Audit Case Study—
Einstein Healthcare Network

Case Study

Einstein Healthcare Network pharmacies use Macro Helix Audit Services to demonstrate compliance with 340B Program requirements

Upon receiving notice of a 340B Health Resources and Services Administration (HRSA) audit, Eileen Kelly knew she wanted her organization to be prepared. Shortly thereafter, it was clear that having the Macro Helix Audit Services team on site for the audit “was a no-brainer,” says Eileen. “Macro Helix knows audits. They know the audit process. They know the format you need for your data. They make it a very smooth process.”

Einstein Healthcare Network owns two Medicare disproportionate share hospitals (DSH) eligible for the 340B program: Einstein Medical Center Philadelphia and Einstein Medical Center Montgomery. Einstein Philadelphia has one of the highest disproportionate patient percentages (DPP) in the state.

“We care very deeply about our patients with high-cost medical and drug needs,” says Eileen. “These are our Oncology patients. Our patients who have Hepatitis C. Or those who have HIV, or other serious conditions. We work very hard at protecting our 340B programs at these facilities, and keeping the programs intact and compliant. We want to do all the right things to stay in the 340B program and to do right by our patients.”

Advance preparation leads to smooth audit

Hospitals participating in 340B programs usually have 1-3 months to prepare their organization after being notified of an audit. “We worked with Macro Helix to ensure our documents were prepared timely and accurately. During the process, Macro Helix said to us, ‘Just tell us what you need and when you need it,’” Eileen says. “We never had any doubt about making the deadline for providing our documentation in time for the audit.”

“With Macro Helix
on site and in the room, it really enabled us to do all the things that need to be done during an audit quickly and efficiently… It’s one of the best decisions you can make!”

Eileen Kelly

Director, Revenue Cycle Analysis, Einstein Healthcare Network (EHN), Philadelphia, Pennsylvania

Audit Services provides confidence while easing the complexity of an HRSA audit

When deciding whether it should use Macro Helix’s Audit Services, Einstein weighed multiple factors. “A lot of what Macro Helix helps with during an audit is focused on numbers, accumulations and documentation. But a lot of what they provide is also emotional support,” Eileen says. “They instill confidence, as well as a great deal of quality control.”

“They know how to demonstrate to the auditor that a drug dispensation has been accumulated properly. With Macro Helix on site and in the room, it really enabled us to do the things that need to be done during an audit quickly and efficiently.”

“If we had to track a hard copy for a prescription or perform other tasks during the audit, we knew we had the right team of people and we were confident that we’d be able to document everything properly.”

Going the extra mile

Eileen comments on several additional value-adds from Macro Helix as well. “A short time before the audit took place, we decided that it would be very beneficial to have the Macro Helix specialist come to the audit location one day early. We made the request and it was no problem.”

“Because the specialist arrived one day in advance, we could conduct a pre-audit walk-through exercise to set expectations and review final requirements for the audit. This was extremely helpful,” Eileen says. “Then, after the audit, we had some time to do an informal ‘post-mortem’ discussion. This meeting focused on other topics related to the audit such as best practices and tips and tricks—covering areas in addition to the audit process that we might want to consider in the future. This was a welcome and useful discussion!”

Eileen is enthusiastic about using Macro Helix products, especially their Audit Services. “Another hospital organization called us recently to ask about the audit process,” she says.

“At first, this hospital told me they didn’t feel the need for an Audit Services partner. I told them that Macro Helix was a huge asset to have on site. I was very pleasantly surprised by how reasonable Macro Helix services are. The cost is very affordable, especially when you are trying to protect a large amount in 340B savings,” Eileen says. “It’s one of the best decisions you can make!”

  • Eileen Kelly, Director, Revenue Cycle Analysis, Einstein Healthcare Network (EHN), Philadelphia, Pennsylvania
  • Hospital Pharmacy group with multiple hospitals and contract retail pharmacies in the Philadelphia area
  • Macro Helix 340B HRSA Audit Services
  • Prepare organization for upcoming 340B HRSA audit and measure compliance with all 340B regulations
  • Ensure all documentation is available, correct and easily accessible
  • Coordinate support for pre-audit, on-site audit and post-audit processes
  • Macro Helix conducted virtual and telephone training in advance of on-site audit to fully prepare pharmacy staff to collect and submit necessary documentation.
  • Macro Helix briefed Einstein Healthcare Network staff on the necessary compliance metrics and overall audit process.
  • Macro Helix provided additional training on use of 340B Architect and the availability of data feeds from electronic health records.
  • Post-audit findings proved EHN to be fully compliant.

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