Excellence in Pharmacy Services... It s Yours with MAXOR

Transcription

1 Excellence in Pharmacy Services... It s Yours with MAXOR

2 Uniquely Qualified Consulting & Management Services Maxor is uniquely qualified to provide the information systems, purchasing, operational and financial leadership to take your ambulatory pharmacy services to the next level. The cornerstone of our pharmacy management services is great business sense and a willingness to explore and develop new business opportunities for you. This entrepreneurial approach to the business of pharmacy enables us to drastically improve the quality, efficiency and cost-effectiveness of your pharmacy services. Reasons to incorporate an on-site pharmacy into your benefits programs: Completely transparent pass-through pharmacy program Drug acquisition cost savings Cost-effective drug utilization Formulary compliance

3 Maxor provides pharmacy management, staffing, leadership, information systems and purchasing knowledge to a multitude of healthcare providers, with expertise across all facets of pharmacy practice. Our expertise in 340B purchasing, workflow and pharmacy design will enable you to improve the quality and efficiency of medication delivery. We are confident that with Maxor as a partner, you will achieve an unparalleled level of patient care, cost effectiveness and profitability in ambulatory pharmacy operations. We will work collaboratively with you to evaluate existing systems and policies, make recommendations for improvement, and then implement effective changes. Our strategy for providing significant savings to clients includes: Increase capture of existing commercial lines of business Develop a specialty pharmacy program Decrease medication costs through cost-effective medication use processes Improve efficiency and reduce overhead costs

4 Accessible & Dedicated Corporate Support Information Technology and Supply Maxor will provide ongoing 24-hour corporate support through our Information Technology and Supply personnel. Maxor s IT and Supply personnel will interface with the pharmacies on a daily basis, by both telephone and . Our robust Information Technology department with systems administrators and supply analysts, software developers and project managers, provides second level support to the Maxor Help Desk. Maxor s Supply Department will purchase all drugs for you through our proprietary procurement system to ensure that your purchases are the most cost-effective medications and that inventory is tightly controlled. Our process of auditing, reconciling and searching for the best possible prices will enable you to save significant dollars in drug purchases.

5 Accounting, Human Resources and Contracting Departments We will designate a Division Controller within our Accounting Department to serve as the primary contact for your accounting issues. Our Human Resources Department will handle all recruitment, hiring and training for pharmacy personnel. Our Contracting Division will coordinate all third party contracting, credentialing and accreditation. Pharmacy personnel can be Maxor employees or employed by you. Our managers give the employees the training, knowledge and motivation they need to succeed in their positions. We begin with thorough Policies and Procedures as a foundation for all training. We develop computer-based training programs, educational readings, competencies and one-on-one and group training to improve the knowledge and performance of employees.

6 Detailed & Accurate Inventory Control Members of Maxor corporate management use a combination of communication, site visits and reporting tools to ensure adequate inventory control. Our managers communicate with the Director of Pharmacy and pharmacy managers on a frequent basis to assure proper inventory control policies and procedures. These policies and procedures are observed and verified during routine site visits. The following audit reports are conducted on a quarterly basis by our Supply and Analyst Departments: Daily Order Summary and Detailed Purchases Purchases versus Dispenses Mispriced Inventory Turns Inventory Inventory Posting Inventory Adjustment Unsold Timely and accurate reporting is a key component for you to evaluate and participate in the management of your pharmacy system.

7 The inventory control reports help serve as a metric of success for our procurement and inventory control systems, and are also available through Maxor s enterprise reporting system. As such, these reports can be requested on an ad hoc basis via the Internet or scheduled to daily to pharmacy managers, accounting staff and Maxor corporate management. Through the enterprise reporting requestor, users can specify any number of report parameters and query data for a specific date, store, controlled substance class, NDC, dollar amount, individual user, etc. These reports facilitate compliance with State Board of Pharmacy law, Federal DEA regulations and 340B regulations.

8 340B Pharmacy Management Maxor has a decade of experience in implementing 340B pharmacies and pricing programs. From procurement to 340B price monitoring, and every step in-between, we have a proven track record of success when it comes to ensuring that your programs are set up and managed according to all applicable laws and regulations. Maxor has the unique capability to electronically monitor and retrospectively audit wholesaler accounts to ensure that an organization is receiving accurate 340B contract pricing. A recognized expert in the field of 340B price monitoring, we also have the ability to identify easily overlooked errors, such as incorrectly loaded pricing at the wholesaler level and eligibility conflicts from the manufacturer. Any monies collected or credited as a result of these audits would be credited to your wholesaler account. Maxor has a long track record of success to passing regulatory inspections conducted by JCAHO, the State Board of Pharmacy, AHCA and the Department of Defense. As part of Maxor s pharmacy benefits, retail pharmacy and mail order pharmacy services contract with the Department of Defense, extremely in-depth records are required, as well as audits and site visits conducted at all Maxor pharmacy locations to ensure compliance with DoD regulations.

9 Benefits of Maxor s 340B Pharmacy Management Assistance in setting up terms of patient definition Evaluate the use of contract pharmacies or hospital pharmacies, as well as the option of obtaining a retail pharmacy license Overall evaluation of contract pricing Updated, auditable records Compliance with all laws and regulations - Having managed 340B programs since 2002, we have extensive knowledge of the stringent record keeping requirements. Ship to/bill to procedures Reduced cost of pharmaceuticals Expanded pharmacy services for patients Review the eligible 340B Covered Entities in terms of potential savings from the 340B program All savings will be passed on to the patient and/or health system The best opportunity for revenue and savings is to operate an outpatient pharmacy which is owned by the Covered Entity. Not only would this pharmacy be able to fill eligible prescriptions for employees and other health plan members using 340B priced product, but it would also be able to fill for patients and accept payments from other third party payers. Third Party Contracting Maxor employs an in-house Contracting Department responsible for PBM contracting. The Contracting Department has been able to secure contracts with more than 99% of the PBMs in the marketplace. Significant success and expertise has been made providing specialty medications to Medicare Part D recipients. We also provide specialty medications to those PBMs who do not restrict specialty drugs to their in-house pharmacies. Reimbursement of specialty drugs is much different from typical pharmacy claims. PBM contracting does not cover all payors. Many plans, including Medicare, require certain specialty medications to be billed as a medical claim. Our Contracting Department has relationships with medical payors and can contract for your pharmacies to have access to these plans. The Contracting Department also has relationships with charity foundations, manufacturers and indigent programs to obtain additional assistance for specialty medications.

10 Completely Integrated Pharmacy Management & PBM Services Maxor is strongly committed to efficiently managing on-site pharmacies. We believe that on-site pharmacy programs as part of a health benefit plan only work effectively when coupled with a transparent Pharmacy Benefit Management (PBM) program and the appropriate clinical pharmacy services. Maxor offers its PBM services to you in conjunction with the management of an on-site pharmacy. There are four major benefits of incorporating an on-site pharmacy into your pharmacy benefit programs: A completely transparent pass-through pharmacy program Drug acquisition cost savings Cost effective drug utilization Formulary compliance

11 Maxor s model of integrating the on-site pharmacy, PBM services and clinical pharmacy component provides a comprehensive pharmacy program with total transparency to you. Under our Complete Disclosure Pricing program, you receive 100% of discounts and rebates from drug manufacturers on all prescriptions filled in the retail network and in-house pharmacy, net acquisition cost pricing on all drugs sold in the in-house pharmacy, and pass-through pricing on all drugs purchased in the retail network. There are no undefined spreads or margins, no hidden sources of revenue, no undisclosed rebates or discounts and no hidden fees for additional services paid to Maxor. Employees may pick up prescriptions at the in-house pharmacy, or have it conveniently delivered to their homes or via inter-company mail. The on-site pharmacy program will allow you to purchase drugs on a net acquisition cost basis, thereby eliminating the profit margin that privately owned pharmacies are currently making on the health plan. Additionally, Maxor s proprietary purchasing system automatically checks to be certain you are receiving the correct contract pricing on every purchase. Another major area of savings occurs from the development of pharmacydriven drug utilization review and intervention programs. Maxor s experienced clinical pharmacy team continually monitors member utilization, and then implements cost saving initiatives to address major cost reduction opportunities. When a plan s in-house pharmacy and PBM work in conjunction, programs such as pill splitting, generic substitution and brand substitutions to achieve formulary compliance are much more successful, and these programs can achieve huge savings for the health plan. For example, in a tightly controlled environment with an integrated in-house pharmacy and PBM, Maxor has been able to achieve as much as a 90% in-house pharmacy capture rate.

12 We welcome the opportunity to discuss benefits in more detail and to work with you in the development of a comprehensive, cost-driven pharmacy program. Since 1926, we have a proven track record in all aspects of pharmacy services and are eager to apply our pharmacy experience to assure a successful outcome for you. 320 S. Polk Street, Suite 100 Amarillo, Texas (806) (800) Fax: (806)