Health System Sees 271% Increase in Recovery Over Three Years

By O'Mally Monahan

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Case Study: Health system sees 271% increase in recovery over three years

Background

University of Missouri Health Care (MUHC) has five hospitals located throughout Missouri. Specialty care is an important part of its mission, and MUHC has 57 primary and specialty clinics. Physicians care for complex and serious conditions, offering services not available elsewhere in the region. Additionally, it has nine ambulatory pharmacies and fills 340,000 prescriptions annually.

The Challenge

Giving patients access to the latest treatments often involves the use of very expensive specialized medications that are beyond the reach of most people — especially the uninsured and underinsured. That’s why patient assistance programs (PAPs) are invaluable to both the hospitals and patients at MUHC. Managing these programs, however, is a time-consuming task that requires knowledge and experience of the regulations and enrollment process. MUHC brought in McKesson to shore up its PAP, anticipating that it could take over the program after a year.

The Solution

McKesson RxO® PAP Recovery Solutions took charge of MUHC’s PAP program, partnering with the hospital system to identify patients eligible for PAP. Once patients were verified, McKesson enrolled them, handled the medication recovery process and documented compliance to avoid billing patients for covered medication. Thanks to careful coordination of differing patient insurance and co-pay requirements, McKesson assures equal access to medication for all MUHC patients, for high-quality care at minimum out-of-pocket expense.

The Results

• $1.8 million PAP recovery in 2018 alone
• Virtually eliminated billing of PAP patients for covered medication
• 271% increase in recovery over three years

Learn more about our Patient Assistance Program (PAP) & Revenue Recovery Management tools.