For the last 40 years, Ramsell Holding Corporation, based in Oakland, Calif., has provided pharmacy-benefit management services and technology solutions to federally qualified healthcare organizations, especially those that provide care for the underserved population.
As Tim Murrill, executive vice president of sales and marketing, explained, this is Ramsell’s niche, and in the current economy, these services are vital.
“Our mission is to provide solutions to organizations that help underserved people get connected to the resources they need to live better lives,” Murrill said. “Over the past four years, the recession has created a growing need for the type of services and solutions that we provide. In this environment of high unemployment, fewer people have health insurance or the means to pay for healthcare. That means that more people are dependent on public-health and safety-net programs to access the care they need. That need is fueling our growth.”
Ramsell assists federal, state, and local departments in managing a variety of safety-net programs. One of the largest programs Ramsell manages is the AIDS Drug Assistant Program, a national program that provides medication to those living with HIV/AIDS who do not have insurance or the means to pay for their own medication.
Currently, Ramsell manages these services for six states—California, Oregon, Washington, Colorado, Texas, and Delaware. These states account for more than 33 percent of the nation’s ADAP claims.
New products for a new time
Increased demand for Ramsell’s services has enabled the company to develop three new products, the first of which is the 340B Management solution. The name is derived from the legislative number of an act that was approved 12 years ago to provide medications to the underserved at below-market prices. Because of 340B, these prices are sometimes 20 to 30 percent less expensive.
However, the legislation mandates many requirements, especially in the area of reporting, for qualifying covered entities, such as health centers, that take advantage of it. Ramsell’s 340B Management provides a solution that helps centers utilize the program, while avoiding the bureaucratic headaches.
After two years on the market, the 340B Management solution has proven to be highly successful.
A second product is Ramsell’s Medication Therapy Management (MTM) solution that focuses on patient outcomes.
MTM allows pharmacists to stay in touch either in person or over the phone with high-risk patients to ensure that patients are taking the right medications and are adhering to the dosage schedules.
Murrill said that adherency is a huge problem in this country and costs billions of dollars that wouldn’t have to be spent if patients were faithful in taking their medications. MTM enables pharmacists to evaluate what’s happening with the patients and also assess any drug-interaction issues that may result from several medications being taken at once.
A number of studies have explored how intervention can save in overall healthcare costs. If a patient is faithfully taking medication for a chronic disease, such as HIV/AIDS or HEP-C, the disease itself should maintain at its current level. However, if an early-stage HIV patient falls off the medication for even six months, that disease can progress to full-blown AIDS, which can be much more expensive to treat.
One study from the University of Minnesota showed the return on an investment in MTM to be 12 to one.
“This is a pretty rich payback and is a win win,” Murrill said. “Patient outcomes are improved and costs are reduced.”
Finally, the Ramsell Correctional Application (RCA) is a web-based software service solution for correctional institutions, such as jails and prisons. While RCA could be characterized as a case-management system, Murrill said it is really more than that.
Following a pre-release interview with inmates, RCA provides probation and parole agencies, correctional healthcare providers, and related correctional-program managers with discharge planning and community supervision by connecting inmates and parolees with local community-based organizations that will provide the resources and support the inmate needs.
“Whatever those issues are, this tool allows the agency to connect them and set up appointments with those providers,” Murrill said. “And then, there’s actually continuity of care that happens, and they are less likely to reoffend.”
Whether the inmate shows up or doesn’t show up for their appointments, feedback is immediately given to the program manager.
“This system comes out of our experience in working with the underserved population over the last 40 years,” Murrill explained. “It’s a high-risk population. There is a high incidence of diseases, like mental health, HIV/AIDS, HEP-C, among the prison population. We have found that if you can provide that little bit of help in getting them connected, and if they stay in treatment, if they’re healthy, if they have a place to live, and they have the support they need, the chances of them recidivating, reoffending and going back, are reduced drastically.”
In California, for example, the current recidivism rate is almost 70 percent. That means that seven out of 10 inmates who are released reoffend and go back into the system, and they are sicker and more expensive to care for, if they don’t have that continuity of care while they are out.
“By getting these folks connected to the care and support that they need, there’s a higher probability of them becoming productive citizens and not reoffending,” Murrill said. “If we can reduce that just in California by five percent, that would save slightly under $400 million just in terms of incarcerating those people.”
Focused on helping
For 25 years, Murrill was involved in the private business sector, where the bottom line was everything. For the last five years, he has been working for Ramsell, which values improving outcomes and helping the underserved live better lives. Murrill believes in the old saying, “Do good by doing well,” and he feels he is helping to do that at Ramsell.
“Our commitment, our passion, is to continue to focus on helping people,” he stated. “In addition to the economic benefits that that’s going to bring, it’s a nice thing to know that we’re helping society and this underserved population, and that feels good.”
-by Pete Fernbaugh