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Successful 340B pharmacy programs deliver much needed savings for covered entities, so those funds can be reinvested in expanding care and improving health outcomes for the communities they serve. However, even programs that have achieved positive results may not be producing the highest and best results.
Do you really know how well your pharmacy program is operating? Could your program deliver more savings for your organization?
Think about your 340B program and try to answer the following questions. You may discover that you are managing your program efficiently and maximizing its potential. On the other hand, if you are unsure about your answer, don’t know the answer, or haven’t thought about the question, there may be room to vastly improve your pharmacy program and deliver better financial and health outcomes for your patients.
Let’s get started:
1. What portion of your patient scripts are filled in your contract pharmacy network and in-house pharmacy and more importantly, which are not?
Understanding where your organization’s scripts are being filled is fundamental to determining if your pharmacy network is successfully serving your patients and providing savings to benefit your organization. Analyzing the performance of your pharmacies can identify if there are opportunities to expand your network or consider implementing an in-house pharmacy. This provides data to clearly see where scripts are being filled, importantly those that are outside your network, and gain insights to those that are underperforming, so you can develop a network that meets your patients’ needs and produces the most savings.
2. Are you certain you are capturing all eligible claims?
Managing your 340B program and maintaining compliance is challenging enough, investing the time, training, and effort to identify additional eligible claims from referral sources is the ideal, but employing a dedicated resource can be costly and many times unsuccessful.
Partnering with a 340B expert that leverages technology and staff trained to identify and qualify more claims is a way to grow your program with little to no effort on your part. Nuvem’s Advanced Referral Program leverages our technology and dedicated Advanced Referral Coordinators to identify and verify additional claims on our clients’ behalf, this includes tracking down hard to locate referring provider notes.
3. Do you know the number of claims as well as potential savings your program may be losing to manufacturer blocks, and more importantly, do you have a strategy to avoid them?
Manufacturer blocks are reducing savings for 340B programs and change frequently making it difficult to project savings for your program. One of the greatest ways to avoid manufacturer blocks is to leverage an on-site pharmacy to capture eligible claims that may not be captured through a contract pharmacy partner due to restrictions.
While opening and managing an on-site pharmacy may sound easy, there are complexities to the process. Relying on an experienced partner can take the stress out of the entire process which leads to quicker implementation, realizing savings faster, with expert guidance and support for your on-site pharmacy.
4. Are your current TPA(s) available to provide the exceptional service and support you need?
You may have multiple TPAs to manage Contract Pharmacy relationships and we understand the need for this at times. However, working with a TPA that has the capability to view your entire network can identify areas for improvement- reducing claim leakage, white space you have not considered- all to improve your overall capture rate and deliver more 340B savings. Are your TPAs able to show you the holistic picture?
5. Do you have the service and support you need to keep your pharmacy program running, and seek opportunities for growth?
This may seem overwhelming. Finding the right vendors to work with is key in maintaining and growing a successful program. There are many options within the 340B space. You may be inclined to think those that specialize in one area are the best choices for each individual service. But are they the best choice for visibility into your entire program? Nuvem has the unique ability to provide the entire expert suite of services you need. After combining our individual services to create a holistic approach, our clients are far exceeding what they initially thought was a successful program.
With Nuvem’s holistic approach, we seek to partner with our clients by addressing all of their needs. We align Account Managers to assist every client in providing answers to the questions asked above, or by reaching out to experts within Nuvem for more insight and information.
Our goal is to empower our partners holistically, with the technology, services, and support they need to successfully manage their pharmacy programs, positively impacting patient health and improve financial outcomes. We’ll be happy to start a conversation about your program with you and to assess opportunities for growth and partner with you to meet your goals.
Learn more about Nuvem here or for questions, please contact Nuvem at info@nuvem.com.
