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Problem Tech Solves
Tech Brief
We live in a time of unprecedented financial pressure for healthcare consumers. Rising out-of-pocket costs have led to $140 billion in medical debt. In a recent survey, nearly one in five U.S. adults, or 46 million people, said that if they needed access to high-quality healthcare today, they would not be able to pay for it. The challenge of affordability impacts the healthcare system as a whole. Providers struggle with poor patient outcomes due to treatment nonadherence, as well as uncompensated care and bad debt. For pharmacies, patients’ inability to pay for treatment leads to increased time on therapy, worse outcomes, and loss of revenue due to prescription abandonment. Our cutting-edge platform and market-leading network enables us to address affordability and expand access to care, wherever prescriptions are written or dispensed.
Tech Differentiators
Our biggest differentiator is our network-driven, technology-powered approach to tackling patient affordability. Just as it takes a village to solve any complex issue, we recognize that the problem of affordability requires a holistic solution. Because affordability touches every part of the healthcare system, we’ve built a comprehensive digital network that empowers all impacted parties to address this challenge, together. When we founded TailorMed in 2017, we focused primarily on partnering with provider organizations like hospitals and health systems. We later expanded our reach to pharmacies, including national retailers such as Walgreens. In addition, we’re now partnering with life science companies, who fund the vast majority of financial resources available to patients. Our vision is to create a single hub through which all patients are connected to the resources they need to afford care. Our network is powered by our premier financial navigation platform, which provides real-time patient solutions, utilizing a mix of high-tech and high-touch channels. Our technology works behind the scenes to predict patient financial risk and create a curated set of cost-saving resources. This allows healthcare organizations to swiftly flag the highest-risk patients and automatically enroll them into financial assistance. We also deliver clear ROI by ensuring that our partner organizations capture revenue from previously uncollected services–and that patients receive funding for treatment, when they need it.
Validation
Five years ago, we started TailorMed because we believe that everyone, regardless of their financial circumstances, should have access to the healthcare they need. Last year, we secured nearly $440 million in financial resources for patients. From manufacturer copay assistance to foundation grants, this vital funding helped patients afford lifesaving treatments and offset living expenses. In the process, we enabled healthcare organizations to reduce uncompensated care and bad debt. In total, we’ve now secured over $1 billion in patient funding, from over 5,000 programs covering more than 1,000 chronic conditions. A deep dive in our process and outcomes can be seen in our recent study with Providence Oregon. As one of the largest health systems in the United States, Providence delivers comprehensive health services to more than five million patients across seven states. Providence Oregon, part of the Providence system, is the largest healthcare provider in Oregon, with eight hospitals, more than 90 clinics, and over 600 employed physicians. Providence Oregon implemented our platform to scale its Medication Assistance Program (MAP) and track the team’s performance. The MAP team, which serves over half a million patients, leveraged our workflow automation and proactive patient discovery to assist 2,234 unique patients and provide 3,170 individual program enrollments in 2021. As a result, Providence Oregon secured $55 million, including $3.9 million in increased revenue and $51 million in cost avoidance. The full case study, which has not yet been published, is attached to this application.
