Case Study

Banner Health Streamlines Pharmacy Reimbursements and Experiences Cost Savings

250K

Records processed in less than two years

Positive financial impact

Consistent audits

To ensure all reimbursements are processed

Headquartered in Phoenix, Arizona, Banner Health is one of the largest not-for-profit healthcare organizations in America, serving over one million members. Banner participates in the Government-sponsored 340B drug pricing program which allows Banner to purchase medications at a discount to pass on to eligible patients. However, it took many full-time employees to audit this program. A Blue Prism digital worker is now in place and has eased the load on the staff and prevented human errors in the process.

Challenge

Banner Health operates an extensive healthcare network throughout America’s West. The cost of healthcare in the US can be expensive. To help, the federal government created the 340B program that allows Banner to purchase medications at a discount to pass on to eligible patients. But with the strict program guidelines (only certain drugs and patients qualified) it was a full-time job to audit and manage.

Solution

To assure Banner was realizing the full 340B program benefit, it was decided intelligent automation was the solution. To manage and validate the process of pharmacy reimbursements, Banner deployed a Blue Prism digital worker called B2D2. The impacts have been nothing short of amazing.

Since January 2020, B2D2 has processed over 250,000 digital records and returned over 1,500 hours back to the organization creating a positive financial impact. What’s more, digital workers can now conduct multiple different regular pharmacy reimbursement audits in addition to the standard audit, which was something Banner staff could not previously accomplish. Using a 340B program to expand the scope of treatable patients can also benefit the covered entity, increasing reimbursements and improving overall revenue. But program participation comes with complex regulatory and audit requirements that must be managed carefully to maintain compliance. This was accomplished by creating a digital worker.

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