Payer Update, February 2020

Payer Update

By Jeff Blake

It has been an exciting start to 2020 for the Payer Team and we are very excited and energized for the remainder of 2020.

We are in the process of finalizing our third Hemophilia Alliance Network Services (HANS) Payer Contract with a mid-sized Pharmacy Benefit Manager (PBM) that wants to have a bleeding disorders solution to offer their clients that include HTCs and their pharmacy programs. Currently, this PBM excludes HTC pharmacy programs from their network and now they understand the value of the integrated medical and pharmacy model of care that our member HTCs bring to payers.

We continue to increase the number of member HTCs that have signed the HANS PPO Participation Agreement. We now have more than twenty (20) signed agreements and we are working with several additional members to finalize agreements. We still have a lot of work to do. We need at least 80% of our members to participate to have a strong national network offering to payers. As more members agree to participate in the HANS PPO Network, we are more aggressively contacting payers to contract with HANS to solve HTC payer issues. If you haven’t heard from us or haven’t provided a status update to your Hemophilia Alliance team member, please respond so that we may continue our efforts to bring your HTC more pharmacy business.

We have expanded the number of payers we work with. Recently, Mark Plencner and Jeff Blake presented HANS and the HTC model of care to forty (40) benefits and pharmacy consultants from Lockton and Excelsior Solutions. Lockton and Excelsior Solutions are national consulting firms working with health plans, self-insured employers and Medicaid Agencies. Establishing this new relationship has already led to three potential opportunities for HTCs. We have also developed a new relationship with Rx Benefits, another pharmacy benefit consultant, and we recently received a potential opportunity that includes more than 20 of our member HTCs.

We continue to work with the payers that we have established strong relationships. We have over fifty (50) potential opportunities with for our member HTCs and we are pursuing additional opportunities with these payers.

We will keep you updated on our efforts and look forward to working with you on solving your payer issues to grow your pharmacy programs. If you have any questions or would like to discuss in more detail, please contact a member of the Hemophilia Alliance Team.

Also in this Issue…

Notes from Joe
· How Did We Get Here and Where Are We Going?

Alliance Update
· The More the Merrier: HTCs and Patients Wanted For Hill Day
· May Meeting for NEW HTC Staff
· Join us for an Informative Meeting at HTRS/THSNA in April
· 2020 Meeting Schedule

Washington Update
· Governmental Food Fight: GAO and CMS Sling 340B Related Publications Back-and-Forth?

Notes from the Community
· University of Michigan Launches Infusion U Program