How to increase 340B pricing adoption with efficient automated prior authorization.
A 340B pharmacy program allows covered hospitals, qualified entities, and health care systems to buy outpatient drugs at discounted…
A 340B pharmacy program allows covered hospitals, qualified entities, and health care systems to buy outpatient drugs at discounted prices.
Drug wholesalers and manufacturers that participate in Medicaid provide medication through a specialty pharmacy to the eligible patients of covered entities and qualified health care systems at these reduced 340B prices.
What is the enrollment process for the 340B program?
To join the 340B program, organizations register for enrollment. To maintain the 340B program status, they must qualify and comply with all the 340B program requirements.
A qualified organization receives a 340B identification number that drug wholesalers and manufacturers use to verify participation in the program to buy drugs at discounted prices.
Some Key issues surrounding 340B pricing we track the prescriptions at those pharmacies to ensure they bill as 340B vs. falling into the routine PBM billing.
Why is it difficult for healthcare organizations and pharmacies to adopt the 340B program?
The 340B program requirements require oversight to:
- Prevent medication diversion to ineligible patients.
- Avoid taking duplicate discounts by using 340B pricing and buying under additional group discounts.
- Maintain auditable records and pass regular audits.
How can we reduce the time and cost with electronic prior authorizations and get patients on 340B meds? Which also helps pharmacies and hospitals grow their revenue?
D2’s innovative solution includes a digital tool called UltraTouch that drastically reduces the time it takes to get authorizations and get a patient on 340B meds. With automated prior authorization, you can start patients on vital therapy in minutes instead of delays that might be many days using an inefficient legacy system.
Most 340B organizations leak 20{4d247f1d133b79da6ef1f23a8f7eda6da4091446aab019904e6e8056db19650d}+ of their 340B opportunity. But D2’s platform ensures that the prescriptions are captured and directed to the applicable 340B pharmacy, effectively maximizing the use of an organization’s contracted 340B pharmacies.
The result is an increase in 340B revenue without the expansion of the 340B network. Fundamentally we track the prescriptions at those pharmacies to ensure they bill as 340B vs. falling into the routine PBM billing.UltraTouch provides tangible results such as:
- 100 of prescriptions are filled at the intended contracted pharmacy
- 96 of the prior authorizations are approved on the first request
- 58 get approval within 10 minutes
- 100 of the data is captured for audit purposes
What are the costs of delays for prior authorizations in specialty med prescriptions or 340B prescriptions?
Dean Erhardt, President and CEO at D2 Solutions, says, “For patients on specialty life-saving therapies, every moment counts.”
In an inefficient health care system with specialty pharmacies and a 340B pharmacy network, up to 62{4d247f1d133b79da6ef1f23a8f7eda6da4091446aab019904e6e8056db19650d} of the prescriptions for specialty therapies may be incomplete, lost, misrouted, or abandoned. This problem represents significant lost revenues and poor patient care.
Contact D2 Solutions for more information about the UltraTouch solution: [email protected], tel 636-537-7805.
