pan foundation offering help and hope for a healthy tomorrow
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August 4, 2014. PAN Foundation Offering Help and Hope for a Healthy Tomorrow. Agenda. PAN Overview HIV/AIDS Financial Assistance Fund Application Process and Instant Approval Summary and Questions/Answers. Mission - PowerPoint PPT PresentationTRANSCRIPT
August 4, 2014
PAN FoundationOffering Help and Hope for a Healthy Tomorrow
Agenda
• PAN Overview
• HIV/AIDS Financial Assistance Fund
• Application Process and Instant Approval
• Summary and Questions/Answers
2
Who We Are
3
MissionEstablished in 2004, PAN Foundation offers help and hope to people with chronic or life-threatening illnesses for whom cost limits access to breakthrough medical treatments.
Independent Board of Directors11-member board with diverse expertise in healthcare, non-profit, financial management, public policy industries
Proud to Say… Helped over 295,000 patients in the last 10 years
99% of patient and providers report satisfaction with our services
95% of each dollar donated goes directly to patient assistance
Nearly 60 disease-specific programs cover a wide range of patient needs by partnering with the largest providers and 20+ manufacturers
Oncology Anaplastic Large Cell Lymphoma Basal Cell Carcinoma Bone Metastases Chemotherapy Induced Neutropenia Chronic Lymphocytic Leukemia Chronic Myeloid Leukemia Colorectal Cancer Cutaneous T-cell Lymphoma Gastrointestinal Stromal Tumors Immunotherapy for Genitourinary
Cancers Hodgkin’s Lymphoma Lung Cancer (Non-Small Cell) Mantel Cell Lymphoma Metastatic Breast Cancer Metastatic Castrate Resistant Prostate
Cancer Metastatic Melanoma Multiple Myeloma Myelodysplastic Syndrome Myeloproliferative Neoplasms Neuroendocrine Tumors of Pancreatic
Origin Non-Hodgkin’s Lymphoma Renal Cell Carcinoma Thyroid Cancer
Rare Disease Acromegaly Cushing’s Disease Gaucher Disease Homozygous Familial
Hypercholesterolemia Methicillin-resistant
Staphylococcus aureus (MRSA) Short Bowel Syndrome Tuberous Sclerosis Complex Uveitis Wilson Disease
Chronic Illness Asthma Auto-Immune Diseases
• Ankylosing Spondylitis• Plaque Psoriasis• Psoriatic Arthritis• Rheumatoid Arthritis
Chronic Iron Overload Cytomegalovirus Growth Hormone Deficiency Hepatitis B Hepatitis C HIV/AIDS Idiopathic Thrombocytopenic Purpura Inflammatory Bowel Disease
• Crohn’s Disease• Ulcerative Colitis
Lower Extremity Ulcers Macular Diseases Multiple Sclerosis Postmenopausal Osteoporosis Respiratory Syncytial Virus Retinal Vein Occlusion Secondary Hyperparathyroidism Solid Organ Transplant
Immunosuppressants
4
PAN Assistance Programs
Travel Assistance Metastatic Castrate Resistant
Prostate Cancer
Premium Assistance Homozygous Familial
Hypercholesterolemia Short Bowel Syndrome
Patient Demand Continues to Grow
5
1185 1216 1551 1060 816 1101 888 1136 1100 850 982 1858
2578
70185259 4491 4184
34203290 3692 4054 4389 3957 4356
9358 10101
72575966 5685 4895 5468
80955389 7929 6849
6870
31023
15489 17022 16376 16349
14651
5715
-3000
2000
7000
12000
17000
22000
27000
32000
January February March April May June July August September October November December
Num
ber o
f Pati
ents
Ass
iste
d
Total Patients Approved
2011
2012
2013
2014
• YTD June—110,910 patients have been approved for financial assistance vs. 43,262 the prior year
Key Performance Indicators
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Inbound Calls
Patient Approvals and Payments
Referral Sources
• YTD, PAN has received 279,856 calls• Average speed to answer 43 seconds*
• YTD, PAN has approved 114,921 applications• 99% of application are processed within a business day• Approval rate of 97%• No. 1 reason for denial is income greater than criteria• Total payments YTD $238,564,874.11**
• 45% of referrals come from providers• Pharmacy referrals have increased
significantly to 38%
*Average speed to answer is calculated using the last six months.
**Total payments is calculated through June 2014.
22%
21%42%
15%Provider Portal
SP Portal
Phone
Website
Application Point of Entry
45%
11%4%
15%
38%
1%
Provider
Reimbursement Support
Patient Advocacy
Website
Pharmacy
Case Manager/Social Worker
Referral Sources
Patient and Provider Satisfaction Surveys
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Objectives•Understand effect of co-pay assistance on adoption of therapy and continuity of care•Assess patient and provider satisfaction with PAN services
Key Findings in 2012
•High out-of-pocket expenses associated with medications are #1 reason why patients fail to begin or continue treatment
•Assistance from PAN helps patients comply with their medical regimen
•Assistance from PAN allows patients to pay other bills, relieves stress, and positively impacts their overall health
•Overall, patients and providers were satisfied with PAN’s services
538 Patient surveys completed; 430 Provider surveys completed
98% of patients are satisfied with PAN’s services
89% of providers are satisfied with PAN services
Q7. Using a scale from 1 to 5, where 1 is Very Unsatisfied and 5 is Very Satisfied; please rate your Satisfaction with PAN Foundation services? N=530
2012 Satisfaction Survey Findings
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Co-pay Expense: #1 Barrier to Treatment
9 Q. 1 Which factors, if any, affected your ability to begin the treatment recommended by your doctor? Q2. Which factors, if any, have affected your ability to continue (comply) with your treatment recommended by your doctor? (Check all that apply.) 2011 N=~500, 2012 N= 512
Patient Compliance Increases
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After PAN's AssistanceBefore PAN's Assistance
Q.4 Prior to receiving assistance from PAN, were you able to take your medication as prescribed by your doctor? N=504 Q.5 Now that you are receiving co-payment assistance from PAN, are you able to take your medications as prescribed by your doctor? N=520
In 2012, assistance from PAN allowed 97% of patients to comply with taking their medications vs. 39% without assistance.
HIV/AIDS FINANCIAL ASSISTANCE FUND
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Medication Information
Application
SP/Provider
Donor Agreement
& Donations
ReportingPatient
DONOR
Patient eligibility criteria:• Patient is insured and insurance
covers medication for which seeking assistance
• Patient's income must be below 500% of the Federal Poverty Level
• Patient must reside and receive treatment(s) in the US and its territories
• $4,000 per year, with the ability to receive another $4,000 if funding is available
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Relationship Flow:
HIV/AIDS Program Assistance
PANFoundation
Approval / Denial Letter
Application
Approval / Denial Letter
PAN: The Only Co-Pay Foundation Providing Financial Assistance to Patients with HIV/AIDS
• Since April 2014, PAN has provided financial assistance to 1,617 patients with HIV/AIDS
• Requests for PAN financial assistance from patients with HIV/AIDS has continuously increased over the last few months
256
665
696
0
100
200
300
400
500
600
700
800
April May June July August September October November December
Num
ber o
f Pati
ents
Ass
iste
d
HIV/AIDS Monthly Patient Activity 2014
2014
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Specialty Pharmacy & Provider Relationships
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PAN partners with many key specialty pharmacies, including:
and many providers…as well as patient advocacy organizations
Specialty Pharmacies are an Important Role in Point of Entry & Referrals
Majority of applications for the HIV fund are submitted electronically, via specialty pharmacies or large practices
31%
43%
26%Portals
Phone
Website 30%
5%3%
26%
34%
Provider
Reimbursement Support
Patient Advocacy
Website
Pharmacy
Case Manager/Social Worker2%
HIV Referral SourcesHIV Application Point of Entry
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APPLICATION PROCESS AND INSTANT APPROVAL
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Streamlined Channels for Accessing PAN Assistance
• Apply Online: www.PANfoundation.org
• Apply Over the Phone: 866-316-PANF (7263)
• Specialty Pharmacy/ Provider Online Portal
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Application & Claims: A Rapid Response
• PAN offers a variety of ways for patients, providers, and advocates to submit applications for financial assistance for high-cost specialty medications
Website/Portals
Staff approve patients
according to PAN eligibility
criteria
PAN pays claims to
pharmacies, physicians or
patients
By PhonePatients orAdvocates
seek assistance
Patients receive
treatment
‒ Ability to “virtually “sign the application across all points of entry
Portal Enrollments: Submission Validation Immediately Displayed in Online Portals
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• Same streamlined enrollment application, now with immediate results• Once application is submitted, pop-up will appear to show in-process
determination
Portal Enrollments: Patient Eligibility and Billing Information Instantly Shared• In under ONE minute, eligibility determination, billing information and
available balance will be populated within the Portal allowing for instant dispensing of medications
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Provider/SP Portal – “Real-Time” Patient Status
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Specific Patient Information for Provider/SP‒Allows Provider to view information on all of their enrolled patients
‒Alerts remind Provider that there is missing information that must be completed for an application review
“Real-Time” Mechanism for Tracking Claims & Account Data
Specific Patient Information for Provider/SP‒Amount allocated to patient
‒ Payments pending
‒Total payments made
‒Patient’s account balance
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Summary —PAN Offers Hope for Patients and Help for Families
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• Significant Growth: – Thousands of patients are able to comply with their medication regimen
because of financial assistance from PAN
• Disease Programs: – Improved application process
• PAN’s Instant Approval system has made our enrollment acceptance time the fastest in the industry
– Efficiencies• Patient transaction cost has been reduced by more than 40%
• Service Excellence: – Despite significant increase in demand, customer service is excellent
• Experienced and well-trained staff • Solid infrastructure in place to handle current and future growth
Korab ZukaVice President, External Relations and Patient Services
Tel: 202.347.9273Cell: 202.344.5551
E-mail: [email protected]
Facebook.com/PANfoundation Twitter.com/PAN_Foundation
http://PANfoundation.org
Contact Information
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