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Find us at 340B Coalition Winter Conference '24 in San Diego 1/29 - 1/31. Visit us at booth #303.
Event Details
Audit case study: Einstein Healthcare Network
Einstein Healthcare Network pharmacies use Macro Helix Audit Services to demonstrate compliance with 340B Program requirements.
August 14, 2024
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5 min
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By Macro Helix
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 would be key. “It was a no-brainer,” says Kelly, director or Revenue Cycle Analysis for Einstein Healthcare Network. “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 eligible for the federal 340B Drug Pricing Program: Einstein Medical Center Philadelphia and Einstein Medical Center Montgomery. Einstein Philadelphia has one of the highest disproportionate patient percentages in the state.
“We care very deeply about our patients with high-cost medical and drug needs,” says Kelly. “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.”
Organization
- 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
Solution Spotlight
- Macro Helix 340B HRSA Audit Services
Critical Issues
- 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, onsite audit and post-audit processes
Results
- Macro Helix conducted virtual and telephone training in advance of the on-site audit to fully prepare the pharmacy staff to collect and submit necessary documentation
- Macro Helix briefed the EHN staff on necessary compliance metrics and overall audit process
- Macro Helix provided additional training on use of 340B Architect and availability of data feeds from electronic health records
- Post-audit findings proved EHN to be fully compliant
Advance preparation leads to smooth audit
Hospitals participating in the 340B Program 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 in a timely and accurate way. During the process, Macro Helix said to us, ‘Just tell us what you need and when you need it,’” Kelly says. “We never had any doubt about making the deadline for providing our documentation in time for the audit.”
Audit Services provides confidence while easing the complexity of an HRSA audit
When deciding whether it should use Macro Helix’s Audit Services, Einstein Healthcare 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,” Kelly says. “They instill confidence, as well as a great deal of quality control.”
Notes Kelly, “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
Several additional value-adds from Macro Helix also made a difference. “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,” Kelly says. “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,” Kelly 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!”
Kelly 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,” Kelly says. “It’s one of the best decisions you can make!”