A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Danville, Pennsylvania-based Geisinger Health Plan and Tomorrow Health announced Tuesday that they have entered into a partnership that will provide patients easy access to medical equipment and supplies at home.
This announcement underscores how Covid-19 is spurring insurers to deliver both care and convenience to members in the home. Earlier this month, Humana announced its partnership with DispatchHealth to give its members access to hospital-level care at home.
Under the terms of the agreement, 540,000 members of the Geisinger Health Plan across Pennsylvania will be covered by the program and receive items like catheters and wound care supplies to manage their conditions — be it a chronic disease or a one-time recovery after a hospital stay at home.
Per the partnership, health plan members who require home-based care can use Tomorrow Health’s platform to connect with medical equipment suppliers in the payer’s network. Tomorrow Health’s staff guides patients through the process, including helping them navigate insurance claims.
“For many patients, making the transition from the hospital to the home is a challenging one that leaves them very vulnerable,” said Vijay Kedar, co-founder and CEO of Tomorrow Health, in a phone interview. “Too often, we as a healthcare system put that onus on the patient to coordinate.”
The benefits of the Tomorrow Health platform are not confined to patients alone. Providers can use the platform to streamline their workflow when discharging patients and ensure their patients have the supplies they need at home.
“The challenges of coordinating care at home can often lead to adverse patient outcomes, from delays in care to hospital readmissions,” said Dr. John Bulger, CMO of Geisinger Health Plan, in a news release. “In partnership with our network of best-in-class home medical equipment suppliers, Tomorrow Health will help us ensure that GHP members receive the highest quality of care at home. We’re delighted to be able to offer exceptional patient support and transparency between patient, provider and supplier.”
Talks between the two began last year and the partnership grew from there.
Kedar added that Tomorrow Health’s demand has increased as the pandemic has forced others including insurers to think about how they can reorient care delivery networks toward the home. In fact, Tomorrow Health itself saw demand grow to such an extent that they emerged from stealth a full three months before scheduled.
With the pandemic raging on, new coronavirus variants to contend with and a permanent rejiggering of the healthcare industry, the demand for home-based care will not fade soon.
Photo: Tomorrow Health
