Payer solutions and services

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Managing your payer contracts

Having medically integrated dispensing capabilities in your practice can help improve patient care and increase patient convenience. But managing payer contracts requires an expert level of understanding and can be overwhelming.

Cencora has the resources and expertise you need to help manage your third-party contracts, increase access to medications for your patients, and increase reimbursements for your practice.

Our payer strategy team can work with your staff to identify a payer strategy that helps you better manage your payer contracts:

A payer partnership with a plan sponsor, such as an employer group; benefit sponsor, for example Blue Cross Blue Shield; or pharmacy benefit manager (PBM), such as Prime Therapeutics.
A pharmacy contract analysis can help your staff better understand the contracts your practice has with specific payers and examine the advantages and disadvantages of those contracts.
During a payer consultation we can help your practice engage with a payer to answer a question or solve a problem.
Your practice can participate in a pharmacy-payer value proposition study to look back at your data to determine if medically integrated dispensing produces better outcomes and total cost of care for your practice than sending a prescription to a specialty pharmacy.
We will develop a payer marketing plan that can help increase our market presence in the payer community through speaking engagements and thought leadership to allow us to engage in other payer partnerships.

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Insights

Clinically integrated oncolytic dispensing: The next frontier in cancer care

Evolving to an integrated oncology care model

As a pioneer in Medically Integrated Dispensing (MID), our commitment is to serve patients by designing and delivering payer access and efficiency solutions for our specialty physician dispensing practices. We have partnered with Prime Therapeutics to build and develop the IntegratedRx^® - Oncology program. This is a first-of-its-kind clinically integrated network that allows patients to receive their oral oncology and companion medications in the clinical setting directly from their oncologist and enable them to manage their patients in a clinically coordinated and holistic way.

Addressing specialty medication access

IntegratedRx - Oncology will allow GPO members to fill specialty scripts directly in their practices, improving patient access to drugs and supportive care products that previously were sent to a specialty pharmacy. Over the next decade, oral therapies likely will be a much larger component of potential treatment plans for patients with cancer – and physicians need to have the ability to dispense these products.

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Shortening the time to therapy

An integrated oncology care model will remove barriers that can complicate the treatment pathway. IntegratedRx - Oncology increases oncologists’ access to specialty drugs and supportive care products that would otherwise be acquired via specialty pharmacy. When patients can receive their medication directly from their oncologist, it can result in faster therapy start times.

This increased efficiency also reduces the administrative burden associated with PBM-affiliated specialty pharmacies that can be placed on already-busy providers.

Adding value through improved contracts and a national MID practice network

For GPO members, IntegratedRx - Oncology will offer competitive discounts on medications and chart the path to oncology value-based contracting. Existing Elevate PSAO contracts will offer enhanced oncology programs and let practices resolve claims more easily. This value-based care model will enable physician practices to remain competitive and relevant with payers.

Together with Prime, we created a national network of MID practices and helped our practices gain access to this new program. It also leverages the power of the EMR to show holistic health histories, giving providers better access to records that can inform and update care plans. Through continued provider engagement, patient care, and data usage, there is a reliable pathway to create healthier futures.

Improving medication adherence and decreasing costs

Improving the patient experience starts with simplifying the process and removing barriers to securing quality care. You can communicate changes in dosage or therapeutic regimen through an integrated EMR. This allows MID practices to see the medical record the prescriber used to document visits and record the labs in real-time.

This integrated approach to care empowers patients and providers to work directly together to ensure the patient is on the right medication, at the right dose, at the right time. Under IntegratedRx - Oncology, specialty providers can have oversight into their patient’s complete pharmaceutical journey. Insights that go beyond that first medication fill mean providers can better monitor and influence their patients’ medication adherence trends and avoid medication waste.

Press Release

AmerisourceBergen to Now Offer Prime Therapeutics’ IntegratedRx – Oncology to Eligible Hospital, Health System & Oncology Practice Customers

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“AmerisourceBergen has been an unwavering supporter of patient choice and flexibility and making cancer treatment accessible at the community level. By participating in this program, our customers have the opportunity to showcase the value of a truly integrated oncology delivery model. This new model will create expanded commercial access to oral oncolytics, enhanced clinical oversight of cancer patients, and will lead to increased administrative efficiencies for providers. We are excited to see how this program shapes the next chapter of cancer care in the U.S.”

Lisa Harrison, RPh, President of Specialty Distribution at AmerisourceBergen

Are you interested in joining this medically integrated network?

IntegratedRx - Oncology is available for GPO members through the Elevate Provider Network. Members will have access to solutions and insights that aim to deliver beneficial payer contracts.

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