Medical Specialty Care mainly revolves around biotechnology and injectable medications for the treatment of diseases such as cancer, Rheumatoid Arthritis, Multiple Sclerosis, etc. While specialty medications can be life-altering and allow patients optimal disease management, these medications are unfortunately a challenge to manage themselves.

Some of the challenges lie in the fact that these drugs are often given by physicians in their offices or administered at outpatient infusion centers. Since these drugs are usually given as injections or infusions, they require precise dosage calculations which, much of the time, can lead to wastage of medications that come in many sizes and forms. Specialty medications also tend to require special handling (e.g. temperature control), so yet another consideration is in the timing of their delivery.

Specialty care medicines are also significantly more expensive than traditional oral medications. According to most experts, they are growing at a rate in the double-digits and this trend is projected to continue into the foreseeable future. These challenges and the growing trends of these specialty medications have only made it most difficult to draft and implement cost-effective containment strategies.

PharMedQuest’s next-generation specialty care management solution, ARC™ has proven that it can manage the complexity of specialty care. To read more about our Medical Specialty Management Solution, ARC™, see related Media below.

Attention, Care, Empowerment, or ACE, was a technology and services platform developed to manage HIV patients. It is a unique platform that uses PMQ’s knowledge of the complexities of managing the disease state, as well as the technology developed specifically for this purpose, that allows the ACE program to tackle a complex disease state.

The Federal 340B Drug Pricing Program was developed to increase access of drugs at an affordable price for inner-city communities. While the intention is good, the ensuing complexities of managing FQHCs (Federally Qualified Health Centers), especially in terms of avoiding committing fraud have made 340B management a growing concern for healthcare stakeholders.

PharMedQuest has developed and operated a 340B management program for its clients. Our unique knowledge, expertise, and experience in operating 340B pharmaceutical management programs enable us to design and provide innovative cost-effective pharmacy solutions to qualified 340B organizations. We have developed, negotiated, and operated full-service 340B programs for large 340B qualified organizations for about a decade.

Our ability to integrate technology, clinical expertise, network management, and inventory processes have delivered unprecedented savings and revenue-generation for clients while delivering the highest quality care and services to eligible patients. To read more about our 340B Management Solution, see related Media below.

Specialty Network Management

The current state of administering healthcare in the United States is very complex. The financial responsibilities and corresponding risks are difficult to understand and manage by clinicians and payers. This is exemplified by the segregation of medications into oral medications (Medicare Part D), injectable medications (Medicare Part B), and other medications that may be either Part B or D depending on a payer’s specific benefit design.

These are areas where PharMedQuest Pharmacy Services (PMQ) excels. Our expertise, experience, use of technology, and proven track record allows us to provide optimal solutions for clinicians, provider groups (medical groups, IPAs, MSOs) and payers (self-insurers or health plans) to deliver cost-effective, quality care and services to patients.

An example of PMQ’s value is our real-time Medical-to-Rx data integration and informatics. This technology is critical in today’s environment. Managed Care contract risk negotiations between payers and providers for the 2015 year occur around mid-2014. However, due to the lack of reliable real-time data, the negotiating parties often use much lagged 2013 data for 2015 decisions.
To further compound the lack of reliable informatics, Part B and D data often reside in different silos and the integration of these specialty claims and expenditures are often not available to negotiating organizations.

Clearly, this is not an optimal situation in any negotiation. PMQ’s solutions prepare our Clients to properly use real-time integrated informatics to forecast and negotiate appropriate rates with a higher degree of accuracy and insight. To read more about our Specialty Network Management solution, see related Media below.