Kelly discusses the obstacles that patients face when attempting to access, afford, and adhere to specialty therapies. She describes how CoverMyMeds improves the patient experience by blending technology with human expertise and connection.
Click here to learn about CoverMyMed’s next-generation patient support services.
Read on for Kelly’s insights.
Transforming Medication Access with the Next Generation of Patient Support Services
By Kelly Martin, Vice President of Product Management, CoverMyMeds.
Patients often follow similarly confusing paths to get, afford and stay on their medications—particularly for complex and chronic conditions.
It’s clear the industry needs more than yesterday’s patient support services. To truly break free from these well-worn ruts, a transformation is needed—one that combines a tailored human touch with the latest technological advances.
In this article, I show how a paradigm shift in patient support services can modernize the way people get, afford and stay on their medicine, as well as highlight three key components of that evolution.
WHAT’S NEEDED FOR A NEW APPROACH TO PATIENT SUPPORT SERVICES
Challenges brands face are as unique as the patients who need their therapy. This is especially true for specialty brands, and that’s why our approach to patient services is built to flex and accommodate changes patients or brands might experience—whether seasonal, like benefits reverification, or brand lifecycle maturation.
Our approach is simple: A single, digital entry point that has easy and quick access to a continuum of patient support services. A single workflow leverages pre-populated patient and provider data, while also providing transparency throughout the patient journey. This is backed by real people with niche patient journey experience to help patients and providers overcome any barriers that may arise.
This is why I joined CoverMyMeds last year. I am excited by our unique opportunity to evolve patient support in a meaningful way. By using a single entry point, we can connect providers, specialty pharmacies and payers through a suite of services. We can seamlessly match specialty brand solutions to evolving patient needs, helping create a clearer patient journey. Ultimately, patients should get their medicines more quickly and efficiently.
However, this evolution requires three key components.
COMPONENT 1: NETWORK CONNECTIONS THAT TRULY MATTER
To get prescriptions cleared for dispense as quickly as possible, we start with patient enrollment. This allows providers to initiate the workflow based on prescribed therapy and coverage. Providers can choose to fully enroll a patient or simply use self-service tools to submit a prior authorization request. Since e-services are integrated with stakeholders and vendors across the access and reimbursement landscape, enrollment becomes modular on an as-needed basis.
If a provider submits only a prior authorization request but receives a denial, our tech-enabled, automated workflow quickly steps in. A prompt is sent to the provider to fully enroll the denied patient into a sponsored patient support program to help them overcome coverage barriers. This potentially gets more patients started on the prescribed therapy that their provider chose.
We're energized by the results we're seeing—in part due to the established provider and pharmacy network we've built and the reputation we carry for resolving access challenges that arise because of prior auth.
The number of providers leveraging our e-enrollment options has steadily increased year over year. Our data shows that electronic enrollments may speed time to therapy by up to three days compared to traditional enrollment channels. (CoverMyMeds data on file, 2023)
COMPONENT 2: INTEGRATED PORTFOLIO OF WRAPAROUND SERVICES
Fully integrated solutions orchestrated through a single, digital entry point offer providers and specialty pharmacies an efficient, consistent experience and brand partners a streamlined workflow with increased transparency.
Patient and provider experiences are improved with access to wraparound services like patient assistance program (PAP) support, non-commercial pharmacy dispensing, field-based reimbursement services, provider nurse education and clinical and behavioral patient-facing services. For our pharma customers, this integration means streamlined workflows and increased transparency into how programs work together, including longitudinal patient journey data.
COMPONENT 3: HUMAN EXPERIENCE & EXPERTISE
In some situations, a patient’s journey is so complex that technology automation isn’t sufficient. Therefore, we rely on an expert team to support the patient post-enrollment and connect them to the solutions that best fit their needs.
These solutions include identifying copay options, PAP opportunities offering free medications or ongoing clinical adherence support. Our team has more than 20 years of hub experience supporting more than 100 brands, including more than 30 oncology brands and therapies that cut across benefit types. Our team’s breadth and depth of experience can support nearly any medication access and affordability challenge a specialty patient may face.
Teams working behind the scenes to build patient support programs will also have working knowledge of care teams’ challenges, too. Our solution-engineering teams are composed of reimbursement specialists, pharmacists, site-of-care experts and benefit-type experts who understand how to build programs that help create a more seamless patient journey.
THE FUTURE OF PATIENT SUPPORT SERVICES
More than a decade ago, together with our network, CoverMyMeds shifted the traditionally manual, time-consuming prior auth process reliant on phones and faxes to a modern, electronic version that is now used by more than 750,000 providers.
Today, we’re prepared for another transformation, this time with patient support services, and we’re just getting started.
Discover how CoverMyMeds is transforming patient support services.
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