Escalating costs of specialty medications are a pressing financial burden for providers. HealthTrust is working to address this challenge, providing a strategic approach to securing contracts and managing expenses for these high-cost drugs.
HealthTrust’s Pharmacy team has pioneered a collaborative strategy within the specialty market. Watch this three-minute intro to learn more:
Let’s explore Specialty GPO concepts and benefits, with a focus on HealthTrust’s unique partnership and the potential savings it offers.
What is a Specialty GPO?
Specialty GPOs are designed to alleviate the financial pressures providers face due to the high costs of specialty medications. Unlike traditional GPOs, which have limitations in securing contracts for these medications, Specialty GPOs focus on specific classes of trade.
Contract Utilization and Potential Savings
HealthTrust’s approach stands out by integrating a collaborative model – we’ve strategically partnered with one of the largest Specialty GPOs to offer a unique savings opportunity for our members. This partnership enables HealthTrust to combine its contracts with those of the contracted Specialty GPO, ensuring best pricing.
The potential savings for members not currently affiliated with a Specialty GPO range between 3-7%. For those already engaged with a Specialty GPO, the savings average between 1-2%. While these percentages may seem modest, they represent significant savings given that specialty medications constitute the highest spending category and are the fastest-growing segment for many health systems and providers.
Eligibility: Who Can Benefit?
The Specialty GPO program primarily services members within the clinic class of trade who infuse drug therapies, dispense specialty medications and operate infusion suites that bill for services using the CMS 1450 form. Eligibility is determined by various factors, including the specific facility’s Healthcare Identification Number, billing practices and location. Ultimately, the manufacturer decides eligibility. Although the primary focus is on oncology drugs, other biologic drugs used in specialties like neurology, ophthalmology and immunology may also qualify for savings opportunities.
Suppliers have set stringent eligibility criteria related to the class of trade. However, there is a potential opportunity for infusion clinics not currently listed within the clinic class of trade through a process known as class of trade optimization. This process allows facilities to modify their existing class of trade assignment, thereby gaining access to more favorable pricing.
Additional Program Membership Benefits
Beyond core savings, HealthTrust’s partnership with the Specialty GPO provides members with access to a suite of valuable tools and resources. These include payor analysis tools, inventory management systems and storage cabinets. Additionally, contract connectivity auditing ensures that all contracts are effectively managed and optimized.
A dedicated Pharmacy Specialty GPO Account Manager supports program members, addressing any issues or concerns. This personalized support is crucial in navigating the complexities of specialty medication procurement and ensuring that members maximize their benefits.
Onboarding for the program occurs on a quarterly basis. The Specialty GPO team is committed to guiding members through every step of the process, both before and after going live. The goal is to ensure a smooth and seamless onboarding experience, with continuous support throughout the contract’s lifecycle.
Next Steps
HealthTrust’s collaboration with a leading Specialty GPO offers a unique and innovative solution, providing significant savings and a range of resources for its members.
If you are interested in learning more about the Specialty GPO Program, contact the HealthTrust Specialty GPO team at HTSpecialtyGPO@HealthTrustpg.com.
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