Note: this article originally appeared on the WeInfuse blog. Click here for the original article.
Safiya Tisdell, Vice President of Adparo Services at Annexus Health, discusses the importance of financial assistance in ensuring patient affordability and shares advice for infusion centers looking to optimize financial assistance management to improve patient outcomes and revenue capture.
For the complex, chronic, and often life-threatening conditions typically treated in the infusion center setting, high costs are the rule rather than the exception. Even patients with insurance can struggle to pay their share for infusion therapy—and this is true not only of patients living in poverty, but those in higher income brackets as well. When patients receive bills they can’t afford to pay, it jeopardizes their treatment and can negatively impact their health outcomes and the financial health of the infusion center.
Fortunately, infusion centers can help patients access a lifeline in the form of patient financial assistance. Read on for tips on how your organization can make the most of these valuable and underutilized resources.
What is patient financial assistance?
Through patient support programs (PSPs), the life science organizations that manufacture infusion therapies offer co-pay assistance, free drugs, and other services to help eligible patients afford treatment. There are also many charitable foundations that have funding available to help qualifying patients who apply.
Tip 1: Don’t wait for the patient to ask for financial help.
As a former revenue cycle manager for a large cancer center, I know that one of the biggest mistakes any healthcare provider organization can make is waiting for a patient to ask for financial assistance. And yet, this is the approach that most organizations take.
The reality is that patients rarely speak up about financial concerns until they’ve been blindsided by a HUGE medical bill arriving in the mail. Why? They might underestimate the cost of care. Or be embarrassed to ask for help. Or think they earn too much to qualify. And there’s a very good chance they have no idea that patient financial assistance even exists.
The right time to work up a patient for financial assistance is right away—before treatment even begins. Being proactive about enrolling patients in financial assistance can prevent treatment delays, interruptions, and even patients giving up on treatment altogether. It can save patients from financial hardship, and save your organization from losing revenue due to unpaid medical bills.
Tip 2: Work up every patient. Yes, EVERY patient.
You might be wondering how you can know which patients to work up ifyou don’t wait for them to ask for financial assistance. The answer is simple: work them ALL up.
In the infusion center, we’re talking about expensive therapies that patients might need to receive every couple of weeks, sometimes indefinitely. That can take a major toll on even the healthiest bank account, so it’s safe to assume any patient would benefit from financial assistance.
There’s also a good chance they qualify for some form of assistance. Lifescience organizations are handing out millions of dollars for FREE so that patients can start and continue on therapy, and we owe it to patients to take advantage of this. Every patient deserves a thorough search for assistance options to ensure opportunities for financial help don’t slip through the cracks.
Tip 3: Technology is your best friend.
Okay, I’ll bet you’re agreeing with me that every patient deserves to be worked up for financial assistance. But if you’ve ever actually managed patient financial assistance, I’ll bet you’re also thinking that working up every patient sounds… impossible.
Well, if you’re relying on traditional tools and manual processes, you’re probably right. You know the ones I mean: binders overflowing with spreadsheets and program information pamphlets; sticky notes covering every surface of your office; dozens of tabs open on your computer so that you can check and double check various disease fund websites each day and enroll patients through individual patient support program portals.
But it’s 2024, and there’s a better way! Take advantage of technological solutions that can streamline and simplify the patient financial assistance management process. Through a single software platform integrated with your infusion management system, you can search a comprehensive library of patient assistance options at the click of a button, quickly enroll eligible patients into individual assistance opportunities, actively monitor award fulfillment to ensure utilization and adherence, and even analyze your organization’s financial assistance activity to inform planning and decision-making.
With the right digital tool, navigating the patient assistance journey doesn’t have to be overwhelming.
Tip 4: You don’t need a financial assistance manager on staff to manage financial assistance.
Does your infusion center have someone on staff in charge of managing patient financial assistance who can take the software solution described above and fully utilize it? If so, great! It’s going to be an absolute game-changer for your patients and for your organization.
But what if you just don’t have the human resources or infrastructure to do this? Or what if you want to free up your full time staff for other important tasks?
You can still ensure your patients have the opportunity to benefit from all available financial resources by using a service to manage patient financial assistance on your behalf.
Choose a service that offers trained, experienced staff with in-depth knowledge of patient financial assistance and revenue cycle complexities to proactively search for assistance opportunities for your patients, enroll them into applicable programs, and track financial assistance activity. Be sure to select a service that uses a comprehensive financial assistance software platform to ensure your patients are getting the thorough workup they deserve while dramatically reducing the administrative burden on your organization.
Tip 5: Investing in patient financial assistance management pays off big time.
In my years in this industry, I’ve encountered a lot of reluctance on the part of healthcare organizations to make managing patient affordability a priority. That’s due in large part to the administrative challenges that have traditionally been part and parcel of managing financial assistance.
But even as digital innovation and tech-enabled service offerings have paved the way for an easy, efficient process, I’ve seen organizations hesitate to invest in these solutions. On the flip side, I’ve seen organizations that have made that investment and seen substantial returns.
If I could offer just one piece of advice to any healthcare organization, it would be this: don’t underestimate the value of patient financial assistance. Getting help to pay for care can keep patients on the treatment they need for as long as they need it, giving them the very best chance at optimal health outcomes and saving them from devastating financial toxicity. Effectively managing patient financial assistance can also helpy our infusion center maximize collections and minimize bad debt, dramatically improving your financial performance.
How Annexus Health Can Help
At Annexus Health, we’re focused on finding innovative ways to reduce financial and administrative burdens so that patients can get the care they need. Our portfolio of healthcare provider solutions includes AssistPoint®, which brings everything needed to manage patient financial assistance together in one easy-to-use platform, and Adparo®, which offers a full suite of administrative services that can be customized
to meet a healthcare organization’s unique needs to effectively and efficiently manage patient financial assistance.
Since 2018, Annexus Health has been at the forefront of innovation when it comes to financial assistance management. I’m excited for future developments as we continue to explore the full potential of technology in this space, and for the benefits to patients as infusion centers and other healthcare organizations grow more comfortable with embracing digital advancements.
WeInfuse + Annexus Health: A Strategic Partnership
WeInfuse, the premiere technology and consulting services for infusion therapy & medication delivery, and Annexus Health have entered into a strategic partnership to streamline the patient financial assistance process for infusion providers. This partnership will provide easier access to specialty & biologic medications between the two platforms. Read more about the partnership here.
