Long-term care (LTC) pharmacies manage a complex and demanding set of processes and business relationships. While much of their operations depend on automation to make this workload possible, there are many opportunities to manage costs that require levels of expertise and resources not commonly found at LTC pharmacies.
This article outlines the added operational power that LTC pharmacies gain with Thirdwave's technology, expertise, and automation with no additional expenditure.
Phase 1: Making an Impact with Hard Data
Relationship management is perhaps as important in long-term care as the management of claims data. SNFs and pharmacies depend on transparency and communication to serve their patient populations with quality, coordinated care. Operations between SNFs and their contracted pharmacy rely on cooperation and communication to thrive together.
However, mistakes happen-claims include erroneous information that can create additional costs for pharmacies and facilities. Depending on contract terms and agreements, it may be the pharmacy or facility footing the bill or chasing credits.
When the wrong payer is billed, or in split bill scenarios, a partner like Thirdwave can help pharmacies get accurately reimbursed in a much more timely manner. By integrating with pharmacy systems, Thirdwave's experts can readily gather the data required (plan coverage, payer information, and eligible third-party payers) to make sure an LTC pharmacy is appropriately reimbursed, often better and faster than the original payer could.
If a provider initiates a claim that includes a therapy that either isn't covered, is costly to the pharmacy, or where an alternative is outlined in a pharmacy's formulary, Thirdwave can make a case using hard data to make adjustments. By communicating with SNFs and clinicians, therapeutic interchanges can be authorized to reduce excessive costs.
Making these changes requires a delicate balance of industry expertise and a seasoned understanding of each stakeholder's responsibilities. This is precisely the expertise that Thirdwave brings to LTC pharmacies.
Phase 2: Formulary Management, Transparency, and Adherence
As formulary program designers and advisors, we understand the immense importance of formulary management and adherence for LTC pharmacies handling thousands of prescriptions every week. Ensuring adherence to managed formularies and therapeutic interchanges is an incredibly effective means of controlling costs and achieving a pharmacy's lowest net drug cost.
Maintaining adherence requires buy-in from all parties involved, which is no easy feat. Building a strong relationship between pharmacies and SNFs requires time and expertise and is an operationally costly prospect for pharmacies already managing busy workflows and balancing staffing restraints.
Thirdwave enables this alignment by ensuring all parties understand the mutual importance of formulary adherence for controlling costs and passing on savings.
In fact, our experts have routinely shown that net costs can be reduced by as much as 15% when Thirdwave solutions are integrated with LTC pharmacy operations and our teams help manage relations.
Beyond our automated systems and alerting mechanisms, our technology gives pharmacies the ability to make data-driven decisions that better support partnerships and deliver unrivaled efficiency. Together, that means being on the right foot when it's time to review and renew agreements with contracted partners.
Get Your Free EvaluationPhase 3: A Zero-Cost Approach to Improving LTC Pharmacy Operations
The Thirdwave solution helps LTC pharmacies improve monitoring and relations with zero additional operational expenditure. We have evolved our services from being an unrivaled rebate administrator with sophisticated automation to include a robust suite of advisory solutions that help pharmacies thrive in a highly competitive industry.
As long-respected experts in long-term care and pharmacy spend management, we understand the unique LTC landscape and the nature of contractual agreements and professional partnerships.
Partnering with Thirdwave enables LTC pharmacies to go beyond lowering their net drug cost and maximizing rebates.
We help all parties involved maintain program adherence, simplify processes, and control costs. As a reliably efficient and cost-saving partner, LTC pharmacies with Thirdwave offer a more competitive service solution for SNFs and new partner facilities.
Thirdwave RX is a rebate administration solution that helps healthcare providers achieve their lowest net drug cost. Our team of healthcare, pharmacy, and financial professionals solve critical challenges in the healthcare ecosystem. With a proprietary technology stack and proven automation, Thirdwave offers the most innovative rebate product and services on the market.
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