Leveraging a Specialty Pharmacy in the Outpatient Environment: A Case Study in How Northwell Health Saved $2 Million

Recent economic pressures on healthcare systems have necessitated a shift toward creative and collaborative solutions for cost savings and efficiency. For Northwell Health’s Central Market Ambulatory team, a group overseeing 230+ medical practices in the New York City metropolitan area, that meant looking at the process by which pulmonary practices were procuring asthma biologics. Upon discovering inadequate reimbursement for these medications through patients' medical benefits, the team collaborated with Northwell Health's specialty pharmacy, Vivo Health, to develop a workflow for ordering these medications through patients' pharmacy benefits.

This collaboration has yielded exceptional results, projecting an annual net benefit to Northwell Health of nearly $2 million, while removing the administrative burden of the practices in obtaining prior authorization, procuring the medications and billing for reimbursement. And patients haven't experienced any disruptions to their care. This session will provide a detailed strategy on how Northwell Health partnered across multidisciplinary teams to identify, build, launch and grow this initiative. Furthermore, we will discuss how the lessons learned from this initiative have informed the development of new projects aimed at the same result: to create cost efficiency without interrupting patient care.