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Optimizing Patient Source Financing Through Pharmacy Assistance Programs

How Can Hospital Pharmacies Optimize Patient Assistance?

Health expenses are a major concern for most Americans. Even though many of them are covered by employers' insurance like Medicaid or Medicare, many pay out of their own pockets. Even those covered can be burdened with formulary regulations or coverage gaps. Patient source financing programs or PAP( Pharmacy assistance programs) caters to those who are either underinsured or uninsured. PAPs are offered by pharmaceutical companies as a safety net that provides patients with affordable medication. These programs provide financial assistance or medications to people who struggle to pay their hospital bills.

The PAP is one of many non-profit and government-sponsored programs that take patient assistance to the next level. The best Front End RCM solution provider in the US, CoverMe, shares a detailed overview of how these processes work and how they can be improved. Continue reading for more information.

Patient Assistance Programs(PAP)

Patient assistance programs are patient source financing programs that make medicines affordable for patients. Furthermore, PAP ensures that the medicines reach patients quickly and are properly instructed about their medical regimens. The purpose of patient assistance programs is to assist patients with choosing the right kind of healthcare insurance and help patients adhere to medication regimens.

PAP enrollments vary for different programs. There are no standard guidelines for these processes, and each program has its own set of rules. However, the patients must meet some basic requirements. Here are some of them.

  • They must be legal and permanent residents of the United States
  • They must submit proof that they are uninsured or that their insurance doesn't cover their medications.
  • The program requires patients to register either online or by contacting them directly
  • They are also required to produce their proof of residence status to prove eligibility.

Once the applications and enrollments are completed, the patients will have their medications, or the program's tenure will be altered based on their eligibility. Below is a brief overview of how PAP benefits patients.

How Do Patient Source Financing Programs Work?

Patient source financing programs receive assistance for co-payments and donations to cover their pharmaceutical costs. Here are more insights into how these work.

Co-payment assistance

In the co-payment mode, the pharmaceutical companies assist patients to co-pay their pharmaceutical expenses. This includes deductible settings as well as co-insurance. In this arrangement, pharma companies pay some or all of the expenses that patients would otherwise have to cover themselves. The payment for prescribed medications or the amount due to the hospital pharmacy is included here.

Replacement drugs

This second form of patient assistance program comes in the form of pharmaceutical donations. The hospital pharmacy will provide patients with the prescribed medication for free. Drug manufacturers will replace the suppliers' stocks for no charge as well.

In essence, the patient source financing programs enable drug manufacturers to move their products and maintain their market share, hospital pharmacies to maintain cash flow and drug inventories, and patients to get their medications. It is, however, quite difficult for hospital pharmacies to manage multiple drug manufacturers and providers who have their unique financing solutions. It's a good thing that multiple strategies are available to make their implementation and execution as hassle-free as possible. The following section discusses the six best approaches to boost patient source financing programs.

6 Strategies to Improve Patient Source Financing Programs

Educating and training staff

An essential element of a successful patient source financing program is educating and training staff about the various health plans patients are eligible for and their benefits. For this to work effectively, the staff needs to be well-versed in available programs and know how to determine whether patients can cover their share of prescription costs. The best way to achieve this is to approach touchpoints with empathy. To manage their programs effectively, the staff must be educated and provided with adequate technical training.

Investing in technology

Technology can facilitate increased patient assistance by allowing staff to approach patient needs empathetically. Patient source financing program management tools and a robust database can be used to manage patient requirements throughout every stage of the program in real-time. PAP can be accessed and matched to patients based on available financial and clinical information. This includes information regarding diagnosis, medications, disease stages, insurance status, payment eligibility, benefits and other vital information.

Seeking third-party interventions

Professional support from third-party providers is the best way to relieve PAP related stress. PAP management outsourced to clinical and financial professionals produces more successful results. Benefits includes:

  • Enrolling more patients to patient source financing programs
  • Improving the customer satisfaction
  • Maximizing the pharmacies' ability to profit from drug recovery
  • Providing timely assistance to hospital pharmacies to cater to the needs of their patients

Guaranteeing timely access to medication

An effective patient source financing program ensures that all stakeholders, including providers, manufacturers, payers, and pharmacies, are well connected and respond well to requests. This process involves coordinating shipping vendors, patient data, notifications, pharmacy integration, and insurance coverage. The outcome of such a well-coordinated PAP system would be a relieved patient.

Dealing with compliance and consent regulations

Helping patients with compliances and privacy in their preferred communication mode is vital to ensure a hassle-free relationship with patients. The focus of hospital pharmacies must be on the needs of patients first and foremost. For the patient source financing program to be successful, pharmacies must be aware of the adverse reactions, product complaints, and side effects beforehand.

Tracking tools for PAP performance

A program's brand value can be determined by adherence rates, speed, fulfillment, call-time reduction, issue resolution, prior authorization, and customer satisfaction. Pharmacy staff can use this tool to evaluate their patients' satisfaction against set standards and improve their efficiency.

PAP- Ensuring a Cohesive Patient Source Financing

The strategies mentioned above will support patient source financing programs by considering their emotional, physical and mental health conditions. Patients' preferences, needs, and interactions focus on patient assistance programs. Using these technologies enhances both the patient and provider experience and reduces redundancies in data collection throughout appointments and conversations. It is, therefore, the responsibility of hospitals to make sure that the above strategies are implemented so that medications can be made available to the needy.

As the leading Front End RCM solutions provider in the United States, CoverMe can assist hospitals with this. CoverMe provides customized coverage solutions to users and real-time enrollment options for various social assistance programs.

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