For Payors

u&i Inc., USA is a provider of hemophilia utilization management and pharmacy services designed to significantly improve the self-management, dignity, and quality of life of persons living with hemophilia.

Our headquarters are located in upstate New York. What makes u&i unique from our competitors is the implementation of our proprietary utilization and outcomes monitoring system. Our system relies on proven guidelines and standards of practice that empower individuals with up-to-date education and specific instructions to identify hemophilia triggers and prevent increased usage of factor. u&i’s program works with individuals to identify opportunities to prevent a significant number of bleeding episodes. If and when a bleed occurs, our clients have the knowledge and therapeutic devices available for use to dramatically reduce the number of treatments it takes to stop the bleeding event.

u&i’s customized, hands on, approach is what separates us from the current environment of providers today. u&i makes personal home deliveries of product and supplies (within a 6 hour radius of the pharmacy), an essential piece of our utilization management program.

Hemophilia is a rare disease affecting approximately 20,000 people nationwide. There is a lack of education among the payors of health care costs and health care providers with respect to the cost drivers that make hemophilia one of the most expensive diseases in the world. Too often the focus of cost reduction has targeted the reimbursement rate of factor products and not the management of the cost triggers, resulting in higher costs and decreased quality of life issues. u&i provides an alternative to the current provider environment by implementing a program that:

1. Provides high quality education to the patient and the payer
2. Identifies opportunities to prevent bleeding episodes
3. Reduces the amount of infusions needed to stop bleeding episodes
4. Closely matches the prescription to the amount of factor product dispensed to the home
5. Ensures treatment log compliance, which guarantees accurate data for outcome monitoring, adherence to plan of care, and treatment intervention

Implementation of u&iI’s utilization management program and services will positively impact the wellness and quality of life of individuals with hemophilia, and reduce hemophilia health care costs by 15 – 40%.

Managing hemophilia requires a thorough understanding of the disease. The following links are presented to provide you with information about hemophilia and u&i’s utilization management process. You may also consider examining some of the educational materials provided on the specialty portion of our website to gain a better understanding of some of the cost drivers such as inhibitors.

A short hemophilia presentation is provided to give you and overview of hemophilia, current approaches to managing the disease and u&i’s utilization management program.

We provide a detailed hemophilia education program upon request. This program is a 2 hour educational program designed to give the attendee detailed information about hemophilia, costs of hemophilia and specifics for managing the cost drivers.

Most payors do not know how many members they have with hemophilia or how much they are spending. We provide a Financial Impact Tool that will give you a better handle on what you may be spending. We also provide J-codes and ICD-9 codes to help you identify your hemophilia population.

Hemophilia education and identification of current costs is the initial step in managing hemophilia. The next step is to target the specific cost drivers of hemophilia. We would like to share with you our approach to managing hemophilia. Our program has successfully reduced costs an average of 15-40%.

u&i has developed a utilization management program with documented historical data that proves successful outcomes. A portion of the vast array of components in our program is outlined in our Utilization Management Reference Sheet. Implementing these components requires a specific utilization management process. Each client is assessed and a baseline is established for stratification into specific clinical pathways and plan of care development that supports the HTC/physician diagnosis and plan of care. Once a baseline of needs assessment is completed, u&i provides products and services customized for the unique needs that each individual client requires.

Upon request, u&i Pharmacy will provide samples of our outcomes management reporting capabilities and cost comparison analysis.