Unlocking Access: How RevenueRX Transforms Drug Assistance for Hospitals

With Host Kevin Chmura, CEO of Panacea Healthcare Solutions and Guest Bre Meadows, President, Revenue Integrity Services

In this episode of Beyond the Bottom Line, Kevin Chmura is joined by BreAnn Meadows as they discuss Panacea’s latest healthcare solution: RevenueRx, a service with the goal of helping hospitals streamline access to free drugs, co-pay assistance and charitable foundation support programs.

Kevin and Bre delve into this new service, what it can provide to hospitals, why the solution is being offered now, and what sets RevenueRx apart from others. In addition, they break down certain examples of the kind of good it can do for your healthcare organization.

Episode transcript available below.

Kevin Chmura

Welcome to Beyond the Bottom Line: Let’s talk healthcare, finance, revenue cycle and compliance. I’m your host, Kevin Chmura, CEO of Panacea Healthcare Solutions. Whether you’re a healthcare executive, a finance professional, or simply curious about how these essential pieces of the healthcare puzzle fit together, you’re in the right place. The goal is simple: Give you actionable insights and expert perspectives that can help you optimize your operations and drive strategic growth.

In today’s episode, we’re talking about a topic that’s becoming a real game changer for hospitals and health systems, patient drug assistance. Joining me is BreAnn Meadows, president of Revenue Integrity Services here at Panacea Healthcare Solutions. Bre and her team just launched RevenueRx, a service that’s helping hospitals streamline access to free drugs, co-pay assistance and charitable foundation support programs.

Welcome, Bre.

Bre Meadows

Thank you.

Kevin Chmura

So let’s start with the basics. What is RevenueRx? And it’s probably a good place to start. And why did we decide to launch this at Panacea now?

Bre Meadows

So RevenueRx is a comprehensive tech enabled service that helps hospitals and cancer centers manage the manufacturer-sponsored drug programs. And then also the foundation assistance. So, as you said, we do include services based around the manufacturer free drug programs, the co-pay assistance programs, and the charitable foundation funding we launched RevenueRx because hospitals are still continuing to face growing pressures.

The cost of drugs just continues to go up, and the payer policies get more and more difficult to manage, along with patients out-of-pocket and coverage determinations always being really challenging. So there’s a lot of roadblocks when a patient gets a diagnosis where they have to go to a cancer or infusion center to start one of these treatments.

And the reason we launched this program is to really help hospitals clear those roadblocks so patients can get access to care without being financially destroyed by their diagnosis. So it’s a great program that really benefits the facility financially as well as the patient, to give them access to these drugs that could save their life.

Kevin Chmura

Wow. So real win/win, right? You’ve got better access for the patients and operational relief and revenue, most importantly, for hospitals and health systems, which is great. It’s always nice when everybody gets a win out of it. So great rundown on the on the benefits of it. But can you walk us through what is the actual deliverable of RevenueRx?

Bre Meadows

Sure. So RevenueRx is almost set up a little bit differently than some other services that are out there that even though we’re technical, we still really focus on the service and really working closely with the organization and their patients. So what we manage is everything, soup-to-nuts, starting with the application process. So we do all the screening of patients looking for all the programs that the patient could qualify for, completing the application and making sure the patients get approved for not just the primary drug that they may be receiving for that service, but any and all drugs to minimize their out-of-pocket as much as possible.

The second piece that we do is making sure that after the application is approved, that everything gets followed through on behalf of the patient and the organization. So when we talk about “free drug,” we handle the ordering and try to get everything ordered as prospectively as possible.

And we could talk a little bit more in depth about the advantages of that and billing compliance, but making sure that also the patient has confidence as they’re coming in for these visits. They know that we’ve taken care of it. They know their drug is sitting there waiting for them and that they’re not going to be getting a bill after they leave the center.

And then the third part is on the co-pay and foundation programs. Again, after a patient is approved, we do all the tracking to make sure that the funds get loaded for the patient and then make it on to the hospital account for them. So we take all the steps out. There’s nothing for the patient or the organization to do except, you know, look at the accounts and we’ll highlight, you know, the dollars that got paid. But we take care of every single step in between so that we’re 100% sure that every approved application gets the maximum value.

Kevin Chmura

Wow. That’s impressive. We know from our Medicaid eligibility business here at Panacea that that’s pretty comprehensive but also single application typically going to one place, county office with the a fair amount of follow up. I imagine the level of tracking and compliance for this is critical, especially with the changing landscape in healthcare.

Bre Meadows

Yeah, I mean, with patient drug assistance programs, getting the application approved is really the easy part. What’s difficult is following all the steps afterwards to make sure that you can maximize the value of that approval. And we see with organizations that either are running their own internal program, or maybe using a limited partnership with an outside business partner, they may not be maximizing everything.

There’s just so many steps to do and so much to cover. And having a comprehensive program where you’re really focused on that ensures that you’re going to get 100% of that value.

Kevin Chmura

So, you and I have been in operations for a long time. And so it’s always helpful for me, and maybe for the audience, would be maybe taking us through a real world example and kind of what the impact of RevenueRx would be for a hospital.

Bre Meadows

Sure. That’s a great question. And it really is eye opening to kind of walk through an example. So the way it works is, let’s say Kevin Chmura, unfortunately has a diagnosis where he needs to get a high cost drug that is going to be administered in a hospital infusion center. And your treatment plan says that you are going to get six treatments over the next six months.

So, one treatment a month. And then you find out that this drug costs $15,000 a dose. Now, you work, you have insurance, but you have a deductible, and you may have a large portion of coinsurance to pay. So, you know, you get a call from patient access and they start to tell you what your out-of-pocket is going to be and start to ask you how you want to pay for that. And most patients are going to find those amounts really shocking.

So what we’re doing is trying to grab those, understand the patient’s insurance coverage and how much out-of-pocket. So say out of this $15,000 infusion, every time you come in, you have a $2500 obligation to pay towards this drug. We will immediately start going through the co-pay and foundation opportunities to get it covered, and then inform you to let you know. So every $2500 payment that you would have had to make for each of these six treatments, we’re hoping to get it down to close to zero.

Now, there are other opportunities. If you are a patient that doesn’t qualify for a copay program for whatever reason, we still want to eliminate your obligation to pay for that drug. And the way we do that is to start an application for free drug and demonstrate the financial burden that you might have and get that drug shipped for free, which then eliminates the hospital’s acquisition cost as well as 100% of any out-of-pocket that you may have had for that drug.

Kevin Chmura

Wow. It would be amazing to get it to zero, right, for any patient.

Bre Meadows

The only reason we can’t get some of them to zero is because, unfortunately, a lot of these programs won’t cover administration fees, but those are very small and the drug is the main thing that we need to worry about with these bills.

Kevin Chmura

Yeah. Yeah. So drug manufacturer assistance programs are not necessarily new. They’ve been around for a bit. And I would imagine that most hospitals are, you know, engaged in some level of activity, trying to avail their patients of the opportunities there. But so how is RevenueRx really different from what you see hospitals are doing today?

Bre Meadows

So the good thing is, I do agree, when we talk to hospitals, there are generally some people who are aware of these programs. They typically tend to be some pharmacy staff, who are not really directly related with a patient or what’s going on with their bills, or maybe social work or patient access. And what we find is people with their heart in the right place trying to do as much as they can for the patient, but not being able to complete 100% of the steps because they have other jobs to do.

So they’re doing their best, but they don’t have the right amount of resources and the focused approach that a business partner can really provide, along with all the financial reporting. And reporting back to the organization, how many dollars they saved, what did they really accomplish for these patients? And what we do find is the numbers can be staggering.

So the amount of dollars that can be recovered, even for a small hospital outpatient infusion center or a small cancer center, can total up to millions of dollars a year. Very, very quickly, if you are screening and grabbing 100% of those opportunities. So we also provide that insight back to, a little higher up the finance ladder to show the value of those programs where we can to the penny, tell you exactly the savings on the free drug and then all of the co-pays that have been recovered for the patients.

Kevin Chmura

Wow. That’s incredible. So in the few minutes we have left, I always like to do this. And you’re always good at this. What advice can you give a hospital leader who is listening to this about how to either launch or improve a drug assistance program?

Bre Meadows

Sure. So find out what you’re doing currently and make sure you involve all the stakeholders. We find as we’re talking to hospitals, it takes multiple conversations to make sure that you have pharmacy included. You talk to your social workers or people at the cancer center who are dealing with the patients and also your billing staff, because again, there’s multiple steps and there are billing requirements that really need to be followed when you do receive free drug, and if you’re receiving them en masse and you’re getting millions of dollars of free drug, you want to make sure you don’t create a billing compliance issue.

So there’s a lot of stakeholders and figure out where you might need help maximizing it, where you may need help measuring it, or possibly making sure that you are getting 100% value for the patients when you tell them that they have an approved application. So, RevenueRx, we can do a couple of different things. We can do anything from a completely 100% fully outsourced program with staff on site, if that’s what you choose to help support the program, or remotely and then anywhere kind of in between.

So if you have an existing program, but you feel like there’s opportunity or you need help, I would encourage you to reach out to us. There’s a lot of ways we can help bolster up an existing program and really help these employees who are trying to do their best, who are also trying to do their other jobs, be much more successful.

Kevin Chmura

Yeah, that’s awesome. So replace or supplement, which is just great. So, incredible stuff, as always. Really appreciate your insights and just want to thank you for coming on today—

Bre Meadows

Thank you for having me.

Kevin Chmura

Yeah, it’s always great. If you’d like to learn more about RevenueRx or any of the services that we provide at Panacea, please visit our web site at panaceainc.com.

One more time, thank you Bre, it was great having you. Everybody, thanks for listening. I’m Kevin Chmura. This has been Beyond the Bottom Line by Panacea. Stay tuned for upcoming episodes featuring additional experts on some really interesting topics. We’d love for you to join the conversation on LinkedIn. You can find Bre there, you can find myself there or you can follow Panacea on LinkedIn.

Your feedback is invaluable. We want to make sure that we’re putting out content that keeps everybody up to date and is the most relevant for you. Until next time, keep striving for excellence and driving innovation in health care. Thank you.