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Specialty
Services Overview
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WIN has extended the successful infertility model to other high cost, low volume conditions and has executed contracts or
initiated discussion with drug manufacturers for the following specialties:
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Multiple Sclerosis
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Growth Stimulating Agents
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Rheumatoid Arthritis
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Hemophilia
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Crohn’s
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Psoriasis
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WIN has identified
and addressed the need for programs that deliver significant reductions in specialty disease costs while achieving high quality
of care and services for members and providers. The company employs an evidence-based, comprehensive approach to patient care,
involving both medical and pharmacy services.
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The basic model employed by WIN is unique in the healthcare industry
and includes the following key components:
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Medical Management
- Proprietary Evidence-based Protocols. WIN’s care-management program incorporates proprietary clinical protocols and pathways developed by the company’s Medical Advisory Panel of prominent specialists.
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Utilization Management. Based on the specific patient profile, medical history, and the clinical protocols, WIN provides prior authorization of medical and pharmacy services in collaboration with the provider and patient.
- Physician Network Development. WIN contracts with fully credentialed, Board-Certified physicians that specialize in the provision of quality services
Pharmacy Management
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Specialty Pharmacy Network Management. WIN contracts directly with local and mail-order pharmacies that specialize in dispensing specialty medications. These pharmacies meet strict standards established and monitored by WIN to ensure that timely, accurate, and quality services are delivered to patients.
- Formulary Management. WIN establishes a preferred drug formulary that capitalizes on clinical effectiveness, preferred pricing, and volume-related manufacturer discounts.
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