Discharge Planning Advisor: Partnership gets drugs for needy patients

Discharges are more efficient, staff less frustrated

Obtaining prescription drugs for patients who can’t afford them has been a problem for Athens (GA) Regional Medical Center for the 18 years that Beverly A. Baker, CRC, CCM, has been with the hospital, she says.

"With the rising cost of medication, this problem had only gotten worse," adds Baker, who is director of social work services. "My staff were spending hours each week looking and begging for medications for patients. The physicians had even gotten to the point where they would refuse to discharge a patient until medications were obtained."

"We were looking at how many discharges were being delayed while we looked for resources," she says. "With hospitals going into bed [availability] crunches, turning over rooms was an issue."

The situation changed dramatically for the better about a year and a half ago, she explains, when the hospital established a medication assistance program (MAP) that works in conjunction with local charitable agencies.

When a patient is being discharged and needs help paying for prescriptions the physician has written, the hospital picks up the cost for the first 30 days, Baker explains, and then refers the patient to a community agency with which the hospital has partnered. That agency assists the patient in applying for the Pharmaceutical Companies Indigent Drug Assistance Program, she adds. "We also do this on readmissions when different medications are required."

Because of the possibility for abuse, the hospital does not pay for pain medications, Baker says, but she notes that for cancer patients, there are other community resources that will cover those drugs. Patients qualify for MAP if their income is below 100% of the federal poverty guidelines and they have no other Medicaid or insurance benefit, she adds.

Once the hospital does its part, Baker says, the community agencies do the paperwork required to obtain the assistance from the pharmaceutical companies. Several agencies participate, including Catholic Social Services, a couple of free clinics, and a fund sponsored by the local newspaper, she explains.

Most patients who need prescription drug assistance, however, are referred to an association of area churches called "ARK," Baker explains, because the group has a program specifically for that purpose.

"If there are language barriers, we refer them to Catholic Social Services," she notes, "and if the person isn’t going to meet the income guidelines of the pharmaceutical companies, we look for other agencies." Continued assistance from the hospital is not available if the patient does not follow up with the indigent drug assistance programs, Baker adds.

Although her department still is in the process of developing ways to measure the program’s effectiveness, she says, indications are that lengths of stay and readmissions are being reduced. "[Before], we were seeing instances of patients coming in, being discharged, and coming back in because they were not taking their medications. The reason they weren’t taking them is because they weren’t buying them."

Meanwhile, her staff members are "feeling much more productive," Baker notes. "They spend their time doing more productive things than calling agencies trying to get money to cover the drugs."

[Editor’s note: Beverly Baker can be reached at (706) 475-3436 or by e-mail at bbaker@armc.org.]