HUB (reimbursement) services are set up by Life Sciences companies to help patients access products, effectively utilize their insurance coverage, and understand what other support may be available. HUB activities include onboarding patients, benefit verification, prior authorization and (as necessary) appeals to the insurance carrier. HUBs can be standalone or work in collaboration with specialty pharmacies.
HUB services are typically separate and distinct from other functions within Life Sciences companies. This can work well for larger companies, but a “de-siloed” approach, with a centralization of services handled by the same team of specialists, can be efficient and effective for emerging companies and those with small patient populations. This approach helps patients access faster and more seamless support, which may lead to greater adherence to their prescribed therapy.
A well-trained, experienced team can effectively handle all traditional HUB activities along with those that are typically the responsibility of other functional areas, including:
- Handling medical inquiries from patients, caregivers, and health care professionals (HCPs)
- Identifying and documenting adverse events and product complaints
- Providing technical support (for medical devices)
- Handling customer service inquiries
- Connecting HCPs with company sales reps and Medical Science Liaisons
- Coordinating early access to investigational products
- Supporting clinical trial screening and recruitment for pipeline products
In the early months of a launch, Life Sciences companies often have reimbursement specialists in the field, to interact with patients and HCP offices and to communicate with insurance providers. As the capacity of these specialists may be limited, the expanded HUB team can support their efforts. If field reimbursement specialists are not part of the company’s infrastructure, the HUB team can perform those functions in their entirety.
This all-inclusive approach provides one point of contact for patients, caregivers, and HCPs. By doing so, it reduces the need for transferring calls and arranging callbacks, resulting in an increase in one-call resolution. Additionally, each team member supports the therapy in a broader fashion, deepening their knowledge and enhancing their value to those with whom they interact.
The benefits gained by patients, caregivers, and HCPs can accrue to the company itself, in terms of goodwill and increased product loyalty. Another advantage to the company is that multiple types of contacts can be documented in the same Customer Relationship Management (CRM) platform, allowing for the creation of reports containing integrated data and insights.
The implementation of expanded HUB services requires careful planning in the areas of regulatory and legal compliance, team structure, training, CRM development and configuration, creation of SOPs, work instructions, business rules, and forms, the establishment of external communication channels, and the writing of email communications and Standard Response Letters.
For such a high-touch approach to be successful, the execution needs to be flawless, and strong focus given to nimble ongoing management. It’s also important to set up intra-company communication channels and protocols to ensure there is a commitment to the continual improvement of the expanded HUB services.
Authors:
Valerie Sullivan
Former President of a HUB services business, Former President and CEO of etectRx, Adjunct Professor of Management at Bentley University, Advisor to Private Equity, digital health and HUB services
Viviana Brun
Subject Matter Expert, HUB Services, Diligent Health Solutions