We are excited to share real stories from our 340B Referral Capture clients in our new series. Check back each month to read a new Q&A and glean insights from your peers in 340B. Interested in being featured? Please contact your par8o account representative.
Blackstone Valley Community Health Care is a Federally Qualified Health Center that offers a range of health services to 21,000 patients in the communities of Pawtucket and Central Falls, Rhode Island, just north of Providence.
These communities are in need. Pawtucket and Central Falls both have higher than average rates of poverty: in Pawtucket, 1 in 6 people live below the poverty line, and in Central Falls, 1 in 3 people live below the poverty line.
Blackstone Valley added par8o 340B Referral Capture in September 2019 to “close the loop” on the referral process and increase 340B revenue, which it uses to fund services including transportation, interpreters and technology.
We spoke with Executive Director Raymond Lavoie and Associate Director & Chief Financial Officer Sandy Pardus about 340B, compliance and the unique needs of their population.
Tell me about Blackstone Valley Community Health Care.
Raymond Lavoie, Executive Director: We operate three health centers in the adjacent cities of Pawtucket and Central Falls, Rhode Island. The residents are mostly poor with little opportunity for decent paying jobs. What used to be the area’s lifeblood, the textile industry, moved out many decades ago. A majority of our patients speak a language other than English in the home. In 2017, we began construction of a new facility in Central Falls, which came on line in June 2019. Patient enrollment has been growing along with our facilities, and for CY 2019, we finally exceeded 21,000 unique users.
We’ve spent several years expanding our network of CVS and Walgreens contract pharmacies, including a CVS in the new Central Falls facility, and now are working with Par8o and our contract pharmacies on specialty scripts.
I’ve been Executive Director since Dec. 1999. Sandy joined six years ago. Sandy came to us after a long and storied career at Lamprey Health Care in New Hampshire.
Can you talk more about the population you serve?
Sandy Pardus, Associate Director and Chief Financial Officer: The need is astronomically different between what I did in New Hampshire and coming to Blackstone. I felt like this is what I was trained all those years to do, to help grow this organization with this population that is just so needy. I think that’s what health centers and the 340B program are all about.
60% of our patients have language barriers, no transportation, cultural [barriers] because they haven’t been integrated into the way things are done here. You also have financial issues, because the unemployment rate is so much higher in the population. We take care of people—we are the last resort, the absolute last resort in the area.
There’s nowhere else to go. We help them in ways way beyond traditional healthcare. Blackstone provides not only primary care, but we also have a huge behavioral health program, dental program, vision program, community health workers, and a robust group of care managers. So it becomes much more of an ability to prop people up. We’re the trusted partner, more of a go-to place.
We are the lowest-cost Medicaid provider in the state of Rhode Island. Part of the reason is because there’s such a high degree of trust between the care we provide and the patients that come to us. I think they trust us more and they’re more reluctant to go to the more expensive parts of the healthcare system because we provide so much, including staff from their neighborhoods, they’d rather stay with us. . .Going to the big city that’s 10 minutes down the road; that’s a huge barrier when you don’t have transportation, you have to get there, the language doesn’t work, and it makes our jobs harder to get certain types of care.
We hire a lot of bilingual folks from the community. That’s part of the reason they feel comfortable.
Can you talk about how you use 340B and how it helps your health center?
Sandy: Three key items: Care managers, translation, transportation. The one difficult thing is that the state has been trying to shift money. Proportionately, the Medicaid dollars keep getting reduced in the state. Without 340B, it would be a lot worse. 340B has really plugged our holes so to speak to keep those wrap-around services going. I hope those services don’t get jeopardized.
Ray: We also employ very leading-edge technology at Blackstone. We were an early adopter of EMR in 2006, well before Meaningful Use was even on the radar, and we’ve been adding to the system ever since. Now, Population Health management drives the discussions here. With these advanced tools, we are able to marry claims data from the MCO with clinical data from the EMR. This gives us an ability to do pre-visit planning, which helps in closing gaps in care, as well as identify the high risk/high cost patients who are provided additional care by our RN care managers.
We’ve been on the bleeding edge of this technology for a while, all of which takes money, some of which is provided by the 340B program and by expanding that program to include specialty scripts with the help of par8o.
Why did you decide to partner with par8o?
Sandy: We had started to research the specialty prescriptions, but it kind of scared us because we’re very big on making sure we’re compliant and we didn’t want to do anything that would potentially put us in a situation where we would have to pay money back or be out of compliance.
So we were thinking about it, and par8o somehow dropped in our lap. We found out that par8o was working with Providence Community Health Center and Thundermist Health Center.
We were intrigued by the fact that somebody else besides us was going to help with referral management because we struggle with referrals. We’d be the first to admit that the patients aren’t itching to go to a big hospital system to get their referral in the first place—it’s hard to get them there. Then, it’s hard to get the specialty to get them to close the referral. The system is very clunky.
The idea that a third party could help us, at least with the “closure” part of that, was really great—oh and by the way, you can potentially get 340B pricing for it! It all came together at the right time.
What has been the best part about working with par8o?
Sandy: It’s been easy! Not only has it been easy, but it’s great for 340B. It’s helped us close [the loop on] referrals because the notes are there. That’s been great.
What is your No. 1 tip for HRSA compliance?
Sandy: We just go by the basics. We try and keep it as electronic as possible and make sure that you have the qualifying visit and that the census of providers and site lists are up-to-date.
Ray does a great job of keeping the right pharmacies on the list at the right time. We make sure that the rest of the electronic systems are working. As long as those things are matching up, it’s good.
And then we do audits to double-check.
What are your goals for 2021?
Ray: To get back the way we were in 2019!
Sandy: Our biggest goal, if our CMO were on the call—our biggest goal besides getting everybody vaccinated, which is a no-brainer, is to get all of those patients the care they couldn’t get in 2020.
We focused on the high-risk people in 2020. For instance, the hypertensives that are in control, of course they dropped. Colonoscopies and mammograms have dropped. People’s healthcare has been adversely affected. Our goal for 2021 is to get back to business and get everybody the care they need.
We keep trying to say to the state: don’t ask us to do something new and fancy in 2021 for our goals. We have to backtrack here.