The Washington Post published an article last year with startling statistics about the growing disparity in health outcomes for patients with chronic conditions living in rural America. Perhaps most startling: In the early 1980s, people in the poorest communities were 9 percent more likely to die each year, but the gap grew to 49 percent in the past decade and widened to 61 percent when Covid-19 struck in 2020.  

The good news is, patient support programs (PSPs) are in a position to help change this. PSPs provide an opportunity for all individuals – in both the poorest and wealthiest areas, in rural communities and urban ones – to access financial, clinical, and educational resources regardless of their background or circumstances. Unfortunately, almost 40% of patients aren’t aware that patient support programs exist.

And in addition to this awareness problem, addressing such disparities requires comprehensive approaches that take into account both the health and socioeconomic factors contributing to health outcomes. While challenging, these hurdles are not insurmountable. In fact, Infinitus partners closely with PSPs working tirelessly to support both patients and providers, and we have witnessed programs make a big difference. 

Embarking on a project to improve the experience for patients with chronic conditions can be overwhelming, however even the smallest of changes in the support services can make a difference to a patient and their provider. Here are some of my favorite recent examples to give you some inspiration:

Limited access to insurance

Patient challenge PSP solution
They may struggle to afford medications, treatments, and preventive care.

They are less likely to have health insurance or may be underinsured. 		Patient assistance programs provide free or discounted medications to uninsured or underinsured patients who meet eligibility criteria

Two example programs:

Patient assistance program (PAP) – For qualifying patients who are underinsured, uninsured, or denied coverage, this program provides a economic support to address affordability challenges often for a specified period of time or up to a specific amount.

Copay assistance – Financial assistance in the form of a copay card or coupon used at the pharmacy counter to reduce or eliminate the out-of-pocket obligation typically for commercially insured patients.

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Limited access to care facilities

Patient challenge PSP solution
There may be fewer healthcare facilities in impoverished areas, especially in rural regions. Clinical services, including:

-Home nursing visits for patients who have difficulty traveling

-Injection/infusion training

-Side effect management support

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Reduced income and job loss

Patient challenge PSP solution
Chronic illnesses can lead to reduced income and job loss, pushing people further into poverty.

The financial burden of managing chronic conditions can be devastating for low-income families. 		Some programs offer assistance with insurance premiums to help patients cover the cost of COBRA and maintain coverage.

Copay assistance programs reduce out-of-pocket costs for commercially insured patients.

A good example of this is a bridge program – patients experiencing a lapse in coverage due to an expired prior authorization (PA) or change in insurance coverage receive a limited free prescription drug supply.

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Chronic stress

Patient challenge PSP solution
Chronic stress from financial instability can take a toll on physical and mental health. Educational materials help patients learn about their condition and treatment.

A good example of this is J&J withMe, which offers step-by-step guidance for every stage of the process, guiding the user through understanding their coverage and providing explanations of complex topics and terminology. Their HCP site is even equipped with a welcome video for providers.

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Limited resources for prevention and management

Patient challenge PSP solution
Poverty can limit one's ability to make healthy lifestyle choices that could prevent or mitigate chronic illnesses. Nurse educators provide training on proper medication use and disease management.

Adherence programs with reminders and follow-ups encourage patients to stay on their prescribed therapy.

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Limited time and knowledge to navigate the US industrial health complex

Patient challenge PSP solution
Limited time and knowledge to navigate the US industrial health complex, which requires time and money that may not be available to those struggling financially. Many PSPs provide dedicated case managers or nurse navigators to offer personalized support throughout a patient's treatment journey. They can help with:

-Benefit verification and prior authorization support

-Appeals assistance for denied claims

-Connecting patients with specialty pharmacies or infusion centers

A good example of this is Skyrizi Complete, which offers a Nurse Ambassador who works with patients to understand their coverage and identify potential ways to save on the cost of their prescription. They can also put patients in touch with an insurance specialist (case manager), and see if they are eligible for a savings card. They have an intuitive website, with video explainers, phone numbers, and a live chat option in addition to a mobile app.

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Infinitus helps support programs improve patient experience and create more value for their business

Infinitus offers a comprehensive solution to PSP workforce challenges by automating tedious phone calls, alleviating staffing shortages, and expanding capacity. Our AI system can be implemented quickly, providing relief to patient- and provider-facing teams within weeks. 

Our AI agents are 10% more accurate than manual callers due to standardized call flows and extensive experience that we’ve gathered from completing millions of calls. Moreover, our platform boosts employee morale by eliminating frustrating aspects of the job, such as having to endure long hold times and navigate complex payor approval processes for prior authorization and formulary exceptions. Our AI platform allows PSP leaders to take care of their teams, so they can in turn take care of patients – regardless of their individual circumstances. 

If you are considering making improvements to your patient support services, consider Infinitus. Driving up the efficiency of your PSP program will allow you to not only enable your talent to reach greater potential, but will ensure patient interactions are accurate, consistent, and equitable, growing the value of your program.