Q4
As the calendar year winds down, health plans often find themselves in a high-pressure environment where every consult, survey response, and adherence measure carries outsized importance. The obstacles they encounter during this period are familiar but no less daunting:
- Backlog of consults: Despite careful planning, many plans still face thousands of members in need of medication reviews or pharmacist-led interventions as the year draws to a close. Unfinished consultations represent not only unmet metrics but also missed opportunities to improve health outcomes.
- Tight deadlines: Once October begins, there’s limited time left to act. Closing care gaps in just weeks requires precision, coordination, and a workforce capable of operating at scale.
- Quality measures at risk: From medication adherence scores to member experience surveys, incomplete or rushed consults jeopardize critical ratings. A drop in Star Ratings or HEDIS performance can have lasting repercussions beyond the current year.
- Internal resource limitations: In-house care teams are often already stretched thin. Adding a surge of consultations to their workload can result in pharmacist burnout, inefficiencies, and lower-quality interactions with members.
Combined, these challenges create a perfect storm. Left unaddressed, the Q4 push can damage both plan performance and the member experience.
Why a pharmacist-led care delivery model is the solution
In the face of Q4 push pressures, a pharmacist-led model offers a proven, scalable solution. Pharmacists are uniquely qualified to step in during crunch time, bringing both the expertise and the capacity to close consults quickly without sacrificing quality.
- Nationwide network of pharmacists: Unlike limited in-house teams, a pharmacist-led model provides access to a vast, on-demand workforce. Health plans can scale up resources instantly, making certain that no member is left behind.
- Clinical expertise: Pharmacists are medication experts. They are trained to identify gaps in therapy, address adherence barriers, and engage members in conversations that promote safer, more effective use of medications.
- Efficiency and quality: The combination of scale and clinical skill allows for consults to be completed both quickly and thoroughly. Plans can accelerate progress toward year-end goals without compromising the member experience.
With pharmacists at the helm of the Q4 push, health plans and organizations can move away from the year’s final quarter acting as a time of scarcity and stress and turn it into a period of opportunity. With the help and expertise of a pharmacist, health plans are empowered to exceed expectations and strengthen member trust.
4 ways Aspen RxHealth helps plans scale during Q4
At Aspen RxHealth, we specialize in equipping health plans with the flexibility and capacity they need during the year-end push. Our approach blends a pharmacist-led model with cutting-edge technology to deliver desired results at scale.
1. Technology-driven efficiency
Through our delivery model, Alliance by Aspen RxHealth, we streamline the entire process of connecting pharmacists to members. Smart matching makes certain that the right pharmacist is paired with the right member while considering language, location, and clinical needs. Integrated workflows reduce administrative burdens and maximize time spent on meaningful clinical interactions.
For health plans and organizations that need additional help delivering medication management services and/or reaching specific patient populations, the Aspen RxHealth pharmacist network offers fully outsourced care delivery, powered by BeWell with Aspen RxHealth.
2. On-demand scalability
Health plans can leverage our nationwide community of pharmacists as a way to mobilize resources quickly to address consultation backlogs and meet deadlines. With this on-demand scalability, health plans gain immediate access to Aspen RxHealth’s highly skilled workforce that can flex with demand.
3. Rapid implementation
Unlike traditional models that take months to deploy, Aspen RxHealth can integrate with health plans late in the year and still deliver measurable impact. Even in Q4, it’s not too late to make a difference.
For new clients, we offer fast onboarding to get programs up and running without delay. For existing clients, our pharmacist community can be activated quickly to address immediate needs. In a space where speed is rarely an option, Aspen RxHealth makes rapid execution in healthcare a reality.
4. High-quality, member-focused care
Every consult is designed not only to meet short-term goals but also to build long-term trust. By focusing on patient-centered care, we help plans improve satisfaction, adherence, and loyalty.
The impact of pharmacist-led care delivery models on quality metrics and patient outcomes
For the modern pharmacy industry, success is measured not only by the number of consults completed but by the outcomes they drive. The benefits of Aspen RxHealth’s pharmacist-led, tech-enabled approach extend directly to the metrics that matter most in Q4:
- Star Ratings: By improving medication adherence and delivering positive member experiences, pharmacists help lift the measures that directly impact Star Ratings.
- HEDIS measures: Consults focused on closing gaps in care ensure preventive services and chronic condition management benchmarks are met.
- CAHPS: Personalized, timely pharmacist interactions enhance member satisfaction, leading to higher survey scores.
- SUPD (statin use in persons with Diabetes): This measure tracks the percentage of adults ages 40 to 75 with diabetes who are prescribed and taking statins, an essential therapy for reducing cardiovascular risk and supporting comprehensive diabetes care.
The overall effect is powerful: health plans meet or exceed year-end goals, reduce member abrasion, and position themselves for stronger performance in the coming year, while laying the groundwork for sustainable quality improvements, deeper member trust, and long-term competitive advantage.
Turning Q4 push into an opportunity for enhanced pharmacist-led care
For health plans, the Q4 crunch is a reality. Deadlines loom, consultations accumulate, and the pressure to perform intensifies. Yet with the right partner, this period does not have to be a crisis.
Aspen RxHealth’s pharmacist-led, tech-enabled model, Alliance by Aspen RxHealth, provides health plans with the capacity, expertise, and efficiency needed to scale rapidly. By leveraging our nationwide network and innovative platform, plans can close consults, meet quality benchmarks, and improve member outcomes, all while building trust and loyalty for the long term.
The year’s final quarter will always be demanding, but it can also be a catalyst for excellence and set the tone for the new year. With Aspen RxHealth, health plans can not only finish the year strong but also lay the foundation for future success.
Connect with us today to see how we can help your in-house team turn Q4 challenges into opportunities.
