Customer Feedback

Payors

Coram has active contracts with most commercial payors, including traditional health insurers, managed care organizations, preferred provider organizations, third-party administrators, at-risk health providers, self-insured plans, provider network managers and more. These contracts include covered lives in all 50 states, and Coram estimates that its contracts currently cover more than 75% of the commercially-insured lives in the United States.

A Complete Solution

With Coram, all of your members' specialty infusion services are provided by one trusted source. Coram combines high-touch home infusion, expertise in complex clinical and patient management, specialty injectable distribution, and a nationwide network of infusion suites to provide a complete solution for cost-effective, yet comprehensive patient care.

Insurance Verification

We are the number one provider to managed care payors, billing directly to Medicare and over 14,000 managed care plans nationwide. Our comprehensive network of national and local payors includes traditional health insurers, managed care organizations, preferred provider organizations, third-party administrators, at-risk health providers, self-insured plans, provider network managers, and more.

We simplify the referral process through our expertise in:

  • Therapy risk identification
  • Medicare and managed care coverage guidelines, verification and billing
  • Medicare Part B qualification expertise
  • Broad payor coverage under both medical and pharmacy benefit plans
  • Efficient coordination of clinical services and consumer delivery, which frees health plans, patients, and physicians from coordination of care
  • Consistency and continuum of care management, even when patient conditions change
  • Improved patient access, compliance, adherence, and retention

Alternate Site of Care

With the CMS reimbursement challenges around hospital-acquired infections, as well as the growing interest at the payor level to offset hospital charges by supporting evidence-based guideline models for hospital avoidance, Coram has developed a program model around an alternate site of care (ASOC).

The primary goal of the program model focuses on diagnosis flagging and transition at four key identification points:

  1. Community: Physician sites, alternative living facilities, urgent care centers.
  2. ED: Flagging at point of entry for hemodynamic stability and initiation of care within an observation model or direct home admission.
  3. Hospital Admission Points: Within 24–48 of admission, flagging hemodynamic stability and transition home for continuation/completion of care.
  4. Chronic Exacerbation Flags: Key diagnoses that have an admission rate greater than twice a year. Patients are often immunocompromised and are more appropriate for home initiation of care.

This model assesses risk stratification and properly identifies candidates for a lower cost model for placement, shortening risk patterns for the hospital and controlling overall cost models for the payor.

ASOC Model


EyeOn Therapy Management

Industry reports indicate that specialty drugs could comprise as much as 40% of a health plan’s drug spend by 2020.* Increasingly, health plans must rely on solutions that effectively manage these escalating costs through improved clinical results. EyeOn Therapy Management is Coram’s proprietary solution, a series of therapy management programs designed to promote appropriate drug utilization and management, optimize site-of-care resources, and improve clinical outcomes and savings on high-cost services.

Monitoring and promoting patient compliance and drug therapy adherence has been a primary component of the Coram specialty service model since its inception, and is detailed extensively in Coram's protocols and standards of practice. Based on the premise that the diseases traditionally treated in the specialty pharmacy arena become more severe and/or more likely to relapse without adequate monitoring, Coram developed a prospective model of patient clinical monitoring and data collection. The information contained in this report is obtained directly from the patient during each refill, and responses are data entered into the Coram outcomes database. The pharmacy staff follows a standardized computerized protocol to record response to therapy, the presence of drug-related problems, compliance, and hospitalizations.

Although we provide disease state-specific protocols, all patients receiving therapy from Coram, regardless of disease state, are monitored on each refill for compliance, drug effectiveness, adverse drug events, and hospitalization.

For more information on the EyeOn program, please contact us at 888.439.3661.

* Medco 2011 Drug Trend Report

Learn More

To learn more, contact us. To enroll or refer a patient for service, click here.

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