Breaking Down Barriers for Health System

Specialty Pharmacies


While many health systems are exploring or expanding specialty pharmacies as a strategy to extend care to patients and generate prescription margin, their success depends on successful prescription claims adjudication — which is becoming a growing challenge.


“Implementing a specialty pharmacy model is complex,” notes Mike Brown, vice president of managed services for Cardinal Health, which operates 75 outpatient and specialty pharmacies across 25 states for hospitals of all types. “We find that many overlook the resources required to navigate payor approval of prior authorizations or lack needed support to connect patients to programs that help them better afford their out-of-pocket cost of medications.”


Read this article to learn how remote models for prescription claims adjudication can unlock greater opportunity for delivering patient care.


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