Case Study - The Road Map to Accreditation [VIDEO]

THE ROAD MAP TO ACCREDITATION

Valisure Achieves Success With Innovatix

INTRODUCTION

When patients pick up their prescription, they place their trust in the pharmacy that their medications are high-quality. But, unfortunately, bad batches and counterfeits still occur.  

Adam Clark-Joseph suffered serious complications caused by batch variability, which is why he pursued changing the industry. In 2017, Clark-Joseph partnered with David Light to establish Valisure, the first digital pharmacy to dispense chemically validated medications directly to consumers, ensuring medications met quality and consistency standards.

Modeled after food labels that contain nutritional information, every prescription Valisure ships comes with a certificate of analysis listing important chemical properties analyzed at Valisure’s lab. They achieve this gold standard with cutting-edge technology that only dispenses medications that pass a rigorous screening process.

INTENDED OUTCOME

Valisure’s chief pharmacist, Deanna Akinbajo, PharmD, RPH, MPH, believed their growing company with a unique value proposition as a mail service pharmacy and analytical lab would benefit from a URAC Mail Service Pharmacy Accreditation. This achievement could increase higher payer reimbursements, demonstrate strict adherence to quality processes, and offer consumers even more evidence of patient safety. From the outset, Akinbajo's primary intent for these initiatives was to make Valisure even more patient-centric.

“Valisure was unique from the start. Our corporate headquarters houses a pharmacy, mail-order prescriptions, and quality-testing lab,” Akinbajo stated. “We experienced early success with our offering. And the growth plan included expanding licensing beyond the existing 38 states and showing high standards to patients and payers by acquiring URAC accreditation.”

Akinbajo told her team that they had to achieve a no deficiencies report if they were going for accreditation. Her mission of excellence went even further. She wanted to earn that seal within a tight time frame.

THE CHALLENGE

Accreditation is not a small initiative, it is rigorous, complex, and time-intensive. The growth-stage independent company already had staff wearing multiple hats when Akinbajo received approval to pursue accreditation. Valisure was also in the midst of major initiatives such as hastening the workflow of transferring prescriptions to mail order and increasing Valisure’s presence with PBMs and insurance networks.

It quickly became apparent to Akinbajo and staff that accreditation was becoming a heavy lift on everyone’s shoulders. Valisure also entered the accreditation realm as COVID-19 arrived in the U.S., making Valisure an essential business where continuity for their patients mattered more than ever.

“If Valisure was to meet its goal, we couldn’t just hope that everything would work out. We had to be all in at 100 percent to achieve 100 percent,” said Akinbajo.

The challenge for Valisure involved knowing when to seek outside counsel. For Akinbajo, it meant engaging an accreditation firm now to keep all initiatives moving forward.

“Hiring a firm was a big deal and a big ask of the founders. I appreciated their trust in my decision that this was the route to take,” said Akinbajo.

The next challenge for Valisure was finding the right firm.

THE DECISION TO GO WITH INNOVATIX

The interviews to find the consulting firm that excelled in URAC accreditation started with Akinbajo asking her peers in the pharmacy industry, specifically those in mail order.

“One name kept coming up, and that was Innovatix. Their strong reputation in the industry, and that of their parent company, Premier, Inc., proceeded them,” said Akinbajo. “My cold call to them ended up being the best call I could make for our pharmacy. From the minute they put me in contact with Jennifer Valentine, I felt reassured Valisure could attain our no deficiencies goal.”

The team at Valisure conducted additional due diligence and assessed other firms, but they kept coming back to Innovatix. The decision proved right at every stage because they exceeded expectations on each criterion. The essential requirements include:

1) Put Patient Care First: The number one priority for Valisure was that the patient came first. When searching for a firm, Akinbajo needed to hear how Innovatix would conduct its program with existing operations and patient care initiatives. Leaders of the Innovatix Accreditation Advisory Services team presented a plan based on Valisure’s imperatives and resources and detailed how each step would work with each department given existing workloads.

Innovatix’s initial spot-on review of Valisure’s differentiating operations and analytical lab for patient safety immediately instilled trust and confidence that only grew throughout the engagement.

2) Want Budget-Friendly Pricing: Pricing was a primary reason Valisure went with Innovatix.

There also couldn’t be any cost surprises down the road. Innovatix was true to their word and met Valisure’s budget and tight time frame. The budget-friendly price also came with Innovatix’s A team, who delivered at every milestone.

“We gave them our expectation, and Innovatix achieved it. They also put forth accreditation daily and monthly goals and made sure we met them. Innovatix was invested in our success. And it wasn’t an overlord situation but rather like working with long-time friends who wanted the best for you.”

3) Make the Process Easy and Flexible: Accreditation is known for its intensity and difficulty. Valisure requested options in terms of capabilities. Innovatix delivered department-specific project plans that Akinbajo viewed as attainable.

The team came to Connecticut and demonstrated its turnkey, pivot-on-a-dime abilities.  

This flexibility would prove invaluable as shortly after their meeting, COVID-19 started shutting down the country. Beyond the immediate affinity between the two organizations, they both understood that a whole new level of difficulty would occur with conducting services remotely.

“Innovatix customized a solution for Valisure. They put creativity into a dry and daunting process,” said Akinbajo. “The team put us at ease from the very first zoom and always made themselves available to us. They even created a color-coded spreadsheet of  everything I needed to submit. We followed the colors and met  the time frames. It was the definition of concierge service.”

4) Provide the Gold Standard: From start to finish, the team at Innovatix went above and beyond to ensure Valisure met the stringent requirements of URAC. They aligned standards and processes against accreditation measures. The tools that proved vital entailed the performance programs, reporting metrics, and risk mitigation strategies.

“Even remotely, Innovatix’s hands-on and helpful approach imparted confidence that the copious amounts of documentation met the necessary benchmarks,” said Akinbajo.

5) Ensure Readiness: Throughout the preparedness time frame, Valisure and Innovatix completed vast amounts of work remotely. The Innovatix team kept Valisure on track with monitoring the required staff, resources, and expertise required by payers and manufacturers.

“Prescriptions require precision, and our URAC documentation and submittals needed the same exactness,” said Akinbajo. “Innovatix had everything prepared, in order, and organized. Valentine and the team would put forth the policies to review and address. We completed the policies and went into the simulated review fully prepared for a successful accreditation survey."

THE RESULTS

“We achieved an accreditation result of no deficiencies. Nothing detracted from our top rating, not a pandemic or expansion plans,” said Akinbajo. “Valisure could not have achieved all we did in 2020 without Innovatix, who was with us every step of the way.”

Beyond accreditation efforts, the partnership with Innovatix produced a tighter organizational alignment and enhanced patient care.

The process started in December 2019 and coincided with the first news of COVID-19, when access to medications took on a whole new meaning for everyone. However, despite a pandemic, in November 2020, Valisure earned the symbol of excellence from URAC, representing a commitment to quality and patient safety. Accreditation reinforces even more quality measures.

URAC accreditation now provides additive evidence to further support Valisure as a leading authority in identifying and addressing medication quality issues because of their high-precision analysis of prescriptions. In 2021, Express Scripts contracted with Valisure, accomplishing a key goal of expanding its customer base.

“Our team became so excited about the new PBM contract because it allowed us to promote the news, resulting in new inquiries. One of the biggest things we are now experiencing is that patients from large PBMs are seeking certified medications,” said Akinbajo. “The work with Innovatix strengthened our pharmacy’s reputation and raised our profile as an analytical lab."

THE CONCLUSION

From analyzing batches to staffing their 24-hour telephone customer service line, Valisure maintained superior service and operational excellence during a pandemic while seeking accreditation for the first time. Valisure’s ability to succeed during a tumultuous time directly correlates with hiring Innovatix and adhering to its program.

“I wouldn’t change a thing with our partnership with Innovatix and choosing them as our advisory firm,” said Akinbajo. “Without Innovatix, I don’t know if we could have done everything we did in 2020. The team alleviated so much of the URAC preparation burden. Their support allowed us to survive and thrive as an essential business and maintain our number one goal of serving our patients.”