Simplifying Pharmacy Management and Accounting Increases Access to Care

Today our country grapples with the physical and financial burden associated with assisting patients who battle substance use disorders and mental health conditions. The federal government allocates billions of dollars annually to subsidize treatment modalities such as medication assisted treatment (MAT) in states and communities throughout the country. Along with intensive outpatient counseling, MAT therapy has been proven to help patients regain control of their lives and become productive in society. Federal grants play a vital role for treatment facilities, ensuring that all socioeconomic classes, regardless of the individuals patients’ ability to pay, have the access to MAT.

Newstart Rx witnessed firsthand the need for both invoice reconciliation solutions as well as formulary creation and management tools to assist not-for-profit organizations, which utilize grant allocations to subsidize their patient populations’ medications used for treatment. Treatment providers nationwide use both in-house pharmacies and community pharmacies as means for their patients to receive the vital medications prescribed for MAT therapy. To date, there is low transparency and consistency surrounding prices associated with MAT therapy medications, which leads to high variances in their associated costs. This leads to arbitrary pricing between pharmacy providers, who receive payment for these medications through grant dollars allocated to the treatment facilities. In healthcare and in most industries, a lack of transparency in pricing contributes to waste, and in the cases of substance use and mental health, reduces access to care for all in need. No longer do these inefficiencies need to be the norm.

This antiquated model also places a strain on treatment facilities’ finance departments. It is common practice for those treatment facilities who use community pharmacies to receive invoices sporadically each month from pharmacy providers seeking payment for medications dispensed. With many treatment facilities using multiple pharmacy providers in the geographies they serve, an invoice reconciliation process provides a simplified finance tool for these facilities. Beyond streamlining the reconciliation process, transparency and predictability around medication costs can be achieved, leading to increased access to care for all patients in need.

Through proper formulary creation and management for each individual treatment facility, customizable timeframes for invoicing of medications dispensed through a centralized billing process provide efficiencies to reduce time spent by treatment facilities’ finance teams. Formulary management tools ensure that desired treatment protocols are adhered to at fair and consistent prices and only for those patients who are following the treatment centers’ program requirements. No longer do treatment facilities need to spend resources tracking down and reconciling pharmacy provider invoices throughout each month. A reconciliation platform allows for real-time tracking of medication spend by their pharmacy providers. Standardized processes in healthcare have shown over time to reduce waste in both organizational resources and treatments. Working with the right partner, substance use disorder and mental health treatment providers nationwide can also achieve these efficiencies.

Jonathan Mordis, PharmD is interim president of NewStart RX.