Our Care Corner this week is focused on how utilizing integrated care teams can streamline treatment, and significantly improve a patient’s health and well-being. When you combine two incredible care-focused teams such as the Patient Support Center and Pharmacy Liaisons, a patient’s care never falls through the cracks. This week’s story shows this integrated care model in action.
A Pharmacy Liaison working for a hospital specialty pharmacy sent a request to her Pharmacy Technician counterpart who works in the Patient Support Center recently on behalf of a patient. The Liaison was seeking other options in trying to reduce the copay amount for the patient’s medication, which was currently costing her $337/month. In hopes of reducing the copay for her patient, the Liaison initially sent it to her Financial Assistance team that works in the background for Liaison to find the best assistance possible for patients. Unfortunately the foundation required a prior authorization for the medication, so the request was brought to the Pharmacy Technician in the Patient Support Center for assistance. The technician dove deep into researching this patient’s specific medication, and was able to do a Tier 1 exception for the patient’s medication due to her health insurance plan. The Technician was able to get the medication quickly approved and back dated to 12/31/2018. He then went a step further and was able to get the patient’s copay down to $10 as well as reimburse the patients for 2 months’ worth of medication costs – about $650. The Pharmacy Technician informed the Liaison that same day of the great news for the patient. Because of following through with a patient’s case from start to finish and going the extra mile, the Patient Support Center team member was able to save the patient over $300/month going forward. He is happy he was able to make a difference in a patient’s life saying, “This might not be as big as saving a hundreds of thousands of dollars for a patient, but it makes my day knowing we are able to help these patient save even a little bit of unnecessary medication costs.”
Key Takeaways For Your Pharmacy:
- Fewer Readmissions: Having a Pharmacy Liaison and a Patient Support Center team member caring for each patient throughout their treatment plan allows 3x-5x more patient care interactions and lower readmission rates for a hospital’s chronically ill patient population.
- Reduced Copays: Being able to reduce a patient’s medication copay to the Shields’ average of $8 versus the national average of $100 relieves the patient of worrying about how they will be able to pay for their life-saving medication, which in turn will improve their medication adherence.
Learn more about how Shields Health Solution’s integrated care model works and the difference it makes in chronically ill patients’ lives here.