1. September 18, 2017
Hemophilia Alliance Network Solutions (HANS) Roland Lamy, VP Payer Relations

2. Hemophilia Alliance Network Solutions (HANS)
Hemophilia Alliance Network Solutions (HANS) was created to help HTCs solve certain network participation issues

3. What is HANS and how is it structured?
We will explain the HANS model and cover important elements of HANS as well as its best fit in helping HTCs remain relevant in payer networks:
What is HANS and how is it structured?
Why did we create HANS, and where is it applicable?
How will HTCs intersect and collaborate with HANS?
How is HANS being used today?
HANS

4. HANS
Payer / PBM
HTC
HANS

5. What is HANS?
Hemophilia Alliance Network Solutions or “HANS” was created in January of 2017 (wholly owned subsidiary of Hemophilia Alliance)
Limited Liability Company
Created with its principal office in the State of Florida
Jeff Blake – President
Roland Lamy – Vice President
Legal entity that allows us to create contracting opportunities between payers and HTCs
HANS

6. What is HANS? HANS capabilities include:
Contracting directly with Payers
Contracting directly with Prescription Benefit Managers (PBMs)
Contracting directly with self-funded Employers (or their Consultants / Brokers)
Claims Processing (if applicable)
A sub specialty network of participating HTCs for clotting factor distribution
HANS

7. What is HANS? HANS is NOT … A competitor of HTCs
A guarantor of payment
Not an insurer
Not a PBM
HANS

8. Why Create HANS?
Hemophilia Alliance has attempted many different versions of helping keep HTCs relevant in networks:
“Elective Model”
Direct to Payer contracting
Direct to PBM networks
Considered Hemophilia Alliance sponsored contracts
HANS can react to PBM “exclusive” arrangements and offer competitively priced product to the ultimate “payer”
HANS

9. Why Create HANS? HANs is designed to:
Be a subspecialty network for HTC clotting factor distribution
Align payer / PBM needs with HTCs in areas like billing, collection, reporting and price points
Be a vehicle for HTCs to get access to new patients for clotting factor distribution
Provide a method for Employers to contract directly for clotting factor distribution
HANS

10. Why Create HANS?
The Hemophilia Alliance team has had great success in the area of self-funded employers
one area of possible improvement is creating a vehicle for VERY large employers covering several states, this requires common HTC policies, procedures, reporting and price
HANS

11. So how does it work? How do HTCs collaborate with HANS?
Step 1 – Hemophilia Alliance (HA) payer team will work with HTCs, Employers, PBMs and Payers to identify key targets for HANS
Step 2 – HA payer team will outreach, share its value proposition and determine what is important to the entity and negotiate terms for Agreement
Step 3 – HANS (through the payer team) will request “joinder” Agreement between HANS and the HTC
HANS

12. So how does it work? How do HTCs collaborate with HANS?
HANS Joinder Agreement will accomplish several things:
Outline key terms between HANS and HTC
Provide necessary HTC demographic data for HANS to transmit to “payer”:
Tax ID
NPI
Address
Billing and collection
HANS

13. So how does it work? How do HTCs collaborate with HANS?
HANS Joinder Agreement will accomplish several things:
Allow HANS to transmit payer specific terms to the HTC
Create a vehicle for HTC to intersect with their Institution if necessary for decisions:
Contract terms
Signature
HANS will also seek to transmit “opportunity” – for example how many patients might the HTC be able to serve and how does the HTC get to the patient?
HANS

14. So how does it work? How do HTCs collaborate with HANS?
Step 4 – HANS will provide more detail to HTC on the specifics of the HANS – Payer Agreement
Step 5 – HANS will ensure process of patient identification, billing procedures and payment between HTC and payer
How many patients in the geography (if known)?
How does patient steerage take place?
Pharmacy bill or Major Medical bill?
Timeliness of payment
HANS

15. HANS – Other Important Considerations
HANS targets include:
Regional or national payers where HTCs are blocked from networks
Large self funded employers seeking a cost effective specialty carve out
Employee benefits consultants and brokers seeking value added carve out networks for their clients
Reinsurers
HANS

16. HANS – Summary of key features
Negotiate with payers, employers, PBMs and brokers
Provide a coordinated opportunity to access new patients for clotting factor distribution
Provide consistent contractual terms across a broad range of providers
Give HTC the ability to participate without vetting with ALL Institutional stakeholders (if desired)
Process claims if required (Northwest Pharmacy Services)
HANS

17. HANS – Early Success Signed first Agreement with Caresource
Caresource details:
Based in Dayton Ohio
Offers Medicare, Medicaid and Marketplace Exchange products (vary by state)
Indiana, Ohio, Kentucky, Georgia and West Virginia
Plans for expansion
HANS

18. Questions and Discussion