total specialty drug management - envolve health · (specialty carve-out) via out clause or...
TRANSCRIPT
Total Specialty Drug Management
Customized pharmacy benefit solutions to meet your needs
Envolve Pharmacy Solutions offers four levels of specialty pharmacy benefit options. Clients can choose the level that best meets their needs.
We provide specialty pharmacy services through AcariaHealth, an Envolve Solution. AcariaHealth is a national comprehensive specialty pharmacy that provides personalized service and support for patients living with complex conditions.
We offer healthcare solutions through our unique brand of specialty services, focusing on hepatitis C, oncology, multiple sclerosis, rheumatoid arthritis, hemophilia, HIV/AIDS, IVIG, infertility and cystic fibrosis.
Our commitment to helping patients manage their complex, high-cost healthcare is unmatched in the industry. It all starts with a simple premise: the patient comes first.
Patient Focused.Solutions Driven.
Overview
Consulting Services Distribution Services Specialty PBM Services Total Drug Management
30 day implementation 60 day implementation 90 day implementation 120 day implementation
Pharmacy/medical claim analysis and consulting
Medical claim rebates
Specialty pipeline impact analysis
Specialty drug distribution
Customized clinical programs
Copay assistance program
Patient-centric model and engagement tools
Data analytics and reporting
Integrated pharmacy/medical management
Specialty claims adjudication and rebate administration
Total formulary management/P&T support
Site of care optimization
Home infusion network strategies
Outcome-based clinical programs
Full PBM services
Utilization management programs
Comprehensive rebate program
Pharmacy/medical data integration and reporting
Cost-effective distribution channels
AT A GLANCE: Specialty Pharmacy Benefit Options
*Implementation times are estimates and may vary based on specific services selected Standard Implementation Time Potential for Expedited Implementation
HIGHLIGHTS
FOR CLIENTS
BENEFITS
> Pharmacy/medical claim analysis and consulting
> Medical claim rebates
> Specialty pipeline impact analysis
> Who want quick implementation of specialty solutions
> Who are locked into a PBM contract that limits specialty carve out opportunities
> Proactive consulting that would not impact existing pharmacy benefit contracts
> Insightful analytics regarding current specialty program and opportunities to manage trend
> Objective analysis on claims data, rebates, existing specialty and benefit programs
> Actionable information on potential program and benefit changes, such as formulary modifications, drug mix/trend (for lower cost drug opportunities), clinical management, site of care, prior authorization changes, off label use, etc.
> Opportunity to offset costs through medical rebates (if not implemented currently)
> Rapid implementation for faster insights, results and cost savings
Consulting Services
IMPLEMENTATION TIMELINE
30DAYS
60DAYS
90DAYS
120DAYS
> Specialty drug distribution
> Customized clinical programs
> Copay assistance program
> Patient-centric model
> Data analytics and reporting
> Plus all consulting services
> Who will use AcariaHealth distribution
> Who have an existing specialty pharmacy contract, but may have a contractual out-clause or upcoming termination/renewal
> Who may consider upgrading service in the future
> Exclusive distribution for specialty pharmacy
> Proactive consultation to manage specialty trend and reduce costs
> Insightful analytics and actionable information for benefit changes, formulary modifications, site of care changes, prior authorizations (PAs), etc.
> Quality of care and case management by nursing team
> Patient access to manufacturer copay assistance programs
> Account management for physicians (provider experience managers)
> Specialty account managers for plan sponsors
HIGHLIGHTS
FOR CLIENTS
Distribution Services
BENEFITS
IMPLEMENTATION TIMELINE
30DAYS
60DAYS
90DAYS
120DAYS
> Integrated pharmacy/medical management
> Specialty claims adjudication and rebate administration
> Total formulary management
> Site of care optimization
> Home infusion network strategies
> Plus all consulting and distribution services
> Who are able to separate specialty PBM management from current vendor (specialty carve-out) via out clause or upcoming renewal/termination
> Who seek to manage specialty spend across pharmacy and medical
> Who may consider upgrading service in the future
> Improved overall care, cost and outcomes for entire specialty pharmacy program
> Comprehensive adjudication or re-adjudication of specialty pharmacy claims
> Unified benefit design with integrated reporting
> Patient access to manufacturer copay assistance programs
> Account management and engagement for physicians
> Specialty account managers for plan sponsors
> Insightful analytics to drive cost savings opportunities
Specialty PBM Services
HIGHLIGHTS
FOR CLIENTS
BENEFITS
IMPLEMENTATION TIMELINE
30DAYS
60DAYS
90DAYS
120DAYS
> Full PBM specialty/traditional services
> Utilization management programs
> Comprehensive rebate program
> Pharmacy/medical data integration and reporting
> Cost-effective distribution channels
> Outcome-based clinical programs
> Who will implement full-service PBM, including new contract and integrated drug management (specialty and traditional) across all benefits
> Who seek the most cost-effective distribution across all channels
> Total drug management, with integrated benefits, reporting and analytics to reduce overall cost
> Highest service level to most effectively manage drug trend
> Unified benefit design with integrated reporting
> Therapy-specific care management and outcomes reporting
> Formulary options across benefits
> Custom clinical programs, clinical policy and case management
> Web-based engagement tools for patients and providers
> Comprehensive account management team, including clinical and specialty account management for clients, and account management for physicians
> Patient copay assistance program
Total Drug Management
HIGHLIGHTS
FOR CLIENTS
BENEFITS
IMPLEMENTATION TIMELINE
30DAYS
60DAYS
90DAYS
120DAYS
AcariaHealth, an Envolve Pharmacy Solution, is a national comprehensive specialty pharmacy focused on improving care and outcomes for patients living with complex conditions.
Our specialized care management services put patients first, bringing a personal touch to specialty drug management. We are committed to providing excellent care while delivering healthcare solutions that lead to the best and most cost-effective outcomes for patients.
AcariaHealth has fourteen pharmacy locations across the US. Our reach allows us to offer easy access to prescriptions and services in all time zones.
It all starts with the simple premise: the patient comes first.
Our National Footprint
AcariaHealth Location Specialized Location
Contact us today to learn more about our specialty pharmacy capabilities.
AcariaHealth.comEnvolveRx.com
800.413.7721 [email protected]
Traditional Mail Order
Compounding & Fertility
Orlando HeadquartersHemophilia
& IVIG
8427 South Park Circle | Suite 400Orlando, FL 32819
© 2017 Envolve. All rights reserved.12/17
EnvolveRx.com | AcariaHealth.com