Cardinal Health expands managed care network
DUBLIN, Ohio Cardinal Health announced Wednesday it has enhanced its suite of managed care services, which provide an array of tools to help pharmacies improve prescription reimbursements.
At the helm of Cardinal Health’s comprehensive managed care offering is LeaderNET, which manages network contracting and plan administration for community pharmacies in the United States, Puerto Rico and the Virgin Islands. The company has recently added contracts for niche markets including immunizations and 90-day medication supply programs. Cardinal Health also offers participating pharmacies access to a call center support team that can provide audit assistance and answer managed care, reimbursement and other general questions.
“One of the key reasons why a growing number of independent pharmacies use our managed care services is that they consistently deliver tangible results,” said Steve Lawrence, SVP independent sales for Cardinal Health. “Customers who use all of our managed care services experience an average annual savings of $42,000 to $70,000 per year. With returns like that, pharmacy owners realize that they can’t afford not to take advantage of the expertise they can get from Cardinal Health.”
There are nearly 3,000 independent pharmacies participate in Cardinal Health’s managed care network, the company said.
Key features of Cardinal Health’s comprehensive managed care offering include:
- Automated Prescription Claim Editing: By electronically pre-editing prescription claims before they are sent to payors, Cardinal Health’s automated pre-adjudication editing tool helps pharmacies improve profitability by maximizing reimbursements paid by third parties. It seamlessly adjusts claims to make sure they contain accurate pricing information and are properly coded. It also provides financial, administrative and regulatory compliance reviews on prescriptions, helping to reduce the likelihood of third-party audits, underpaid claims and billing errors.
- Electronic Payments from Payors: LeaderNET members receive prescription reimbursements faster and more efficiently through direct deposit. This service also saves pharmacists time by removing the time-consuming step of having to deposit and track hundreds of checks into an account.
- Reimbursement Reconciliation: Even when prescription claims are properly submitted to payors, many can be underpaid – or worse – they can go completely unpaid. Unfortunately, the process of making sure that every individual claim is paid in full can be very time consuming, taking pharmacists’ time away from patients. Cardinal Health analyzes dispensing data, and then contacts payors directly to resolve outstanding payment issues. Participating retailers receive customized reports letting them know which reimbursements are still outstanding and which have been recovered by the service.
- Customized Reimbursement Consulting Services: Cardinal Health offers independent retail pharmacy owners one-on-one consultations with an experienced managed care expert who can identify additional opportunities for revenue growth and profitability through customized analytics of each customer’s pharmacy dispensing data.
- Audit and Reimbursement Assistance: Professional audit assistance is also available to help independent pharmacists understand how to improve prescription claim compliance and reduce the likelihood of audits. The company also provides an online tool for independent pharmacies to submit – and receive prompt responses to – reimbursement questions and issues.
‘Silent strokes’ linked to kidney failure in diabetics
WASHINGTON Tiny areas of brain damage caused by injury to small blood vessels can signal an increased risk of kidney disease and kidney failure, according to a new study by Japanese researchers.
Publishing in the Journal of the American Society of Nephrology, researchers led by Takashi Uzu of the Shiga University School of Medicine in Otsu, Japan, included 608 patients with Type 2 diabetes, all initially free of symptomatic stroke, heart disease or kidney disease.
Using magnetic resonance imaging scans of the brain, the researchers found that 29% of the patients had the small areas of brain damage, known as silent cerebral infarction or “silent stroke.” A long-term follow-up of the patients found that those with SCI had higher risks of progressive kidney disease, and compared with those who had normal MRI scans, patients with SCI were about 2.5 times more likely to die or develop end-stage kidney disease.
“Silent cerebral infarction may be a new marker to identify patients who are at risk for declining kidney function,” Uzu said in a statement.
Uzu said that small amounts of the protein albumin present in the urine – a condition known as microalbuminuria – are the most important market to predict the progression of kidney disease in diabetics, but decreased kidney function without microalbuminuria is common in those with Type 2 diabetes. According to the new study, diabetics with SCI were more likely to develop serious kidney disease regardless of the protein condition.
Decision Resources: Spiriva to remain clinical gold standard as COPD treatment
WALTHAM, Mass. A drug from Boehringer Ingelheim and Pfizer will retain Decision Resources’ status as a gold standard of treatment for chronic obstructive pulmonary disease through 2018, according to a report released by the market research firm Tuesday.
While some COPD drugs in development held promise, they lacked the same efficacy, safety and tolerability and delivery features of Spiriva (tiotropium bromide), according to the report, titled “Chronic Obstructive Pulmonary Disease: Opportunity Exists for Combination Therapies that Offer Improved Convenience and Outcomes.”
“Our survey of primary care physicians indicates that a drug’s effect on quality of life improvement is the attribute that most influences PCPs’ prescribing decisions in moderate to very severe chronic obstructive pulmonary disease,” Decision Resources analyst Amy Whiting said.