Pharmaceutical manufacturer hub programs have, for many years, played a vital role in getting patients access to life-saving and life-altering medications. There is no question the value of these programs remains high, but there are emerging market dynamics that will require hub programs to evolve to continue meeting the needs of patients and healthcare providers.
Drug price transparency is one of the hottest topics in the healthcare industry. In November 2018, CMS proposed a new rule focused on modernizing Part D and Medicare Advantage in order to lower drug prices and patient out-of-pocket expenses. One aspect of the proposed rule mandates that all Part D plan sponsors provide electronic real-time benefit tools (RTBTs) at the point of prescribing. Additionally, Congress also passed the H.R. 6 – Support for Patients and Communities Act, which included a provision (Sec. 6062) requiring electronic prescription programs to be able to securely transmit prior authorization requests for covered drugs under Medicare.
Interoperability between hub technology platforms and electronic prescribing/ medical record systems will be necessary to meet these new regulatory and legislative requirements. Patients and healthcare providers are also starting to expect hub programs to support electronic benefit verifications (eBVs) and electronic prior authorizations (ePAs) at the point of care. TrialCard’s QuickPath™ patient management platform is built on a services architecture which enables real-time integration with third-party technology platforms via application programming interfaces (APIs). This open and agnostic approach to technology integration not only allows for greater transparency at the point of care but also faster speed to therapy for newly diagnosed patients.
Value-based care models are finally beginning to gain some traction in the marketplace as evidenced by numerous CMS and commercial payer initiatives. In October 2018, the Health Care Payment Learning and Action Network, part of the U.S. Department of Health and Human Services, published a report revealing that value-based care reimbursement represented 34% of payments in 2017, up 23% from 2015. As the industry shifts from a world of fee-for-service to pay-for-performance, pharmaceutical manufacturer hub programs are well positioned to conduct patient interventions, support transitions of care, and capture the essential outcomes data required to support these models. TrialCard’s TC Catalyst™ reporting and analytics platform has been designed to not only capture hub and co-pay assistance program data, but also to incorporate other real-world data sources such as pharmacy dispenses, payer/PBM claims data, and patient-reported outcomes. Pharmaceutical manufacturers that can demonstrate an ability to leverage hub services and data to advance value-based care models will be viewed favorably by both healthcare providers and payers.
Like all aspects of society, consumerism is on the rise in healthcare. Patients are demanding multiple self-service channels (i.e. web portals, mobile apps, text) for connecting with care and more personalized experiences with the services they are utilizing. In fact, in McKinsey’s Healthcare Consumerism 2018: An Update on the Journey, approximately 70% of consumers prefer digital healthcare solutions versus phone/in-person solutions. Hub programs are one of the best tools pharmaceutical manufacturers have for engaging with patients. TrialCard’s EngagePath™ product leverages evidence-based tools and digital technology to meet patients where they are in their healthcare journey. EngagePath™ utilizes clinically validated assessments to stratify patients into distinct risk cohorts that drive more personalized interventions. In a world where patients are used to interacting with Amazon, Apple, and Google, it will be incumbent upon pharmaceutical manufacturer hub programs to adopt a more tech forward, consumer-friendly approach to delivering services.
At TrialCard, we are experts on the changing healthcare landscape and are committed to partnering with our hub clients to evolve their programs to meet the marketplace demands.
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