ProxsysRx’s 340B Team has generated more than $500 million in savings for the hospitals and health systems we serve. And yet, if there is one thing that every member on our team can agree-on, it’s this: There is no such thing as a 340B Expert; for the simple reason that, given the ever-expanding scope and severity of manufacturer restrictions, 340B is a constantly-moving target.
“I’ve lost count of how many times this has happened,” says ProxsysRx 340B Optimization Manager Chance Spivey: “I come into work and find an email in my Inbox that changes all of the data analytics I’d been using to submit a sizable percentage of my clients’ prescriptions for 340B discounts.”
The fundamental problem with 340B healthcare data
Healthcare data, in general, tends to be extremely siloed. The over-arching goal of ProxsysRx’s 340B Analytics platform, from Day One, has been to safely and securely take hospital data from all the locations it currently resides, and assemble it all in a meaningful way that enables our 340B team — and the 340B program-managers in the health systems we serve — to quickly and easily make good decisions.
Documenting a 340B prescription’s journey
ProxsysRx’s 340B Analytics enables us to document the entire journey of every prescription written within a 340B health system. Tracking and following each prescription through that journey enables our team members to constantly improve their understanding of a hospital 340B program’s Big Picture. And with 340B Analytics’ reporting capabilities, they can help health systems take steps to close the gaps in their 340B programs.
Helping hospitals close 340B gaps
“Here’s a typical gap-scenario that we often see in hospitals’ 340B programs,” notes ProxsysRx’s 340B Analytics project manager Clay Cooper: “We identify clinics within a health system that have potential to generate 340B income, but they're not taking advantage of the opportunities. At the same time, we can quickly produce data demonstrating unmet 340B-savings potential — and supplement that data with insights we can take to hospitals in explaining where they can make changes to become more effective in generating 340B savings.
Analyzing hospitals’ prescription histories for 340B savings opportunities
When we begin supporting a health system’s 340B program, we look at its 340B history — and identify 340B savings opportunities — as far back two years. We can see the hospital’s entire quantifiable 340B market, and every 340B prescription that’s worth claiming for savings, over that time-period.
Reporting 340B prescriptions by drug. And by provider.
We can drill-down our analytics and reporting for every 340B-eligible prescription. We can also see which physicians and contract pharmacies are qualifying eligible prescriptions for 340B reimbursement, and which are not.
Helping providers better serve 340B patients.
Let’s remember that the 340B program was created to help eligible non-profit health systems fill-in the often-significant revenue gaps inherent to their business models. For many of the health systems we serve, 340B revenue is nothing short of a lifeline — enabling them to serve their communities’ neediest patients; patients who generally lack the financial resources to pay for the care they need.
Automation’s ultimate advantage: Better 340B program decisions faster.
The primary advantage of automating so many of the team’s processes comes in reacting to external changes to the ways 340B prescription claims are made; which happens almost daily. “Before we automated so many of our processes,” Clay explains, “when external changes were made, our team had to manually research how to deal with them. Now that we’ve logged, into our database, all the historical 340B program changes we’ve adapted-to over the years, when new changes are made, we don't have to start-over from scratch.”
Ensuring 340B program compliance at all times
How do we keep clients compliant? Again, by knowing every prescription drug that’s 340B eligible — and by maintaining a constantly-updated database that keeps us, and the 340B hospitals we serve, compliant.
Providing instant access to NDC numbers
The 340B program runs off of NDC (National Drug Code) numbers. Since very few hospitals have the in-house manpower to dig into their systems and determine NDC numbers (separate and apart from the drugs’ names), our data department has assigned NDC numbers to all the drugs by name.
Positively impacting 340B charity support. And hospitals’ self-insured plans.
ProxsysRx’s Analytics database can be used to help financially-struggling patients with prescription-payment assistance programs. We can also positively impact the self-insured plans of health systems we serve, by reporting which drugs are most costly to them, and which of those drugs are 340B eligible. When we help hospitals lower their costs, they can pass-along those savings to employees in the form of lower co-pays. The opportunities are endless.
Advantage ProxsysRx: Our 340B Analytics’ Project Manager
Before making a career pivot into data analytics, Clay Cooper was a licensed pharmacist for 10 years. “I understand the nuts and bolts of pharmacy, and where 340B fits within the spectrum of healthcare, clinical, prescriptions, refills and disease states. I also understand our platform’s technical nuts and bolts. Which means that when someone from the 340B team has a new-feature request, they don't have to waste a lot of time explaining it to me.
“That said, the user experience in our platform is absolutely critical,” Clay concludes. “At some point, anyone who’s ever used technology has been forced to accept product updates that ultimately made a familiar app harder to use — and that’s something we never want to do with our 340B platform.”
ProxsysRx is here to help, if you have questions.
There are so many ways to optimize 340B drug programs’ savings and benefits, while minimizing the likelihood of noncompliance — using the optimal combination of 340B software solutions and experienced, expert support. For more information, contact Howard Hall. C: 214.808.2700 | howard.hall@proxsysrx.com
Recommended For Further Reading:
Specialized Software Can Only Do So Much For 340B Programs
ProxsysRx offers hospital systems proven solutions for optimizing pharmacy services’ positive impact on the continuum of care; solutions ranging from management of their 340B prescription-savings programs, Retail and Specialty Pharmacy operations, to Prescription Benefits program management, and patient financial assistance.
