From Sympathy to Empathy: Practical Ways to Support Members
Pharmacy benefit managers (PBMs) play a central role in the continuity of care, yet patients are often left frustrated by claim denials and unaffordable drug prices. When members face disruptions, the emotional toll can be just as significant as the physical one that might put their health at risk. That’s why AffirmedRx goes beyond sympathy and into actionable empathy: acknowledging hardship, validating member experiences, and mobilizing support across teams at the service of our members.
When people think of empathy in healthcare, they may think of a nurse or doctor with excellent bed-side manner, or a provider helping a patient and their family navigate a difficult life-changing event. From simple acts of kindness to going the extra mile to ensure patient safety and satisfaction, empathy is central to high-quality healthcare delivery. At AffirmedRx, we emphasize that a patient’s medical journey does not end when they leave the doctor’s office or upon hospital discharge – nor does the need for empathy-driven engagement.
Empathy in Action
A powerful example of empathy-driven engagement comes from a recent case involving a member who required a specific brand of seizure medication that was not on formulary. The wrong brand medication could lead to seizures, emergency room visits, or worse. Over the course of several weeks, Kristin Rice, a dedicated AffirmedRx Patient Care Advocate, worked tirelessly to ensure access to the exact medication the patient needed. It wasn’t a quick fix – Kristin researched pharmacy options, verified brand availability guarantees, and escalated to leadership when initial solutions failed.
Through her member-focused persistence and collaboration across internal and external teams, Kristin was able to secure an override for the brand medication effective through 2026. Empathy was the cornerstone of this effort. She stayed closely connected with the patient, listening to her fears and frustrations, and reassuring her that her safety was AffirmedRx’s top priority. This wasn’t just about solving a problem – it was about validating a lived experience and offering peace of mind. As a result, the member now receives her medication reliably, safeguarding their health and restoring stability.
Follow-Up Impact
While the health and safety of AffirmedRx members is paramount, the benefits to Kristin’s advocacy didn’t end there. Recently, the same member reached out again—this time to share that her pharmacist wanted to personally commend AffirmedRx. The pharmacist told her they had never seen an advocacy for a patient like this and were deeply impressed by the level of service and persistence shown. Their feedback reinforced the ripple effect of empathy in action: when members feel heard and supported, the trust extends and strengthens the entire care network.
Empathy as a Strategic Capability
Empathy isn’t just about being kind, it’s about being effective. AffirmedRx is proud to empower its Patient Care Advocates with the tools they need to problem-solve for members. Investments in cloud-based technology enable real-time identification of claim denials and proactive outreach to providers, pharmacies, and members. PCAs receive training to effectively identify cost-savings opportunities for members, including out-of-the-box solutions.
Kristin didn’t just follow protocol – she pushed boundaries, escalated concerns, and stayed engaged until a lasting solution was secured. What makes Kristin’s example exceptional is the level of ownership and advocacy she displayed as a Patient Care Advocate. AffirmedRx employs dozens of PCAs that do this work every day, each with their own stories of going above and beyond for members.
Leading with empathy results in measurable impacts. Member satisfaction surveys consistently show that PCAs enhance the member experience by providing a human touch to an otherwise impersonal relationship. Empathy isn’t a checked box – it’s a commitment. When we lead with it, everyone wins.
