CASE STUDY
www.cps.com
“That’s when we started asking ourselves — how do we get medications to patients who
need them with the least friction? How do we ensure we give them every opportunity to
comply with medication regimens?” Zimmer says. The answer was clear. They needed to
add specialty pharmacy services to their initiatives. The next question was: should they do
it on their own or find an external partner?
THE SOLUTION: AN ONSITE SPECIALTY PHARMACY MODEL
For MVHS, building a specialty pharmacy centered on improving patient outcomes.
“We felt bringing an expert on board would help us get the program up and running faster,”
Houle explains. After exploring several options, MVHS ultimately chose CPS Solutions, LLC
(CPS), one of the country’s largest pharmacy and hospital solution providers. According to
Zimmer, what they liked best about CPS’ offering was their local care model. “The promise
of real at-the-elbow support and having CPS pharmacy staff in our offices — not just
remote support — was key for us. It’s just a much more personalized approach.”
Nicolina Castilla, PharmD, who was born and raised in Utica and now works for CPS as
MVHS’ director of onsite operations, general manager, describes how the program works.
“The CPS pharmacy team supports both physicians and patients from MVHS’ 30 medical
groups and Wynn Hospital. We help patients access specialty prescriptions in a timely
way,” Castilla says. “That includes getting prior authorizations and financial assistance for
patients in need, so medications are available immediately.”
THE RESULT: HIGHER-QUALITY CARE, EASIER ACCESS, AND
BETTER OUTCOMES
When prior authorization is required, the CPS team will start the process immediately so
patients can receive their prescriptions as soon as possible. On average, the CPS team
has achieved a 98% approval rate for submitted prior authorizations. “If the cost of the
medication isn’t covered or the co-pay is too high, we’re going to hit the ground running
for patients to fix it,” says Castilla. She and her team do whatever they can to help patients
overcome financial barriers. As a result, they have secured over $6 million in financial
assistance for their patients. According to Houle, taking the administrative burden of prior
authorizations and financial assistance away from providers gives frontline clinical staff
more time for quality patient visits.
Another way the CPS’ team is freeing up providers’ time is by helping patients better
manage their care. They follow up with patients regularly to talk to them about how
they are feeling, if they have missed any doses, and if they are having side effects.
“This ongoing communication not only helps improve adherence rates but also reduces
the number of sick calls coming into the office. We’ve found that many patient concerns
are medication-related, which we’re now addressing before they even think to call
the doctor,” explains Castilla. Monitoring adherence and helping patients make a plan
to comply with medication protocols also reduces longer-term hospitalization and
readmissions.
“
“
Te promise of real
at-the-elbow support
and having CPS
pharmacy staf in
our ofces — not just
remote support — was
key for us. It’s just a
much more personalized
approach.”
If the cost of a
medication isn’t covered
or the co-pay is too
high, we’re going to hit
the ground running for
patients to fx it.”
Dr. Gary Zimmer, MD, FACEP
Chief Medical Officer
~ Mohawk Valley Health System
(MVHS)
Nicolina Castilla, PharmD
Director of Onsite Operations,
General Manager
~ CPS Solutions, LLC/Mohawk
Valley Health System (MVHS)