Tag: Industry Insights

SPONSORED CONTENT

The word “innovation” gets tossed around so much these days that we almost forget its meaning—the introduction of new and different ideas for out-of-the-box problem solving that have meaningful impacts. Yet, innovation is different in every industry, and it’s essential in a field as complex as 340B.

To get a handle on it, we sat down with healthcare technology veteran Andrew Stevenson, VP of Product Strategy and Business Development, and 340B industry expert Christy Bryant, VP, Customer Service & Regulatory Affairs at Macro Helix, a third-party administrator that facilitates the 340B programs of more than 900 covered entities as well as hospital-owned and retail pharmacies. Responsible for supporting customer relationships, and driving the execution of critical innovation programs with Macro Helix’s customers, they have valuable insights to share for a 340B community faced with new challenges almost daily.

In a nutshell, what is Macro Helix? How do you help customers succeed with 340B?

Christy Bryant: We help healthcare entities maximize their 340B

SPONSORED CONTENT

While specialty drugs were used by less than 2% of the population in 2020, “they accounted for almost 51% of spending under the pharmacy benefit.”^[1] Within your 340B program, these numbers can be even higher. On average, we see about six percent of volume resulting in close to fifty percent of savings for our clients. With numbers like this, it’s imperative to understand how to manage your 340B specialty contract pharmacies in order to maximize program value.

Below are five strategies to optimize your specialty pharmacy program:

1. Register your “ology’s”

There are six types of eligible clinics within a health system typically driving the majority of specialty value:  dermatology, gastroenterology, rheumatology, endocrinology, neurology, and oncology. Medications dispensed through these clinics have high utilization and yield high savings. Ensuring these clinics are eligible and registered is the first, and most important strategy when capturing specialty value.

2. Set up your ideal specialty network

When developing a specialty network tailored to

SPONSORED CONTENT

Program integrity is crucial to the management of a covered entity’s 340B operations.  Key components include knowing what is expected of the covered entity and having the right questions to ask your third party administrator about their practices and software.  The purpose of this article is to highlight valuable objectives to have in place to ensure continuous program oversight and compliance with 340B guidelines and regulations.  In this piece, I focus in particular on compliance and oversight related to patient eligibility and include important questions 340B providers must ask to both optimize their program performance and ensure compliance.

Program Integrity

What it Means

One of the driving principles of HRSA’s 340B Program Integrity Guide is that there must be a formalized process related to program operational oversight that will ensure compliance with 340B requirements. 

To meet the definition of patient, covered entities must establish a relationship with their patients such that the entity will maintain records of the individuals’

SPONSORED CONTENT

The Net Promoter Score^® (NPS) offers an objective measurement of what is arguably one of healthcare’s most critical—but subjective—areas of focus: patient satisfaction. It is a cross-industry standardized index designed to measure people’s willingness to recommend a company’s products or services to others. While traditional customer satisfaction surveys usually measure a customer’s perception of a specific interaction, NPS measures a customer’s overall attitude toward your brand over time.

Within healthcare, NPS is a strong gauge of how satisfied patients feel with the care they receive. Therefore, it’s noteworthy when organizations receive a significantly higher NPS than the average NPS for other companies offering similar products or services.

Zitter Insights, a division of Managed Markets Insight & Technology (MMIT), conducts a quarterly NPS survey to assess patient satisfaction with specialty pharmacies. In the Q2 2021 fielding, the results revealed that Trellis Rx received an average NPS of 90. By comparison, the overall average NPS across health system, independent, payer, retail, and pharmacy

SPONSORED CONTENT

If you work for an organization specializing in HIV care and/or prevention, you no doubt work incredibly hard to ensure you provide care that is patient-focused in an environment that is affirming and welcoming. I can imagine on your clinic’s walls there are informational posters about the importance of preventative tools like PrEP. On Facebook and Twitter, you might post about the importance of U=U and breaking down the barriers caused by decades of shame and stigma. You are also likely surrounded by health care providers and staff who understand the unique experiences of LGBTQIA+ patients and who treat every single person with care and respect. In your work in HIV prevention or with individuals living with HIV, you understand how important it is to ensure that every single touchpoint in a patient’s care journey aligns with your overall mission. You make every effort to ensure that you meet the specific needs of your community and that each patient feels

SPONSORED CONTENT by Hannah Drake, Senior Director of Marketing, par8o

340B covered entities strive to ensure they are getting the maximum benefit out of the 340B program in order to help fund services for vulnerable patient populations. For health centers, this means setting up a robust contract pharmacy network.

Surprisingly, more than 70% of par8o’s 340B Referral Capture clients did not have a specialty pharmacy as part of its contract pharmacy network before partnering with par8o. For CEs that include referral scripts in their 340B programs, however, making sure that the contract pharmacy network includes a specialty pharmacy can be key to maximizing valuable 340B opportunity. 

Why Do Health Centers Need Specialty Contract Pharmacies?

Specialty pharmacies tend to dispense drugs that are both high-cost and high-touch, meaning they are part of or require complex therapeutic regimens for diseases that require more comprehensive patient care, such as hepatitis, cancer, HIV, rheumatoid arthritis and Crohn’s disease. Retail pharmacies generally dispense

SPONSORED CONTENT

When it comes to operating a 340B program, health systems, hospitals, and other entities that participate in the federal drug pricing program administered by HRSA have found that hiring graduates of the Apexus Advanced 340B Operations Certificate Program is helping them achieve compliance and implement a successful 340B program. 

In the five years since Apexus established the Advanced 340B Operations Certificate Program in 2016, it has become the standard 340B education in the marketplace. Metrics from the baseline knowledge exam compared to final exam scores prove that learners increase their 340B knowledge by 30% after completing the Operations Certificate Program.  Upon successfully completing the Apexus Advanced 340B Operations Certificate, learners join the elite group of Apexus Certified Experts (ACE) nationwide.  This self-led online education also provides learners with more than 30 hours of continuing education credit.

For the more than 1,000 graduates across the nation, their credential as a 340B ACE is helping them transform policy into practice for their entities.

SPONSORED CONTENT

Running a 340B pharmacy is a complicated business, especially considering the varying requirements from payers that can wreak havoc on your bottom line. That’s why Sentry continually works to develop new tools and services to help you stay on top of things and keep your reimbursements moving.

Claims Manager Plus (CMP) is our solution; an automated software solution that helps users adhere to payer requirements, minimize denials, and speed up processing pharmacy claims by almost any payer, or for carving in or out 340B. It’s also indispensable in helping manage complex, government-mandated reporting requirements.

Claims Manager Plus helps you correct errors on claims and adhere to other requirements by flagging items such as:

• Missing modifiers and prices
• Purchase validation of NDCs billed
• Unspecified destination payer codes
• Incorrect NDC codes
• Drug quantity and unit of measure validation
• NDCs not matched to HCPCS codes
• Crossover modifiers between payers

The tool automatically modifies claims based on the configurations you establish. It flags errors and rejections and can

Eighteen 340B Covered Entities to Receive Grant Funding to Help Further Their Missions in the Communities They Serve

Capture Cares is pleased to provide grantees once again with the funding that they need to enable their missions. The projects and programs that these Covered Entities wished to receive grants for are honorable and empower the community, as well as the entity to provide additional services. The 2021 Grantees announcement was made during the 340B Summer Conference on July 27.

Capture Cares is an organization created to help fund the personal or organizational missions of 340B safety net providers and their patients in need. Since its inception in 2019, the Foundation has granted more than $900,000 in funding. Capture Cares was created by Chris Hotchkiss, President of Capture Cares and Co-Founder of CaptureRx, in order to further the missions of providers that focus their efforts on helping those that are underinsured or uninsured.

2021 Capture Cares Grantees:

Community Mission Grants

An organization’s unique mission