Gentry Health Specialty Pharmacy Services and Capabilities May 2019 - - PowerPoint PPT Presentation
Together Creating a Path to Better Care Gentry Health Specialty Pharmacy Services and Capabilities May 2019 2019 Asembia Specialty Pharmacy Conference Agenda I. Company and Leadership Overview II. Strategic Approach III. Delivering
Together Creating a Path to Better Care
2019 Asembia Specialty Pharmacy Conference
May 2019
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common products
Equipment
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scale mail service fulfillment operations
▪ Operations and clinical programs built on the premise of compassionate patient service, convenience, and delivering overall satisfaction while remaining flexible to adjust to client needs and market trends. ▪ Nationally recognized for customer service ▪ Major payer recognition demonstrating the commitment of DDM and GHS to patient care and healthy outcomes
http://www.chaindrugreview.com/pharmacy-retailers-win-rx-adherence-challenge/
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▪ Operated by experienced leadership, extensive infrastructure, and the industry leading service model of Discount Drug Mart
pharmacists, 400+ pharmacy technicians
At Gentry Health Services, we are an actively involved care partner helping to create a pathway to better health for our patients. Our team
safety, and convenience in the services we provide with the goal of delivering positive clinical outcomes and 100% patient satisfaction.
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CEO
Services, bringing more than 35 years of experience in the retail/pharmacy industry. Doug oversees all corporate sales, pharmacy and home health care operations, sports marketing and sponsorships, and is a senior buyer. As CEO of Gentry Health, Doug has oversight of business development and growth.
management.
that has been awarded nationally for customer satisfaction and excellence in MTM services. Pete’s role at Gentry Health includes planning, development and execution on strategic initiatives at Gentry Health including business development.
volume mail service operations as well as PBM clinical operations in both the commercial and Medicare
PIC for licensing in all states, as well as maintaining accreditation standards with URAC, ACHC, and VIPPS and oversight of clinical therapy management programs.
Business Administration from Kent State University. 8
developing customized data acquisition and reporting solutions necessary to meet the demands of high performing pharmacy operations. Kurt’s role at Gentry Health includes information security, managing all technology platforms as well as developing customized solutions to meet the specific needs of Gentry Health’s Clients.
In her current role, she is responsible for the development, implementation, and management of all clinical programs. She also oversees the clinical team at Gentry Health Services.
The University of Toledo.
the liaison between Gentry Health Services and our clients with the goal of ensuring excellent customer service, client satisfaction and compliance with regards to our service programs. As Gentry’s client relations manager, Michele will ensure our clients are receiving appropriate support from all areas of our business as well as conduct our monthly and quarterly reviews.
▪ Chuck brings over 18 years of pharmacy and leadership experience to Gentry Health including various roles in high volume mail service operations as well as pharmacy automation, and inventory management experience. Chuck’s role at Gentry Health includes handling day to day operations including management of our certified pharmacy technicians as well as our dispensing, shipping and call center operations. He is also responsible for compliance to our accreditation standards from a service and operational performance perspective. ▪ Chuck has been a PTCB Nationally Certified Technician since 2010.
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Service Solutions that Deliver Results
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Ensuring the Patient Experience Meets or Exceeds Expectations
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Clinical Assessments and ongoing monitoring Benefits Research Medication Education Financial Assistance Individualized Service Adherence Programs
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Administration Training
Appropriate Med Use
Ongoing Support
▪ Gentry Health’s Management Program
Patient onboarding process
▪ Understand the patient’s needs including and cultural differences maximizing engagement ▪ Information and education provided to the patient to keep them engaged and empowered to take control of their care limiting their frustration and potential poor outcomes.
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Monthly refill reminder call and
assessment conducted ▪ Evaluation criteria
Changes in medical condition or
medications, medication effectiveness, adherence
▪ Clinical intervention based on responses provided
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specialty pharmacy when necessary
prior authorization and coverage determination requests
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that may need escalated to a pharmacist at every refill reminder call
authorizations as well as assistance with appeals
reducing the risk for interruption of therapy
safety & prevent lapse in therapy
▪ Point-of-contact individuals staffed by Gentry Health with the primary role of communication between specialty pharmacy and provider to get qualified patients on therapy efficiently
Communicate available specialty pharmacy services and
determine best approach to support the provider
Educate on protocol to follow for successful referrals
▪ Lab data collection ▪ Previous treatment history ▪ Utilization of Gentry Health’s Provider Portal ▪ Gentry P.A.T.H.
Develop and manage relationship
for continued success
Assist in accessing Gentry Health’s Provider Portal
▪ Provides order status and updates on pending referrals
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Proactive Advantage for Total Healthcare
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up their specialty medication at one
locations across Ohio.
to pick up their refill medication with a retail option
when a retail option is available for specialty medications
the ability to choose where they receive their medication
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Patient Focus
support
pharmacy pick-up at Discount Drug Mart pharmacy locations
phone, email, website, online chat, SMS Text
Clinical Focus
monthly or more frequent touch points
adverse events, inappropriate use
to connect with Discount Drug Mart retail pharmacies to stay abreast of acute medication fills
coordinate with Discount Drug Mart maintenance medication fills
guidelines to develop clinical management protocols
Regional same day delivery capabilities for emergency situations
Value-added Services Custom Designed to Achieve Targeted Goals
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Have there been any changes in your medical condition, allergies or medication list in the last month?
Do you know the date of your next scheduled appointment with your doctor?
Do you feel the medication is still helping you? (Effectiveness)
Have you missed any doses in the past 4 weeks?
Do you have any questions for me or our pharmacist or any concerns with the care we provide? (Determining if all needed care/services are being provided and accessible)
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New start vs. established New to Gentry vs. established patient
Initial appropriateness of therapy evaluation
▪ Medical history/comorbid conditions ▪ Relevant diagnosis ▪ Previous therapies ▪ Concomitant medications
Patient education and counseling
▪ Warnings/precautions ▪ Common side effects ▪ Serious side effects requiring physician intervention ▪ Therapy specific goals and expectations ▪ Medication storage, dosage, frequency and administration training
Baseline disease state specific assessment and scoring
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Used primarily in patients identified as
having a problem with therapy
▪ Adherence ▪ Adverse effects ▪ Lapse in therapy
Follow up on previously identified concerns
Scheduled at regular intervals
▪ Review patient-specific medical history ▪ Evaluate progress on therapy ▪ Unfavorable responses trigger prescriber intervention activity
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Recommend therapy changes Communicate safety concerns Relay adherence issues or
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Analyze Intervene Assess
Suggest adherence strategies Encourage persistent adherence Educate on side effect management strategies and
Advise prescriber follow-up when applicable
Delivering consistent excellence in services that build trusting relationships
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▪ Expedited Services and delivery via UPS ▪ Package transit updates available through UPS MY Choice (phone, e-mail, or text options) ▪ All packages fully insured by UPS Capital Insurance against loss, damage, spoilage, late delivery ▪ All temperature sensitive products are shipped with package monitors to ensure product viability ▪ ISTA 7E Certification on temperature sensitive packing techniques assuring adequate refrigeration temperatures are maintained for at least 36 hours of transit time.
Shipping with Confidence
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State of the art 20,000 square foot dedicated facility.
Dual-compressor refrigeration units Wirelessly monitored and remote controlled with
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▪ Call Center
9 second Average Speed to Answer
0.00% Abandonment Rate
97.4% of calls answered within 20 seconds ▪ Overall PDC = 96.95% ▪ Fulfillment of Promise to Deliver Date = 99.996% ▪ Dispensing Accuracy = 99.999% ▪ Overall Customer Satisfaction – 99.74% rated “Satisfied” or “Very Satisfied” ▪ Average $275 in Patient out-of-pocket savings per claim ▪ Turnaround time for Prescriptions as defined by URAC:
Clean Prescription: Prescriptions for which the pharmacy received all necessary information to fill the prescription upon receipt – 2.15 business days
Prescriptions requiring intervention: Prescriptions for which the pharmacy needed to
clinician) before filling the prescription – 6.95 business days
▪ NOTE: This includes time required to contact patient and wait for response, secure payment, schedule delivery, and medication fulfillment.
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Certification Board (PTCB)
experience
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focused on service, quality and clinical
consistency of the patient experience
Assessment
competency assessments
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Gentry Health Distribution Support
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▪ Business Development
PCO-Pharmacy Contracting Office
▪ Fair Market Value fee for service programs for enhanced services ▪ Legal resources available
▪ Implementation Team
Business Analyst for Reporting
Clinical Liaison
▪ Account Management Team ▪ Hub Liaison ▪ IT customization ▪ Quality Assurance programs and processes ▪ Audit compliance ▪ Experience
HUB interactions
LDD
3PL
REMS products
Customized Reporting
Launching new products & programs
Starter-kit coordination
Provider Liaison/Marketing Team
▪ Clinical and education programs
Customizable based on program goals
Targeted data collection
▪ URAC, ACHC, VIPPS and .pharmacy Accreditation with licensing in all 50 states
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Data Setup Data Reporting
Specific data collection Targeted question sets Contact frequency / adherence
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programs and reporting to meet the needs of the client
stats and information
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Gentry Health Services understands the journey that patients face with complex disease states. We will proudly partner to
customized and qualified resources, focused treatment and care, along with educational support to your
team of professionals is committed to improving the clinical
patients with the most complex
disease states. Together, we can CREATE A PATH TO BETTER CARE.
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Exceptional Service
Excellence in Care
Reliability
Exceptional Service
Ongoing Support
Communication
Collaboration
Patient Services
▪ Take care of the Patient!
Helping the patient afford their medication – automatically search for financial assistance including manufacturer copay cards, funds, charity organizations
Education – through clinical assessments initially and ongoing on quarterly or more frequent basis
Keeping patients on track – adherence refill reminder calls, proactive renewal or prior authorizations
Interventions – when necessary to ensure safety, adherence, and treatment effectiveness
Communication – constant proactive communication with patient and prescriber providing order status ▪ Service and Quality Statistics – The Patient is our #1 Priority!
99.74% of all respondents are at least satisfied or extremely satisfied with their overall experience at Gentry Health Services
Answering our patient and prescriber calls are important to us ▪ Telephony Statistics
9 second Average Speed to Answer (ASA)
0.00% call abandonment rate
97.4% of all inbound calls answered within 20 seconds
Focus on quality - dispensing accuracy at 99.999%
Making sure our patients understand the importance of staying on treatment ▪ Overall PDC is 96.95%
Delivering on our promise - 99.996% of all packages are delivered when promised
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▪ Account Management – Your partnership is important to Gentry Health Services ▪ Single point of contact - dedicated assigned account representative with operational authority
Prompt response and resolution
Work-in-process status reports
Quarterly Performance Reviews
▪ Customized Solutions ▪ Flexibility in operations to develop unique programs
Data Collection
Clinical Programs
Patient Support Initiatives
Reporting in any format required
▪ Capabilities ▪ Contracting, Licensing and Accreditation
Accreditations - Quality and excellence in
▪ URAC, ACHC, and VIPPS
Licensing
▪ Pharmacy licensing in all state jurisdiction
▪ Payor Contracts Covering 3MM lives in the state of Ohio
Medical Mutual of Ohio & AultCare
BCBS IL, ND & MS via Prime Therapeutics
MetroHealth Hospital Systems
Network of 75 retail pharmacies for convenient home delivery or patient pick-up options
▪ Pharmacy Wrap Program available to funnel appropriate prescriptions to Gentry for enhanced service ▪ Allows for a complete view of patient history for comprehensive care
▪ Experience with contractual reporting to Pharma ▪ Work with HUBs and other SPs to forward non-network patients ensuring continuity of care ▪ Regional same-day delivery available for emergency situations ▪ Disaster Recovery
Contingencies in place for operational redundancies
▪ Two Diesel-powered generators capable of supporting 100% of systems and operations ▪ Back-up facility ▪ Back-up refrigeration and freezers ▪ Fully redundant data management system ▪ Cross-trained staff from corporate offices for continuity of staff and rapid growth ▪ Multiple licensed pharmacists on staff for non-resident pharmacy licensing needs
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▪ Customized evidence based clinical programs with a comprehensive approach to assessments and reassessments
Motivational Interviewing Practices
Morisky Medication Adherence Scaling
Utilization Management Review
Patient Education and Counseling
Lab Data Capture
Medical History Review
Quality of Life Screen
Medication and Administration Guide
Persistency Data Collect
Clinical interventions when appropriate
Schedule Follow-up Assessment ▪ Customizable Clinical Pathways and Data Collection
Software is configurable to deliver on targeted client initiatives Customized comprehensive Clinical Management Programs for the following disease states:
Ankylosing Spondylitis
Crohn’s Disease
Cystic Fibrosis
Growth Hormone Deficiency
Hemophilia
Hepatitis
HIV
Hyperlipidemia
Juvenile Idiopathic Arthritis
Multiple Sclerosis
Oral Oncology
Psoriasis/Psoriatic Arthritis
Rheumatoid Arthritis
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Nimesh C. Patel R.Ph., MBA Director of Specialty Pharmacy Gentry Health Services, Inc. 33381 Walker Road, Suite A Avon Lake, Ohio 44012 Nimesh.Patel@GentryHealthServices.com Direct: 330-721-1077 Fax: 330-470-9633
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www.GentryHealthServices.com