Becker's Hospital Review

17 EXECUTIVE BRIEFING EXECUTIVE BRIEFING 2 rightfully focused on patient access, they miss opportunities to leverage a service like specialty pharmacy that could be one of their highest revenue producers and drivers of patient loyalty." Clearway Health reduces clinician burden + improves patient access to specialty drugs Specialty medications commonly require prior authorization from payers. From an administrative standpoint, approval cycles can be intensive and take hours, days or even weeks. "The industry average for prior authorization for specialty medication therapies is up to 17 days," Arant said. "It's no surprise that clinical care teams spend valuable time chasing insurance companies for approval. At the same time, patients must go weeks without lifesaving or life-changing medications." In fact, in a survey of 1,000 patients, 55% of patients reported a delay in receiving their specialty medications because of prior authorization turnaround time. Clearway Health embeds dedicated pharmacists, clinical pharmacists and specialty pharmacy patient liaisons into their clients' specialty clinics and pharmacies. They work alongside providers and care team members to ensure better care coordination. Onsite, Clearway Health team members are supported by experts who lead access and advocacy efforts on behalf of organizations and their patients. "Clearway Health promotes provider and clinician well-being by removing administrative burden," Arant said. "We typically secure prior authorizations in a day and a half or even less." As a result, providers can see more patients. On average, providers spend nearly 15 hours per week on their prior authorization workload. 71% of nurses report that they are less than satisfied with the amount of time they spend on the phone with insurance companies battling for prior authorizations and approvals. Arant described how, prior to adopting Clearway Health, one provider partner devoted four days per week to clinic visits and set aside her complete fifth day to contact insurance companies for prior authorizations — as well as to conduct follow-up calls to patients for education. "Thanks to our service, that clinician is now able to see patients five days a week," Arant said. "All of the administrative tasks that she was doing related to specialty medications are now handled by the experts that Clearway Health has embedded in the clinic." Clearway Health's pharmacists and specialty pharmacy liaisons serve as patient counselors and advocates, navigating care pathways, including insurance pre-authorizations, coupons and manufacturer discounts. They also review medical therapies and provide ongoing patient education, which improves access and supports patients on their specialty pharmacy journey. "This is important in a world where nearly one third of initial prescriptions go unfulfilled due to reasons like cost, prior authorization denials, clerical errors, missing medical documentation and more," Arant said. "All of these factors create barriers to adherence for patients and unnecessarily consume time for providers. Specialty medications, in particular, can be extremely expensive with very high copays. This environment requires care coordination in the ambulatory specialty care setting." Specialty pharmacy services promote public and community health Clearway Health's specialty pharmacy services are playing a central role in many community health projects that are focused on diminishing health disparities, preventing disease and providing equal access to care for all. One example is the screening program for hepatitis C that Clearway Health built at Boston Medical Center. Hepatitis C is one of the deadliest infectious diseases nationwide, according to the CDC. The preventive screening and treatment programs created by Clearway Health include improved testing protocols, clinical workflows, patient education and treatment plans. In the last eight years, Arant noted, Boston Medical Center has treated more than 3,000 patients for hepatitis C. "Many of these patients had disparate social determinants of health, psychosocial factors, chronic homelessness or high alcohol and illicit drug use," she said. "Of those 3,000 patients, 90% have completed treatment and 96% of those patients treated have been cured." A pathway to improved access + outcomes for organizations at any stage Clearway Health partners with hospitals and health systems that are at different stages of their specialty pharmacy journeys to deliver patient-centered, connected and coordinated care. Some have well-established specialty pharmacy programs, while others don't have a pharmacy at all. The important thing for all organizations to remember is that it's not too late to get started. "It can feel so daunting at times — healthcare leaders may think it's too late to explore specialty pharmacy services," Arant said. "But it is important to realize that it isn't too late. The key is to find the right support system, whether that's sharing information with colleagues at another health system or partnering with a specialty pharmacy expert like Clearway Health. A specialty pharmacy services program can accelerate gains for healthcare organizations, as well as the communities of patients that they serve." Clearway Health partners with hospitals and health systems to build or strengthen their own specialty pharmacy program, improve access to care and provide personalized support to vulnerable patients, families, providers and care managers to eliminate barriers and ensure medications are received on time.

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