When it comes to 340B compliance, there’s really only one number for total savings that’s right for your organization. In the popular gameshow, The Price Is Right, the objective is to get as close to the right number without going over. It’s not that different for 340B. If you go over the right number, you’re non-compliant. If you’re under the right number, you’re not optimizing your savings. So, the question is, how do you get to that right number of savings that fits your organization?
Stay on top of 340B Compliance
At CaptureRx, we believe compliance is the top priority of any 340B program, and it is not a one-and-done endeavor. We focus on strengthening your 340B program by having a dedicated Compliance Team and provide special education programs for you and your employees. A dependable TPA will also provide a platform that includes robust fail safes to protect against diversion, strong eligibility filters to mitigate risk and comprehensive reporting capabilities.
3 ways we recommend for building a stronger, more compliant program:
- Have your employees certified in 340B management through programs like Apexus or the CaptureRx 340B Coordinator training so that they are educated in how to manage a program successfully.
- Apply for an ACE Buddy CaptureCares grant. Given out once a year, these grants pair up a CaptureRx ACE Certified Expert with you (or your employees) to provide financial assistance, guidance and mentorship while they complete their certification to ensure success.
- Work with a TPA that makes compliance the number one priority. At CaptureRx, we offer a robust platform; CaptureCard, a sliding fee scale solution to meet HRSA requirements; employee experts and dedicated account managers that can help simplify the complexity of 340B compliance.
Take advantage of all savings opportunities
Implement solutions and programs that are designed to uncover opportunities for growth. Although it may be daunting to add more aspects to your program, the rewards can be a game changer. One of our specialties is Pharmacy Network Buildout. We recommend growing your pharmacy network through deep analysis of your program and patients in a way that is tailored specifically for your entity. Capturing referrals and adding specialty programs can also greatly impact your savings. Consult a partner/TPA that is experienced in these strategies and can provide testimonials or examples of how they’ve transformed savings for other clients.
3 ways you can begin to achieve the savings you deserve:
- Pharmacy network buildout: Work with a TPA that can evaluate existing pharmacy buildout to recommend and identify additional pharmacy candidates by leveraging existing relationships with major chains and independents. At CaptureRx, we thoroughly analyze your current network and opportunities and can help implement a network that is right-sided and optimizes your savings to find your right number.
- Specialty programs: Ensure your patients have easy access to specialty medications by partnering with specialty pharmacies with the medications and payors your patients need most. Your TPA should be able to design a program that fits your business, matches highest prescribed NDCs and yields the most savings in a compliant way.
- Referral capture: Establish your own program or use a service, such as CaptureReferral, to ensure all eligible referrals are accounted for. Identify provider referrals for your patients on a regular basis and regularly monitor switch data for claims from referrals. Make sure to develop a process that helps ensure compliance is maintained for claims from referral providers, as well as processes to help prevent manufacturers from duplicating the 340B discount pricing to both providers.
Finally, use your savings to implement programs that help you enable your mission – whatever that may be. From offering discounted prescriptions to organizing a food bank or transportation services, work with a partner that can offer assistance. At CaptureRx, our mission is to enable yours and we are here to help you accomplish your goals for your organization and within the community. Learn more at www.capturerx.com or contact us through the web or at 888.345.6424.